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Hydrogen, the universe’s most elementary element, plays a crucial role in cosmic genesis and the evolution of life. In recent times, the field of hydrogen medicine has experienced rapid advancements, revealing novel trends and challenges. This review delineated significant milestone events in the evolution of hydrogen medicine and sorted out the general trend of its development. It evaluated the present state and emerging trends of hydrogen medicine in terms of therapeutic effects, molecular mechanisms, research domains, and models. The review also provides recommendations for addressing current challenges in hydrogen medicine.

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氢作为自然界中最简单的元素,无论是在宇宙的起源还是在生命的进化过程中,都扮演着至关重要的角色。近年来,氢医学领域迅速崛起,展现出新的发展趋势,同时也遭遇了诸多挑战。文章通过回顾氢医学发展历程中的关键事件,梳理其发展的总体趋势。从氢医学的效应证据、分子机制、研究范围与模式等方面总结现状及研判趋势,并针对氢医学目前所面临的挑战提出相应的发展建议。

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卢宏涛,讲师。主要从事氢医学与代谢性疾病研究。入选全军医学科技青年培育计划、上海市扬帆计划。主持各类科研与人才项目5项。出版专著3部,发表论文10余篇。电子信箱:

孙学军,教授,博士研究生导师。上海交通大学氢科学中心兼职教授。中国医疗保健国际交流促进会常务理事,中国医疗保健国际交流促进会氢分子生物医学分会主任委员,中国健康促进基金会氢分子生物医学发展专项基金副理事长和专家委员会主席。主要从事气体生物学研究。主持国家自然科学基金项目3项。出版专著3部,发表论文260余篇。电子信箱:

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卢宏涛,讲师。主要从事氢医学与代谢性疾病研究。入选全军医学科技青年培育计划、上海市扬帆计划。主持各类科研与人才项目5项。出版专著3部,发表论文10余篇。电子信箱:

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卢宏涛,讲师。主要从事氢医学与代谢性疾病研究。入选全军医学科技青年培育计划、上海市扬帆计划。主持各类科研与人才项目5项。出版专著3部,发表论文10余篇。电子信箱:

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孙学军,教授,博士研究生导师。上海交通大学氢科学中心兼职教授。中国医疗保健国际交流促进会常务理事,中国医疗保健国际交流促进会氢分子生物医学分会主任委员,中国健康促进基金会氢分子生物医学发展专项基金副理事长和专家委员会主席。主要从事气体生物学研究。主持国家自然科学基金项目3项。出版专著3部,发表论文260余篇。电子信箱:

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孙学军,教授,博士研究生导师。上海交通大学氢科学中心兼职教授。中国医疗保健国际交流促进会常务理事,中国医疗保健国际交流促进会氢分子生物医学分会主任委员,中国健康促进基金会氢分子生物医学发展专项基金副理事长和专家委员会主席。主要从事气体生物学研究。主持国家自然科学基金项目3项。出版专著3部,发表论文260余篇。电子信箱:

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Marked aggression of the tumors was found, leading to the possibility that hyperbaric hydrogen therapy might also prove to be of significance in the treatment of other types of cancer.), Reference(id=1242113989203792753, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1038/nm1577, pmid=17486089, pmcid=null, year=2007, volume=13, issue=6, pageStart=688, pageEnd=694, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Ohsawa I, Ishikawa M, Takahashi K, journalName=Nature Medicine, refType=null, unstructuredReference=Ohsawa I, Ishikawa M, Takahashi K, et al. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals[J]. 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The inhalation of H(2) gas markedly suppressed brain injury by buffering the effects of oxidative stress. Thus H(2) can be used as an effective antioxidant therapy; owing to its ability to rapidly diffuse across membranes, it can reach and react with cytotoxic ROS and thus protect against oxidative damage.), Reference(id=1242113989262513010, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1016/j.brainres.2008.11.048, pmid=19063869, pmcid=null, year=2009, volume=1256, issue=null, pageStart=129, pageEnd=137, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=Cai J M, Kang Z M, Liu K, journalName=Brain Research, refType=null, unstructuredReference=Cai J M, Kang Z M, Liu K, et al. Neuroprotective effects of hydrogen saline in neonatal hypoxia-ischemia rat model[J]. Brain Research, 2009, 1256: 129-137., articleTitle=Neuroprotective effects of hydrogen saline in neonatal hypoxia-ischemia rat model, refAbstract=Cerebral hypoxia-ischemia (HI) represents a major cause of brain damage in the term newborn. This study aimed to examine the short and long-term neuroprotective effect of hydrogen saline (H(2) saline) using an established neonatal HI rat pup model. Seven-day-old rat pups were subjected to left common carotid artery ligation and then 90 min hypoxia (8% oxygen at 37 degrees C). H(2) saturated saline was administered by peritoneal injection (5 ml/kg) immediately and again at 8 h after HI insult. At 24 h after HI, the pups were decapitated and brain morphological injury was assessed by 2,3,5-triphenyltetrazolium chloride (TTC), Nissl, and TUNEL staining. Acute cell death, inflammation and oxidative stress were evaluated at 24 h by studying caspase-3 activity, MDA measurement as well as Iba-1 immunochemistry in the brain. At 5 weeks after HI, spontaneous activity test and Morris water maze test were conducted. We observed that H(2) saline treatment reduced the caspase activity, MDA, Iba-1 levels, the infarct ratio, and improved the long-term neurological and neurobehavioral functions. H(2) saline has potentials in the clinical treatment of HI and other ischemia-related cerebral diseases.), Reference(id=1242113989321233267, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1194/jlr.M036640, pmid=23610159, pmcid=null, year=2013, volume=54, issue=7, pageStart=1884, pageEnd=1893, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=Song G H, Li M, Sang H, journalName=Journal of Lipid Research, refType=null, unstructuredReference=Song G H, Li M, Sang H, et al. Hydrogen-rich water decreases serum LDL-cholesterol levels and improves HDL function in