{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T10:40:21Z","timestamp":1768560021390,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:00:00Z","timestamp":1693699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u2018Fo.R.S.T.\u2014Fondazione per la Ricerca Scientifica Termale grants\u2019","award":["300397CPRFORST18"],"award-info":[{"award-number":["300397CPRFORST18"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Oxidative stress, a condition induced by an excessive amount of free radicals, such as reactive oxygen species (ROS), shows several gender-related differences in basal cellular redox state and antioxidant responses. Crenotherapy with sulfureous mineral water can improve the cellular redox state. In this retrospective observational study, gender-related differences in the efficacy of sulfureous crenotherapy in decreasing oxidant species were investigated. Seventy-eight patients, stratified by sex, with osteoarthritis or degenerative joint disease and Vulgar psoriasis who have received a cycle of sulfureous mud-bath therapy + sulfureous hydropinotherapy were enrolled. Plasma concentration of oxidant species and clinical outcomes were measured at baseline and at the end of treatment. After 2 weeks of sulfureous crenotherapy, a significant amelioration of clinical outcomes and a significant reduction of oxidant species were observed in both sexes, more marked in females than in males (p = 0.0001 and p = 0.04, respectively). For patients with high oxidant species at baseline, females showed a greater reduction in itching compared to males (\u221295% vs. \u221250%), while men had a higher amelioration in pain and morning stiffness (\u221245% vs. \u221232%, and \u221250% vs. \u221237%, respectively). In conclusion, sulfureous crenotherapy can be a valuable strategy to improve cellular redox state in both sexes.<\/jats:p>","DOI":"10.3390\/jcm12175731","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T02:43:20Z","timestamp":1693795400000},"page":"5731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Marked Reduction of Oxidant Species after Sulfureous Crenotherapy in Females with Joint Diseases and Psoriasis: A Retrospective Real-Life Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria","family":"Costantino","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80070 Bacoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6964-2739","authenticated-orcid":false,"given":"Valeria","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Pharmacology Unit, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84131 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3441-889X","authenticated-orcid":false,"given":"Graziamaria","family":"Corbi","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Naples \u201cFederico II\u201d, 80138 Naples, Italy"},{"name":"Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7492-6848","authenticated-orcid":false,"given":"Valentina","family":"Giudice","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9659-9940","authenticated-orcid":false,"given":"Francesco De","family":"Caro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-9118","authenticated-orcid":false,"given":"Amelia","family":"Filippelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Baronissi, Italy"},{"name":"Clinical Pharmacology Unit, University Hospital \u201cSan Giovanni di Dio e Ruggi d\u2019Aragona\u201d, 84131 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,3]]},"reference":[{"key":"ref_1","first-page":"13","article-title":"The importance of oxidative stress as a risk factor for morbidity","volume":"1","author":"Cornelli","year":"2004","journal-title":"La. Med. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00726-008-0032-y","article-title":"Possible antioxidant role of SPA therapy with chlorine-sulphur-bicarbonate mineral water","volume":"36","author":"Costantino","year":"2009","journal-title":"Amino Acids"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1163\/156856700X00769","article-title":"The radical cation of N, N-dietil-para-fenilendiammina: Un possibile indicatore di stress ossidativo in campioni biologici","volume":"26","author":"Alberti","year":"2000","journal-title":"Res. Chem. Intermed."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4103\/0973-7847.70902","article-title":"Free radicals, antioxidants, and functional foods: Impact on human health","volume":"4","author":"Lobo","year":"2010","journal-title":"Pharmacogn. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1245049","DOI":"10.1155\/2016\/1245049","article-title":"Role of ROS and RNS Sources in Physiological and Pathological Conditions","volume":"2016","author":"Reed","year":"2016","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"R453","DOI":"10.1016\/j.cub.2014.03.034","article-title":"ROS function in redox signaling and oxidative stress","volume":"24","author":"Schieber","year":"2014","journal-title":"Curr. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3324\/haematol.2010.025510","article-title":"Cardiac iron and cardiac disease in males and females with transfusion-dependent thalassemia major: A T2* MRI study","volume":"96","author":"Marsella","year":"2011","journal-title":"Haematologica"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101488","DOI":"10.1016\/j.redox.2020.101488","article-title":"Sex differences in the response to oxidative and proteolytic stress","volume":"31","author":"Tower","year":"2020","journal-title":"Redox Biol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e1121","DOI":"10.1038\/cddis.2014.73","article-title":"Taking into account the gender issue in cell death studies","volume":"5","author":"Ortona","year":"2014","journal-title":"Cell Death Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1096\/fj.08-114348","article-title":"Cell sex: A new look at cell fate studies","volume":"23","author":"Maselli","year":"2009","journal-title":"FASEB J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3959","DOI":"10.2174\/138161211798764942","article-title":"Females live longer than males: Role of oxidative stress","volume":"17","author":"Vina","year":"2011","journal-title":"Curr. Pharm. Des."},{"key":"ref_12","first-page":"339","article-title":"Gender differences in oxidative stress and antioxidant response to acute exhaustive exercise","volume":"66","author":"Balci","year":"2013","journal-title":"Med. Dello Sport"},{"key":"ref_13","first-page":"385","article-title":"Evaluation of gender-related differences in various oxidative stress enzymes in mice","volume":"54","author":"Chen","year":"2011","journal-title":"Chin. J. