Ozonated water attenuates nucleus pulposus cell apoptosis and matrix degradation by suppressing NF-κB signaling in a rat model of <i>Staphylococcus aureus</i>-induced discitis

This study evaluated the therapeutic efficacy of ozonated water (OW) in a rat model of <i>Staphylococcus aureus</i>-induced discitis and elucidated its underlying mechanisms, focusing on NF-κB signaling, extracellular matrix homeostasis, and nucleus pulposus (NP) cell apoptosis.</p> <p>A rat tail coccygeal IVD discitis model was established by injecting <i>S. aureus</i> (10² cfu) into the disc space.

From day 3 post-infection, animals received transdiscal lavage with normal saline, levofloxacin (5 mg/mL), or OW (30 μg/mL) three times daily until day 9. In vitro, NP cells were stimulated with S. aureus Protein A (SpA, 1 μg/mL). Antibacterial activity, extracellular matrix metabolism, inflammatory cytokine expression, NF-κB p65 signaling, and apoptosis were evaluated by bacterial culture, Western blotting, immunohistochemistry, TUNEL assay, and flow cytometry.</p> <p>OW significantly alleviated tail swelling and IVD structural damage.