patients with potential metabolic syndrome[J]. Journal of Lipid Research, 2013, 54(7): 1884-1893., articleTitle=Hydrogen-rich water decreases serum LDL-cholesterol levels and improves HDL function in patients with potential metabolic syndrome, refAbstract=We have found that hydrogen (dihydrogen; H2) has beneficial lipid-lowering effects in high-fat diet-fed Syrian golden hamsters. The objective of this study was to characterize the effects of H2-rich water (0.9-1.0 l/day) on the content, composition, and biological activities of serum lipoproteins on 20 patients with potential metabolic syndrome. Serum analysis showed that consumption of H2-rich water for 10 weeks resulted in decreased serum total-cholesterol (TC) and LDL-cholesterol (LDL-C) levels. Western blot analysis revealed a marked decrease of apolipoprotein (apo)B100 and apoE in serum. In addition, we found H2 significantly improved HDL functionality assessed in four independent ways, namely, i) protection against LDL oxidation, ii) inhibition of tumor necrosis factor (TNF)-α-induced monocyte adhesion to endothelial cells, iii) stimulation of cholesterol efflux from macrophage foam cells, and iv) protection of endothelial cells from TNF-α-induced apoptosis. Further, we found consumption of H2-rich water resulted in an increase in antioxidant enzyme superoxide dismutase and a decrease in thiobarbituric acid-reactive substances in whole serum and LDL. In conclusion, supplementation with H2-rich water seems to decrease serum LDL-C and apoB levels, improve dyslipidemia-injured HDL functions, and reduce oxidative stress, and it may have a beneficial role in prevention of potential metabolic syndrome.), Reference(id=1242113989400925044, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2018, volume=9, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=Zhao P H, Jin Z K, Chen Q, journalName=Nature Communications, refType=null, unstructuredReference=Zhao P H, Jin Z K, Chen Q, et al. Local generation of hydrogen for enhanced photothermal therapy[J]. Nature Communications, 2018, 9(1), doi: 10.1038/s41467-018-06630-2., articleTitle=Local generation of hydrogen for enhanced photothermal therapy, refAbstract=null), Reference(id=1242113989501588341, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2021, volume=22, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[14], rfOrder=14, authorNames=Zheng Z G, Sun W Z, Hu J Y, journalName=Respiratory Research, refType=null, unstructuredReference=Zheng Z G, Sun W Z, Hu J Y, et al. Hydrogen/oxygen therapy for the treatment of an acute exacerbation of chronic obstructive pulmonary disease: Results of a multicenter, randomized, double-blind, parallel-group controlled trial[J]. Respiratory Research, 2021, 22(1), doi: 10.1186/s12931-021-01740-w., articleTitle=Hydrogen/oxygen therapy for the treatment of an acute exacerbation of chronic obstructive pulmonary disease: Results of a multicenter, randomized, double-blind, parallel-group controlled trial, refAbstract=null), Reference(id=1242113989589668726, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2024, volume=187, issue=12, pageStart=2952, pageEnd=2968, url=null, language=null, rfNumber=[15], rfOrder=15, authorNames=McCurry M D, D’Agostino G D, Walsh J T, journalName=Cell, refType=null, unstructuredReference=McCurry M D, D’Agostino G D, Walsh J T, et al. Gut bacteria convert glucocorticoids into progestins in the presence of hydrogen gas[J]. Cell, 2024, 187(12): 2952-2968.e13., articleTitle=Gut bacteria convert glucocorticoids into progestins in the presence of hydrogen gas, refAbstract=null), Reference(id=1242113989644194679, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.19586/j.2095-2341.2022.0028, pmid=null, pmcid=null, year=2022, volume=12, issue=3, pageStart=332, pageEnd=343, url=null, language=null, rfNumber=[16], rfOrder=16, authorNames=王濛, 仪杨, 孙梦婷, journalName=生物技术进展, refType=null, unstructuredReference=王濛, 仪杨, 孙梦婷, . 富氢水和富氢生理盐水生物医学研究进展: 动物实验[J]. 生物技术进展, 2022, 12(3): 332-343., articleTitle=富氢水和富氢生理盐水生物医学研究进展: 动物实验, refAbstract=自2007年发现吸氢可有效保护脑缺血再灌注损伤以来,氢气的生物学作用被陆续发现。富氢水或富氢生理盐水作为主要的氢气干预方式已广泛应用于基础医学和临床研究中,并且已被证实对多种疾病有很好的预防和治疗作用。以往关于富氢水或富氢生理盐水的研究多是针对其医学效应的介绍,通过介绍富氢水或富氢生理盐水干预后体内氢浓度的变化情况、对正常生理功能的影响、对疾病的保护作用以及对肠道菌群的影响,并对不同动物实验中富氢水或富氢生理盐水的氢气浓度、干预介入时间点、干预时长以及每次干预剂量进行阐述,以期为氢分子基础研究提供一定的理论依据。), Reference(id=1242113989770023800, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=3, pageStart=332, pageEnd=343, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=Wang M, Yi Y, Sun M T, journalName=Current Biotechnology, refType=null, unstructuredReference=Wang M, Yi Y, Sun M T, et al. Biomedical research progress of hydrogen-rich water and hydrogen-rich saline: Animal experiment[J]. Current Biotechnology, 2022, 12(3): 332-343. (in Chinese), articleTitle=Biomedical research progress of hydrogen-rich water and hydrogen-rich saline: Animal experiment, refAbstract=null), Reference(id=1242113989832938361, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=19, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Botek M, Krejčí J, Valenta M, journalName=International Journal of Environmental Research and Public Health, refType=null, unstructuredReference=Botek M, Krejčí J, Valenta M, et al. Molecular