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"943824","DOI":"10.1155\/2014\/943824","article-title":"Thermal water applications in the treatment of upper respiratory tract diseases: A systematic review and meta-analysis","volume":"2014","author":"Keller","year":"2014","journal-title":"J. Allergy"},{"key":"ref_15","first-page":"e15","article-title":"Effects of drinking spa therapy on oxidative stress","volume":"163","author":"Costantino","year":"2012","journal-title":"Clin. Ter."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1055\/s-0033-1334894","article-title":"The antioxidant activity of sulphureous thermal water protects against oxidative DNA damage: A comet assay investigation","volume":"63","author":"Braga","year":"2013","journal-title":"Drug Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1038\/sj.ejcn.1602892","article-title":"Antioxidative effects of sulfurous mineral water: Protection against lipid and protein oxidation","volume":"63","author":"Benedetti","year":"2009","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_18","first-page":"3","article-title":"Effects of sulfurous mineral water Minieri-Telese on the kinetic of gastric and gallbladder emptying and intestinal transit in subjects with functional dyspepsia","volume":"4","author":"Coiro","year":"2004","journal-title":"Prog. Nutr."},{"key":"ref_19","first-page":"124","article-title":"Effets antioxydants du traitement hydromineral avec une eau sulfur\u00e9e chez le lapin","volume":"133","author":"Albertini","year":"1996","journal-title":"La. Presse Therm. Et. Clim."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Costantino, M., Conti, V., Corbi, G., and Filippelli, A. (2021). Hydropinotherapy with Sulphurous Mineral Water as Complementary Treatment to Improve Glucose Metabolism, Oxidative Status, and Quality of Life. Antioxidants, 10.","DOI":"10.3390\/antiox10111773"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Costantino, M., Conti, V., Corbi, G., Ciancarelli, I., Morone, G., and Filippelli, A. (2022). Sulphurous Crenotherapy Is Effective at Reducing Pain and Disability in Overweight\/Obese Patients Affected by Chronic Low Back Pain from Spine Osteoarthritis. Healthcare, 10.","DOI":"10.3390\/healthcare10091800"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1504\/IJENVH.2007.012230","article-title":"Drinking mineral waters: Biochemical effects and health implications\u2014The state of the art","volume":"1","author":"Albertini","year":"2007","journal-title":"Int. J. Environ. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1038\/emm.2005.58","article-title":"Alternative therapy of earth elements increases the chondroprotective effects of chondroitin sulfate in mice","volume":"37","author":"Caraglia","year":"2005","journal-title":"Exp. Mol. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/0753-3322(96)85097-9","article-title":"Mud pack treatment increases serum antioxidant defences in osteoarthrosic patients","volume":"50","author":"Bellometti","year":"1996","journal-title":"Biomed. Pharmacother."},{"key":"ref_25","first-page":"216","article-title":"Effect of sulfur baths on antioxidative defense systems, peroxide concentrations and lipid levels in patients with degenerative osteoarthritis","volume":"9","author":"Ekmekcioglu","year":"2002","journal-title":"Forsch. Komplementarmed Kl. Naturheilkd"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1080\/10408398.2012.692737","article-title":"Types and Characteristics of Drinking Water for Hydration in the Elderly","volume":"55","author":"Casado","year":"2015","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.clinbiochem.2010.05.004","article-title":"Biomarkers of oxidation, inflammation and cartilage degradation in osteoarthritis patients undergoing sulfur-based spa therapies","volume":"43","author":"Benedetti","year":"2010","journal-title":"Clin. Biochem."},{"key":"ref_28","unstructured":"Iorio, E.L. (2004). The d-ROMs Test and the Evaluation of Oxidative Stress, Diacron International."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8034084","DOI":"10.1155\/2017\/8034084","article-title":"Sulphurous mineral water: New applcations for Health","volume":"2017","author":"Carbajo","year":"2017","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1873962","DOI":"10.1155\/2018\/1873962","article-title":"Antioxidant and Cell-Signaling Functions of Hydrogen Sulfide in the Central Nervous System","volume":"2018","author":"Shefa","year":"2018","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s00394-015-1094-8","article-title":"Efficacy and safety of a natural mineral water rich in magnesium and sulphate for bowel function: A double-blind, randomized, placebo-controlled study","volume":"56","author":"Bothe","year":"2017","journal-title":"Eur. J. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S1043661802002323","article-title":"Effects of a bicarbonate-alkaline mineral water on gastric functions and functional dyspepsia: A preclinical and clinical study","volume":"46","author":"Bertoni","year":"2002","journal-title":"Pharmacol. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1097\/00042737-200209000-00010","article-title":"Effects of carbonated water on functional dsyspepsia and constipation","volume":"14","author":"Cuomo","year":"2002","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_34","first-page":"372","article-title":"A meta-analysis of the effectiveness of mud-bath therapy on knee osteoarthritis","volume":"172","author":"Mennuni","year":"2021","journal-title":"Clin. Ter."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1042576","DOI":"10.1155\/2018\/1042576","article-title":"Efficacy of Spa Therapy, Mud-Pack Therapy, Balneotherapy, and Mud-Bath Therapy in the Management of Knee Osteoarthritis. A Systematic Review","volume":"2018","author":"Fraioli","year":"2018","journal-title":"Biomed. Res. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1007\/s00296-018-4081-6","article-title":"Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: A systematic review and meta-analysis","volume":"38","author":"Antonelli","year":"2018","journal-title":"Rheumatol. Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1007\/s00484-021-02102-3","article-title":"The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: An overview of reviews","volume":"65","author":"Coclite","year":"2021","journal-title":"Int. J. Biometeorol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5731\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:45:37Z","timestamp":1760129137000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,3]]},"references-count":37,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175731"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175731","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,3]]}}}