Received: June 21, 2026
Accepted for publication: August 28, 2026
Published online: September 30, 2026
UDC: 616.24-085.835.56:615.835.56
DOI: 10.26212/2227-1937.2026.32.43.006
OZONE THERAPY IN PULMONOLOGY: ANTI-INFLAMMATORY AND IMMUNOMODULATORY EFFECTS (A Narrative Literature Review)
Dauletova M.D. 1, 3, Rakhymberdiyev D.S. 1, AzimkhanovaG.K. 2,
Aitmetova G.A. 2, Abdiramasheva K.S. 2
1NAO “International University of Tourism and Hospitality”, Turkestan, Kazakhstan
2Akhmet Yassawi International Kazakh-Turkish University Turkestan, Kazakhstan
3SMPE “Regional Sports Medicine Dispensary”, Turkestan, Kazakhstan
Introduction. Ozone therapy is a biologically active treatment method based on the administration of an oxygen-ozone mixture. In recent years, this approach has been considered as an adjunctive therapy for diseases associated with inflammatory and immune dysfunction. In pulmonology, chronic obstructive pulmonary disease, bronchial asthma, interstitial lung diseases, and infectious inflammatory processes are among the most prevalent conditions. In these disorders, increased levels of inflammatory mediators, oxidative stress, and dysregulation of the immune response represent key pathogenetic mechanisms. Therefore, a scientific evaluation of the anti-inflammatory and immunomodulatory effects of ozone therapy is of considerable relevance.
Objective. To analyze the anti-inflammatory and immunomodulatory effects of ozone therapy in pulmonology based on current scientific evidence and to assess its clinical efficacy and safety.
Materials and Methods. This study was conducted as a narrative literature review. The aim of the review was to summarize and qualitatively analyze the current scientific evidence regarding the anti-inflammatory and immunomodulatory effects of ozone therapy in pulmonology.
A comprehensive literature search was performed using the PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar databases. Publications published between January 2020 and June 2025 were considered for inclusion. The search strategy included the following keywords and their combinations: “ozone therapy,” “medical ozone,” “pulmonology,” “chronic obstructive pulmonary disease (COPD),” “bronchial asthma,” “interstitial lung disease,” “lung inflammation,” “oxidative stress,” “immunomodulation,” and “respiratory diseases.”
The literature selection included full-text articles published in English or Russian that reported experimental or clinical studies, systematic reviews, or meta-analyses investigating the anti-inflammatory, antioxidant, and immunomodulatory effects of ozone therapy, as well as its application in respiratory diseases. Publications without full-text availability, duplicate records, studies with insufficient scientific evidence, and articles unrelated to the use of ozone therapy in pulmonology were excluded.
The initial search identified 108 publications. After removing duplicate records, 79 articles remained for screening. Following title and abstract screening, 44 full-text articles were assessed for eligibility. Ultimately, 40 publications that met the objectives of this review were included in the qualitative analysis.
This study was not designed as a systematic review or a PRISMA-guided meta-analysis; therefore, no statistical synthesis of the findings was performed. Instead, a qualitative analysis was conducted to summarize current evidence regarding the mechanisms of action of ozone therapy, its effects on inflammatory biomarkers, immunological responses, clinical efficacy, and safety in respiratory diseases.
Results. The reviewed studies indicate that low concentrations of ozone contribute to the activation of antioxidant enzymes, regulation of the balance between pro- and anti-inflammatory cytokines, and improvement of microcirculation. Clinical observations suggest that the use of ozone therapy as part of comprehensive therapy is associated with reduced inflammatory activity, improved pulmonary functional parameters, and stabilization of the immune response. However, variability in outcomes has been reported depending on dosage and route of administration.
Discussion. Ozone therapy exerts a multifactorial effect on the inflammatory process by reducing oxidative stress, enhancing antioxidant defense mechanisms, and modulating immune responses. These properties support its potential role as an adjunctive therapeutic option in chronic inflammatory respiratory diseases. Nevertheless, heterogeneity in study design and sample size limits the generalizability of the findings. Well-designed randomized controlled trials are required to clarify long-term efficacy and safety.
Conclusion. Current scientific evidence suggests that ozone therapy possesses anti-inflammatory and immunomodulatory potential in pulmonology. However, further high-quality research is necessary to define its place in clinical practice and to develop standardized treatment protocols.
Keywords: ozone therapy, pulmonology, inflammation, immunomodulation, oxidative stress, respiratory system.