hydrogen positively affects physical and respiratory function in acute post-COVID-19 patients: A new perspective in rehabilitation[J]. International Journal of Environmental Research and Public Health, 2022, 19(4), doi: 10.3390/ijerph19041992., articleTitle=Molecular hydrogen positively affects physical and respiratory function in acute post-COVID-19 patients: A new perspective in rehabilitation, refAbstract=null), Reference(id=1242113989900047226, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2018, volume=8, issue=4, pageStart=135, pageEnd=143, url=null, language=null, rfNumber=[18], rfOrder=19, authorNames=Sha J B, Zhang S S, Lu Y M, journalName=Medical Gas Research, refType=null, unstructuredReference=Sha J B, Zhang S S, Lu Y M, et al. Effects of the long-term consumption of hydrogen-rich water on the antioxidant activity and the gut flora in female juvenile soccer players from Suzhou, China[J]. Medical Gas Research, 2018, 8(4): 135-143., articleTitle=Effects of the long-term consumption of hydrogen-rich water on the antioxidant activity and the gut flora in female juvenile soccer players from Suzhou, China, refAbstract=null), Reference(id=1242113989958767483, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1016/j.ejphar.2015.04.051, pmid=25962664, pmcid=null, year=2015, volume=762, issue=null, pageStart=96, pageEnd=101, url=null, language=null, rfNumber=[19], rfOrder=20, authorNames=Tamasawa A, Mochizuki K, Hariya N, journalName=European Journal of Pharmacology, refType=null, unstructuredReference=Tamasawa A, Mochizuki K, Hariya N, et al. Hydrogen gas production is associated with reduced interleukin-1β mRNA in peripheral blood after a single dose of acarbose in Japanese type 2 diabetic patients[J]. European Journal of Pharmacology, 2015, 762: 96-101., articleTitle=Hydrogen gas production is associated with reduced interleukin-1β mRNA in peripheral blood after a single dose of acarbose in Japanese type 2 diabetic patients, refAbstract=Acarbose, an α-glucosidase inhibitor, leads to the production of hydrogen gas, which reduces oxidative stress. In this study, we examined the effects of a single dose of acarbose immediately before a test meal on postprandial hydrogen gas in breath and peripheral blood interleukin (IL)-1β mRNA expression in Japanese type 2 diabetic patients. Sixteen Japanese patients (14 men, 2 women) participated in this study. The mean±standard deviation age, hemoglobin A1c and body mass index were 52.1±15.4 years, 10.2±2.0%, and 27.7±8.0kg/m(2), respectively. The patients were admitted into our hospital for 2 days and underwent test meals at breakfast without (day 1) or with acarbose (day 2). We performed continuous glucose monitoring and measured hydrogen gas levels in breath, and peripheral blood IL-1β mRNA levels before (0min) and after the test meal (hydrogen gas: 60, 120, 180, and 300min; IL-1β: 180min). The induction of hydrogen gas production and the reduction in peripheral blood IL-1β mRNA after the test meal were not significant between days 1 (without acarbose) and 2 (with acarbose). However, the changes in total hydrogen gas production from day 1 to day 2 were closely and inversely associated with the changes in peripheral blood IL-1β mRNA levels. Our results suggest that an increase in hydrogen gas production is inversely associated with a reduction of the peripheral blood IL-1β mRNA level after a single dose of acarbose in Japanese type 2 diabetic patients. Copyright © 2015 Elsevier B.V. All rights reserved.), Reference(id=1242113990025876348, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1111/hdi.12112, pmid=24274030, pmcid=null, year=2014, volume=18, issue=2, pageStart=459, pageEnd=466, url=null, language=null, rfNumber=[20], rfOrder=21, authorNames=Terawaki H, Zhu W J, Matsuyama Y, journalName=Hemodialysis International, refType=null, unstructuredReference=Terawaki H, Zhu W J, Matsuyama Y, et al. Effect of a hydrogen (H2)-enriched solution on the albumin redox of hemodialysis patients[J]. Hemodialysis International, 2014, 18(2): 459-466., articleTitle=Effect of a hydrogen (H2)-enriched solution on the albumin redox of hemodialysis patients, refAbstract=Elevated oxidative stress (OS) is associated with severe cardiovascular disease and premature death among patients treated with hemodialysis (HD). Oxidative stress is enhanced by contact between blood and dialysis membranes during HD sessions. This study aimed to clarify whether hydrogen (H2), which is a known antioxidant, is capable of suppressing increased OS induced during HD sessions. Eight patients on regular HD treatment were studied. Two HD sessions were performed in a cross-over design trial using standard and hydrogen-enriched solutions (mean of 50 p.p.b. H2; H2-HD). Blood samples were obtained from the inlet and outlet of the dialyzer during HD to determine changes in plasma levels of glutathione, hydrogen peroxide, and albumin redox state as a marker of OS. Comparison of inlet and outlet blood revealed significant decreases in total glutathione and reduced glutathione, as well as significant increases in hydrogen peroxide in both HD treatments. However, the mean proportion of reversibly oxidized albumin in outlet serum was significantly lower than that in inlet serum following the H2-HD session, whereas no significant changes were found in the standard solution session, suggesting that "intra-dialyzer" OS is reduced by H2 -HD. In conclusion, the application of H2-enriched solutions could ameliorate OS during HD.