Balneotherapy (BT) is one of the most commonly used complementary therapies for many pathological conditions. Its beneficial effects are related to physical and chemical factors, but the exact mechanism of action is not fully understood. Recently, there has been an increased interest in the use of preclinical models to investigate the influence of BT on inflammation, immunity, and cartilage and bone metabolism. The objective of this comprehensive analysis was to summarize the current knowledge about the in vitro studies in BT and to revise the obtained results on the biological effects of mineral waters. Special attention has been paid to the main rheumatological and dermatological conditions, and to the regulation of the immune response. The objective of this review was to summarize the in vitro studies, on human and animal samples, investigating the biological effects of BT. In particular, we analyzed the properties of a thermal water, as a whole, of an inorganic molecule, such as hydrogen sulfide in different cell cultures (keratinocytes, synoviocytes, chondrocytes, and peripheral blood cells), or of the organic component. The results corroborated the scientific value of in vitro studies in demonstrating the anti-inflammatory, antioxidant, chondroprotective, and immunosuppressive role of BT at the cellular level. However, the validity of the cell culture model is limited by several sources of bias, as the differences in experimental procedures, the high heterogeneity among the available researches, and the difficulties in considering all the chemical and physical factors of BT. We would like to stimulate the scientific community to standardize the experimental procedures and enhance in vitro research in the field of BT.

中文翻译：

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全面分析了解浴疗法的作用机制：为什么，如何以及在哪里可以使用它们？来自对人类和动物样本进行的体外研究的证据

浴疗法 (BT) 是许多病理状况最常用的补充疗法之一。其有益作用与物理和化学因素有关，但确切的作用机制尚不完全清楚。最近，人们越来越关注使用临床前模型来研究 BT 对炎症、免疫、软骨和骨代谢的影响。这项综合分析的目的是总结目前关于 BT 体外研究的知识，并修改获得的关于矿泉水生物效应的结果。对主要的风湿病和皮肤病以及免疫反应的调节给予了特别关注。本综述的目的是总结对人类和动物样本的体外研究，研究 BT 的生物学效应。特别是，我们分析了热水作为一个整体的无机分子的性质，例如不同细胞培养物中的硫化氢（角质形成细胞、滑膜细胞、软骨细胞和外周血细胞）或有机成分的性质。结果证实了体外研究在证明 BT 在细胞水平上的抗炎、抗氧化、软骨保护和免疫抑制作用方面的科学价值。然而，细胞培养模型的有效性受到多种偏差来源的限制，如实验程序的差异、现有研究之间的高度异质性以及难以考虑 BT 的所有化学和物理因素。