Diabetic cardiomyopathy (DCM) is the leading cause of death worldwide, and oxidative stress was discovered to serve an important role in the pathophysiology of the condition. An imbalance between free radicals and antioxidant defenses is known to be associated with cellular dysfunction, leading to the development of various types of cardiac disease. Nuclear factor-erythroid-2-related factor 2 (NRF2) is a transcription factor that controls the basal and inducible expression levels of various antioxidant genes and other cytoprotective phase II detoxifying enzymes, which are ubiquitously expressed in the cardiac system. Kelch-like ECH-associated protein 1 (Keap1) serves as the main intracellular regulator of NRF2. Emerging evidence has revealed that NRF2 is a critical regulator of cardiac homeostasis via the suppression of oxidative stress. The activation of NRF2 was discovered to enhance specific endogenous antioxidant defense factors, one of which is antioxidant response element (ARE), which was subsequently illustrated to detoxify and counteract oxidative stress-associated DCM. The NRF2 signaling pathway is closely associated with the development of various types of cardiac disease, including ischemic heart disease, heart failure, myocardial infarction, atrial fibrillation and myocarditis. Therefore, it is hypothesized that drugs targeting this pathway may be developed to inhibit the activation of NRF2 signaling, thereby preventing the occurrence of DCM and effectively treating the disease.

The dry form of ARMD is becoming a serious problem because of the rise in the number of old individuals. No effective therapy is available in dry ARMD except for the illusory oral administration of antioxidant vitamins. Despite scepticism in the medical community, the therapeutic effect of ozonetherapy had been evaluated since 1996. This evaluation has been based on specific biochemical, molecular and pharmacological reactions. Nevertheless a number of visual scientists continue to ignore ozonetherapy conservatively and prescribe only antioxidant vitamins. Two small clinical studies involving 217 patients have been performed at the University of Siena showing that ozonetherapy can stop the progression of the disease while improving the visual acuity and the well-being of the patient. Moreover, it seems that ozonetherapy is a safe procedure and tends to have an excellent compliance.