© 2013 International Society for Hemodialysis.), Reference(id=1242113990097179517, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2017, volume=12, issue=9, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=22, authorNames=Nakayama M, Itami N, Suzuki H, journalName=PLoS One, refType=null, unstructuredReference=Nakayama M, Itami N, Suzuki H, et al. Possible clinical effects of molecular hydrogen (H2) delivery during hemodialysis in chronic dialysis patients: Interim analysis in a 12 month observation[J]. PLoS One, 2017, 12(9), doi: 10.1371/journal.pone.0184535., articleTitle=Possible clinical effects of molecular hydrogen (H2) delivery during hemodialysis in chronic dialysis patients: Interim analysis in a 12 month observation, refAbstract=null), Reference(id=1242113990168482686, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2018, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[22], rfOrder=23, authorNames=Nakayama M, Itami N, Suzuki H, journalName=Scientific Reports, refType=null, unstructuredReference=Nakayama M, Itami N, Suzuki H, et al. Novel haemodialysis (HD) treatment employing molecular hydrogen (H2)-enriched dialysis solution improves prognosis of chronic dialysis patients: A prospective observational study[J]. Scientific Reports, 2018, 8, doi: 10.1038/s41598-17-18537-x., articleTitle=Novel haemodialysis (HD) treatment employing molecular hydrogen (H2)-enriched dialysis solution improves prognosis of chronic dialysis patients: A prospective observational study, refAbstract=null), Reference(id=1242113990235591551, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1038/s41573-021-00233-1, pmid=34194012, pmcid=null, year=2021, volume=20, issue=9, pageStart=689, pageEnd=709, url=null, language=null, rfNumber=[23], rfOrder=24, authorNames=Forman H J, Zhang H Q, journalName=Nature Reviews Drug Discovery, refType=null, unstructuredReference=Forman H J, Zhang H Q. Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy[J]. Nature Reviews Drug Discovery, 2021, 20(9): 689-709., articleTitle=Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy, refAbstract=Oxidative stress is a component of many diseases, including atherosclerosis, chronic obstructive pulmonary disease, Alzheimer disease and cancer. Although numerous small molecules evaluated as antioxidants have exhibited therapeutic potential in preclinical studies, clinical trial results have been disappointing. A greater understanding of the mechanisms through which antioxidants act and where and when they are effective may provide a rational approach that leads to greater pharmacological success. Here, we review the relationships between oxidative stress, redox signalling and disease, the mechanisms through which oxidative stress can contribute to pathology, how antioxidant defences work, what limits their effectiveness and how antioxidant defences can be increased through physiological signalling, dietary components and potential pharmaceutical intervention.), Reference(id=1242113990311089025, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2020, volume=9, issue=9, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=25, authorNames=Sies H, journalName=Antioxidants, refType=null, unstructuredReference=Sies H. Oxidative stress: Concept and some practical aspects[J]. Antioxidants, 2020, 9(9), doi: 10.3390/antiox 9090852., articleTitle=Oxidative stress: Concept and some practical aspects, refAbstract=null), Reference(id=1242113990374003586, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1007/s10863-019-09814-7, pmid=31768722, pmcid=null, year=2019, volume=51, issue=6, pageStart=393, pageEnd=402, url=null, language=null, rfNumber=[25], rfOrder=26, authorNames=Li L T, Liu T T, Liu L, journalName=Journal of Bioenergetics and Biomembranes, refType=null, unstructuredReference=Li L T, Liu T T, Liu L, et al. Effect of hydrogen-rich water on the Nrf2/ARE signaling pathway in rats with myocardial ischemia-reperfusion injury[J]. Journal of Bioenergetics and Biomembranes, 2019, 51(6): 393-402., articleTitle=Effect of hydrogen-rich water on the Nrf2/ARE signaling pathway in rats with myocardial ischemia-reperfusion injury, refAbstract=The effects of hydrogen-rich water on oxidative stress via the Nrf2/ARE signaling pathway were studied in rats with myocardial ischemia-reperfusion injury (MIRI). Sixty rats were randomly divided into a hydrogen-rich water group and a control group, with 30 rats in each group. The two groups were randomly divided into three groups: pre-ischemic period, ischemic period and reperfusion period. After the heart was removed, it was fixed in a Langendorff device and perfused with an oxygen-balanced 37 °C perfusate. The control group was perfused with Kreb's-Ringers (K-R) solution, and the hydrogen-rich water group was perfused with K-R solution + hydrogen-rich water. The levels of mRNA and protein of Nrf2, NQO1, HO-1 and SOD-1 in cardiomyocytes were detected by