105 www.centauro.it Rivista Italiana di Ossigeno-Ozonoterapia 5: 105-108, 2006 Plasma Concentrations of Thiols and Malondialdehyde in Patients with Age-Related Macular Degeneration Treated by Major Ozonated Autohaemotherapy E. BORRELLI Postgraduate Course in Oxygen-Ozone Therapy, University of Siena; Siena, Italy Key words: major autohaemotherapy, age-related macular degeneration, protein SH, malondialdehyde SUMMARY - We measured the plasma levels of SH protein and malondialdehyde expressed as thiobarbituric acid reactive substances (TBARS) in 15 healthy subjects and in 15 patients with age-re- lated macular degeneration before and after treatment with major ozonated autohaemotherapy. Patients showed an increase in SH protein groups and a decrease of TBARS after 12 sessions of major ozonated autohaemotherapy, with an improvement in quality of life. Introduction Age-related macular degeneration (AMD) is an acquired degenerative disease of the retina affect- ing individuals over the age of 55 years. The disease has a major social impact as it is a leading cause of blindness in the Western world. Changes in central vision at onset and during the disease course cause considerable disability and have a major impact on quality of life 1,2 . The causes of AMD are multifactorial and in addition to age risk factors include arterial hyper- tension, obesity and a diet poor in antioxidants. Oxidative neurotoxic damage to the retinal pig- ment epithelium plays an important role in AMD pathogenesis with the formation of free radicals in the retina. AMD can therefore be considered a disease caused by chronic oxidative stress in which pathological changes occur following the imbal- ance between the body’s antioxidant and oxidant substances. Treatment to date has consisted in the adminis- tration of antioxidant supplements, but no studies have yet demonstrated the true benefits of vitamin and mineral intake in patients with AMD 3 . Many AMD patients have been treated at our institution using major ozonated autohaemotherapy (MAHT) with the aim of reducing chronic oxidative stress. To assess possible changes in plasma antioxidant and oxidant levels during ozone therapy, we meas- ured some indices of the redox balance like plasma thiols – the main antioxidants against free radicals, and plasma malondialdehyde expressed as thiobar- bituric acid reactive substances (TBARS), deemed an important index of lipid peroxidation. We report the basal values of thiols and malond- ialdehyde in healthy subjects and AMD patients and the changes in the redox balance measured after MAHT in AMD patients. Materials and Methods Fifteen healthy control subjects (group 1) and 15 patients with age-related macular degeneration (group 2) were enrolled in the study. Control sub- jects were matched with AMD patients in terms of age, sex and anthropometric characteristics. Three ml of blood were taken from all subjects in groups 1 and 2 and centrifuged. SH protein groups and malondialdehyde were measured and expressed as thiobarbituric acid reactive substanc- es (TBARS) as reported elsewhere 4 . Group 2 patients underwent a cycle of 12 twice weekly treatments of MAHT at an ozone con- centration of 60 mg/ ml. At the end of the twelfth treatment session blood samples were taken to measure SH protein groups and plasma malondi- aldehyde. All patients completed the cycle of treatment without no side-effects and with a general improve- ment in quality of life.