RT-qPCR, immunohistochemistry (IHC) and Western blot analysis. SOD activity and MDA content were determined. Hydrogen-rich water increased the activation of the Nrf2/ARE signaling pathway, and the levels of mRNA and protein Nrf2, NQO1, HO-1 and SOD-1 were significantly increased (P < 0.05) in the ischemia-reperfusion period compared with the ischemic period. In the control group, the levels of mRNA and protein of Nrf2, NQO1, HO-1 and SOD-1 were significantly decreased (P < 0.05) in the ischemia-reperfusion period compared with the ischemic period. Compared with the ischemic period, the ischemia-reperfusion phase showed significantly increased SOD activity and significantly decreased MDA content in the hydrogen-rich water group, while SOD activity was significantly decreased, and MDA content was significantly increased in the control group (P < 0.05). Hydrogen-rich water can activate the Nrf2/ARE signaling pathway, alleviate ischemia-reperfusion injury in isolated rat hearts and reduce the oxidative stress level of myocardial tissue.), Reference(id=1242113990436918147, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2020, volume=34, issue=5, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[26], rfOrder=27, authorNames=Lu Y, Li C F, Ping N N, journalName=Journal of Biochemical and Molecular Toxicology, refType=null, unstructuredReference=Lu Y, Li C F, Ping N N, et al. Hydrogen-rich water alleviates cyclosporine A-induced nephrotoxicity via the Keap1/Nrf2 signaling pathway[J]. Journal of Biochemical and Molecular Toxicology, 2020, 34(5), doi: 10.1002/jbt.22467., articleTitle=Hydrogen-rich water alleviates cyclosporine A-induced nephrotoxicity via the Keap1/Nrf2 signaling pathway, refAbstract=null), Reference(id=1242113990512415620, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=1981, volume=5, issue=2, pageStart=259, pageEnd=264, url=null, language=null, rfNumber=[27], rfOrder=28, authorNames=Katz R J, Roth K A, Schmaltz K, journalName=Neuroscience & Biobehavioral Reviews, refType=null, unstructuredReference=Katz R J, Roth K A, Schmaltz K. Amphetamine and tranylcypromine in an animal model of depression: Pharmacological specificity of the reversal effect[J]. Neuroscience & Biobehavioral Reviews, 1981, 5(2): 259-264., articleTitle=Amphetamine and tranylcypromine in an animal model of depression: Pharmacological specificity of the reversal effect, refAbstract=null), Reference(id=1242113990583718789, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=19, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[28], rfOrder=29, authorNames=Yin H L, Feng Y J, Duan Y, journalName=Journal of Inflammation, refType=null, unstructuredReference=Yin H L, Feng Y J, Duan Y, et al. Hydrogen gas alleviates lipopolysaccharide-induced acute lung injury and inflammatory response in mice[J]. Journal of Inflammation, 2022, 19(1), doi: 10.1186/s12950-022-00314-x., articleTitle=Hydrogen gas alleviates lipopolysaccharide-induced acute lung injury and inflammatory response in mice, refAbstract=null), Reference(id=1242113990655021958, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[29], rfOrder=30, authorNames=Xu L Y, Guo W H, Dai J Y, journalName=International Immunopharmacology, refType=null, unstructuredReference=Xu L Y, Guo W H, Dai J Y, et al. Hydrogen gas alleviates acute ethanol-induced hepatotoxicity in mice via modulating TLR4/9 innate immune signaling and pyroptosis[J]. International Immunopharmacology, 2024, 127, doi: 10.1016/j.intimp.2023.111399., articleTitle=Hydrogen gas alleviates acute ethanol-induced hepatotoxicity in mice via modulating TLR4/9 innate immune signaling and pyroptosis, refAbstract=null), Reference(id=1242113992123028359, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.1016/j.jss.2021.01.022, pmid=33639371, pmcid=null, year=2021, volume=263, issue=null, pageStart=63, pageEnd=70, url=null, language=null, rfNumber=[30], rfOrder=31, authorNames=Matsuura H, Matsumoto H, Okuzaki D, journalName=Journal of Surgical Research, refType=null, unstructuredReference=Matsuura H, Matsumoto H, Okuzaki D, et al. Hydrogen gas therapy attenuates inflammatory pathway signaling in septic mice[J]. Journal of Surgical Research, 2021, 263: 63-70., articleTitle=Hydrogen gas therapy attenuates inflammatory pathway signaling in septic mice, refAbstract=Molecular hydrogen (H) has been used in clinical cases. However, there are few studies of H therapy to treat sepsis, and anti-inflammatory mechanisms of H are mostly unknown. We aimed to confirm effects of H therapy on sepsis and reveal its therapeutic mechanism via RNA sequencing in multiple organs in septic mice.Nine-week-old C57BL/6 male mice underwent cecal ligation and puncture (CLP) or sham procedure. Subsequently, the CLP model received immediate ± continuous inhalation of 7% H. Mice were observed for a week to assess survival rates. Serum inflammatory cytokines were evaluated at 24 h after CLP procedure. Liver, intestine, and lungs in CLP mice receiving 24-h ± H therapy were assessed by RNA sequencing. Data were analyzed with Ingenuity Pathways Analysis (QIAGEN Inc).Seven-day survival rate in septic mice was significantly improved in the H inhalation group compared with that in the control group (75% versus 40%, P < 0.05). H treatment attenuated serum interleukin-6 and tumor necrosis factor-α levels at 24 h after CLP, and blood glucose levels were maintained in the H-treated group. In RNA sequencing, canonical pathway analysis revealed inactivity of various inflammatory signaling pathways, for example, acute phase response signaling and STAT3 pathways, in the liver and intestine in the CLP model after 24-h H inhalation. We detected significantly decreased expressions of upstream regulator genes such as the CD14 antigen gene in the liver and various cytokine receptor genes in the intestine and lungs in the H-treated group.These findings may contribute to clarifying the mechanism of action of H therapy in sepsis.Copyright © 2021 Elsevier Inc. All rights reserved.), Reference(id=1242113992219497353, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=9, issue=10, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[31], rfOrder=32, authorNames=Yao X X, Chen D Y, Zhao B, journalName=Advanced Science, refType=null, unstructuredReference=Yao X X, Chen D Y, Zhao B, et al. Acid-degradable hydrogen-generating metal-organic framework for overcoming cancer resistance/metastasis and off-target side effects[J]. Advanced Science, 2022, 9(10), doi: 10.1002/advs.202101965., articleTitle=Acid-degradable hydrogen-generating metal-organic framework for overcoming cancer resistance/metastasis and off-target side effects, refAbstract=null), Reference(id=1242113992282411914, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2023, volume=158, issue=12, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[32], rfOrder=33, authorNames=Turan H T, Boittier E, Meuwly M, journalName=The Journal of Chemical Physics, refType=null, unstructuredReference=Turan H T, Boittier E, Meuwly M. Interaction at a distance: Xenon migration in Mb[J]. The Journal of Chemical Physics, 2023, 158(12), doi: 10.1063/5.0124502., articleTitle=Interaction at a distance: Xenon migration in Mb, refAbstract=null), Reference(id=1242113992353715083, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[33], rfOrder=34, authorNames=Bulut M, Çelebi S Y, Ceylan M M, journalName=Food Chemistry, refType=null, unstructuredReference=Bulut M, Çelebi S Y, Ceylan M M, et al. Hydrogen-rich water can reduce the formation of biogenic amines in butter[J]. Food Chemistry, 2022, 384, doi: 10.1016/j.foodchem.2022.132613., articleTitle=Hydrogen-rich water can reduce the formation of biogenic amines in butter, refAbstract=null), Reference(id=1242113992420823948, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2024, volume=35, issue=2, pageStart=203, pageEnd=219, url=null, language=null, rfNumber=[34], rfOrder=35, authorNames=Alwazeer D, journalName=Phytochemical Analysis, refType=null, unstructuredReference=Alwazeer D. Hydrogen-rich solvent method in phytochemical extraction: Potential mechanisms and perspectives[J]. Phytochemical Analysis, 2024, 35(2): 203-219., articleTitle=Hydrogen-rich solvent method in phytochemical extraction: Potential mechanisms and perspectives, refAbstract=null), Reference(id=1242113992483738509, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2015, volume=100, issue=7, pageStart=2724, pageEnd=2733, url=null, language=null, rfNumber=[35], rfOrder=36, authorNames=Song G H, Lin Q Q, Zhao H, journalName=The Journal of Clinical Endocrinology and Metabolism, refType=null, unstructuredReference=Song G H, Lin Q Q, Zhao H, et al. Hydrogen activates ATP-binding cassette transporter A1-dependent efflux ex vivo and improves high-density lipoprotein function in patients with hypercholesterolemia: A double-blinded, randomized, and placebo-controlled trial[J]. The Journal of Clinical Endocrinology and Metabolism, 2015, 100(7): 2724-2733., articleTitle=Hydrogen activates ATP-binding cassette transporter A1-dependent efflux ex vivo and improves high-density lipoprotein function in patients with hypercholesterolemia: A double-blinded, randomized, and placebo-controlled trial, refAbstract=null), Reference(id=1242113992550847374, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2014, volume=392, issue=1/2, pageStart=117, pageEnd=124, url=null, language=null, rfNumber=[36], rfOrder=37, authorNames=Xin H G, Zhang B B, Wu Z Q, journalName=Molecular and Cellular Biochemistry, refType=null, unstructuredReference=Xin H G, Zhang B B, Wu Z Q, et al. Consumption of hydrogen-rich water alleviates renal injury in spontaneous hypertensive rats[J]. Molecular and Cellular Biochemistry, 2014, 392(1/2): 117-124., articleTitle=Consumption of hydrogen-rich water alleviates renal injury in spontaneous hypertensive rats, refAbstract=null), Reference(id=1242113992617956239, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=37, issue=1, pageStart=103, pageEnd=108, url=null, language=null, rfNumber=[37], rfOrder=38, authorNames=王金璞, 史红颜, 赵敬国, journalName=山东师范大学学报(自然科学版), refType=null, unstructuredReference=王金璞, 史红颜, 赵敬国. 氢气在运动医学领域应用的研究进展[J]. 山东师范大学学报(自然科学版), 2022, 37(1): 103-108., articleTitle=氢气在运动医学领域应用的研究进展, refAbstract=null), Reference(id=1242113992689259408, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=37, issue=1, pageStart=103, pageEnd=108, url=null, language=null, rfNumber=[37], rfOrder=39, authorNames=Wang J P, Shi H Y, Zhao J G, journalName=Journal of Shandong Normal University (Natural Science), refType=null, unstructuredReference=Wang J P, Shi H Y, Zhao J G. Research progress of hydrogen application in sports medicine[J]. Journal of Shandong Normal University (Natural Science), 2022, 37(1): 103-108. (in Chinese), articleTitle=Research progress of hydrogen application in sports medicine, refAbstract=null), Reference(id=1242113992752173969, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.4103/2045-9912.222448, pmid=29497485, pmcid=null, year=2017, volume=7, issue=4, pageStart=247, pageEnd=255, url=null, language=null, rfNumber=[38], rfOrder=40, authorNames=Mizuno K, Sasaki A T, Ebisu K, journalName=Medical Gas Research, refType=null, unstructuredReference=Mizuno K, Sasaki A T, Ebisu K, et al. Hydrogen-rich water for improvements of mood, anxiety, and autonomic nerve function in daily life[J]. Medical Gas Research, 2017, 7(4): 247-255., articleTitle=Hydrogen-rich water for improvements of mood, anxiety, and autonomic nerve function in daily life, refAbstract=Health and a vibrant life are sought by everyone. To improve quality of life (QOL), maintain a healthy state, and prevent various diseases, evaluations of the effects of potentially QOL-increasing factors are important. Chronic oxidative stress and inflammation cause deteriorations in central nervous system function, leading to low QOL. In healthy individuals, aging, job stress, and cognitive load over several hours also induce increases in oxidative stress, suggesting that preventing the accumulation of oxidative stress caused by daily stress and daily work contributes to maintaining QOL and ameliorating the effects of aging. Hydrogen has anti-oxidant activity and can prevent inflammation, and may thus contribute to improve QOL. The present study aimed to investigate the effects of drinking hydrogen-rich water (HRW) on the QOL of adult volunteers using psychophysiological tests, including questionnaires and tests of autonomic nerve function and cognitive function. In this double-blinded, placebo-controlled study with a two-way crossover design, 26 volunteers (13 females, 13 males; mean age, 34.4 ± 9.9 years) were randomized to either a group administered oral HRW (600 mL/d) or placebo water (PLW, 600 mL/d) for 4 weeks. Change ratios (post-treatment/pre-treatment) for K6 score and sympathetic nerve activity during the resting state were significantly lower after HRW administration than after PLW administration. These results suggest that HRW may reinforce QOL through effects that increase central nervous system functions involving mood, anxiety, and autonomic nerve function.), Reference(id=1242113992823477138, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[39], rfOrder=41, authorNames=Si Y C, Liu L L, Zhang Y Y, journalName=Renal Failure, refType=null, unstructuredReference=Si Y C, Liu L L, Zhang Y Y, et al. Magnesium hydride protects against acetaminophen-induced acute kidney injury by inhibiting TXNIP/NLRP3/nf-κb pathway[J]. Renal Failure, 2024, 46(1), doi: 10.1080/0886022X.2024.2330629., articleTitle=Magnesium hydride protects against acetaminophen-induced acute kidney injury by inhibiting TXNIP/NLRP3/nf-κb pathway, refAbstract=null), Reference(id=1242113992886391699, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2023, volume=12, issue=2, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[40], rfOrder=42, authorNames=Gong F, Yang N L, Xu J C, journalName=Advanced Healthcare Materials, refType=null, unstructuredReference=Gong F, Yang N L, Xu J C, et al. Calcium hydride-based dressing to promote wound healing[J]. Advanced Healthcare Materials, 2023, 12(2), doi: 10.1002/adhm.202201771., articleTitle=Calcium hydride-based dressing to promote wound healing, refAbstract=null), Reference(id=1242113992945111956, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[41], rfOrder=43, authorNames=Johnsen H M, Filtvedt W, Hiorth M, journalName=International Journal of Pharmaceutics, refType=null, unstructuredReference=Johnsen H M, Filtvedt W, Hiorth M, et al. Silicon nanoparticles for oral administration of molecular hydrogen[J]. International Journal of Pharmaceutics, 2022, 629, doi: 10.1016/j.ijpharm.2022.122371., articleTitle=Silicon nanoparticles for oral administration of molecular hydrogen, refAbstract=null), Reference(id=1242113993016415125, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.4103/2045-9912.330692, pmid=34854419, pmcid=null, year=2022, volume=12, issue=3, pageStart=91, pageEnd=99, url=null, language=null, rfNumber=[42], rfOrder=44, authorNames=Tanaka Y, Xiao L, Miwa N, journalName=Medical Gas Research, refType=null, unstructuredReference=Tanaka Y, Xiao L, Miwa N. Hydrogen-rich bath with nano-sized bubbles improves antioxidant capacity based on oxygen radical absorbing and inflammation levels in human serum[J]. Medical Gas Research, 2022, 12(3): 91-99., articleTitle=Hydrogen-rich bath with nano-sized bubbles improves antioxidant capacity based on oxygen radical absorbing and inflammation levels in human serum, refAbstract=This study compared the effects of hydrogen-water (HW) bath on the oxygen radical absorption-based antioxidant capacity and the inflammatory indicator, C-reactive protein (CRP), in serum between healthy volunteers and inflammatory/collagen disease-patients. The HW bath apparatus supplied nano-bubbles with a diameter of 110 ± 10 nm and 338-682 μg/L of dissolved hydrogen after 120 minutes electrolysis, and nano-bubbles increased to 9.91 × 10/mL along with the increase of correlative dissolved hydrogen. Ten-minute HW bath increased the oxygen radical absorption-based antioxidant capacity to 110.9 ± 9.2% at post-bathing 120 minutes, although unaltered with 10-minute normal water bath at 40°C in healthy subjects. The CRP level was repressed to 70.2 ± 12.1% at 120 minutes after HW bath, although rather increased for normal water bath. In the patients with connective tissue diseases, the CRP level was repressed to 3-24% upon 9 days to 4 months of HW bathing. In another six patients with diverse autoimmune-related diseases, upon daily HW bathing as long as 2-25 months, the pre-bathing CRP level of 5.31 mg/dL decreased to 0.24 mg/dL being within the standard-range, with relief of visible inflammatory symptoms for some cases. Thus, the HW bath with high-density nano-bubbles has beneficial effects on serum antioxidant capacity, inflammation, and the skin appearance. The study was approved by the Committee of Ethics, Japanese Center of Anti-Aging Medical Sciences (Authorization No. H-15-03-2, on January 15, 2019), which was a non-profitable organization officially authenticated by the Hiroshima Prefecture Government of Japan.), Reference(id=1242113993096106902, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.19586/j.2095-2341.2023.0005, pmid=null, pmcid=null, year=2023, volume=13, issue=3, pageStart=366, pageEnd=374, url=null, language=null, rfNumber=[43], rfOrder=45, authorNames=马晨, 宋怡菲, 仪杨, journalName=生物技术进展, refType=null, unstructuredReference=马晨, 宋怡菲, 仪杨, . 氢气与线粒体作用关系的研究进展[J]. 生物技术进展, 2023, 13(3): 366-374., articleTitle=氢气与线粒体作用关系的研究进展, refAbstract=氢气是一种无色无味的惰性气体,随着氢分子医学的发展,研究人员发现氢气对多种疾病都有很好的预防和治疗效果,但有关氢干预治疗性效应的作用机制及其具体靶点尚不明确,这些问题都等待着人们深入探索。研究发现,氢气的抗氧化、抗凋亡、调节代谢等都与线粒体有关,同时线粒体还与氢化酶和氢化酶体具有一定程度的同源性,这些发现为氢分子作用机制的研究奠定了基础。对目前已知的与线粒体相关的氢分子作用机制进行了总结,讨论了氢代谢与线粒体之间的关系,以期为后续研究氢分子生物学效应的作用机制提供参考。), Reference(id=1242113993163215767, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=10.19586/j.2095-2341.2023.0005, pmid=null, pmcid=null, year=2023, volume=13, issue=3, pageStart=366, pageEnd=374, url=null, language=null, rfNumber=[43], rfOrder=46, authorNames=Ma C, Song Y F, Yi Y, journalName=Current Biotechnology, refType=null, unstructuredReference=Ma C, Song Y F, Yi Y, et al. Research progress on the relationship between hydrogen and mitochondria[J]. Current Biotechnology, 2023, 13(3): 366-374. (in Chinese), articleTitle=Research progress on the relationship between hydrogen and mitochondria, refAbstract=

Hydrogen is a colorless and tasteless inert gas. With the development of hydrogen molecular medicine, researchers have found that hydrogen has a good preventive and therapeutic effect on a variety of diseases, but the mechanism and specific targets of hydrogen intervention for therapeutic effect are not clear. It has been found that the antioxidant, anti apoptotic, metabolic regulation and other effect of hydrogen are related to mitochondria, and mitochondria also has a certain degree of homology with hydrogenase and hydrogenosome. These foundings have laid the foundation for the research on the mechanism of hydrogen. In this review, we summarized the currently known mechanisms of hydrogen related to mitochondria, and discussed the relationship between hydrogen metabolism and mitochondria, in order to provide reference for the subsequent research on the mechanism of molecular biological effects of hydrogen.

), Reference(id=1242113993230324632, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=13, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[44], rfOrder=47, authorNames=Chen S Q, Zhu Y X, Xu Q Q, journalName=Nature Communications, refType=null, unstructuredReference=Chen S Q, Zhu Y X, Xu Q Q, et al. Photocatalytic glucose depletion and hydrogen generation for diabetic wound healing[J]. Nature Communications, 2022, 13(1), doi: 10.1038/s41467-022-33475-7., articleTitle=Photocatalytic glucose depletion and hydrogen generation for diabetic wound healing, refAbstract=null), Reference(id=1242113993293239193, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=S0142-9612(19)30057-2, pmid=30703744, pmcid=null, year=2019, volume=197, issue=null, pageStart=393, pageEnd=404, url=null, language=null, rfNumber=[45], rfOrder=48, authorNames=Zhang L, Zhao P H, Yue C P, journalName=Biomaterials, refType=null, unstructuredReference=Zhang L, Zhao P H, Yue C P, et al. Sustained release of bioactive hydrogen by Pd hydride nanoparticles overcomes Alzheimer’s disease[J]. Biomaterials, 2019, 197: 393-404., articleTitle=Sustained release of bioactive hydrogen by Pd hydride nanoparticles overcomes Alzheimer’s disease, refAbstract=Oxidative stress-induced mitochondrial dysfunction plays an important role in the pathogenesis of Alzheimer's disease (AD). Hydrogen molecule, a special antioxidant, can selectively scavenge highly cytotoxic reactive oxygen species such as ·OH, exhibiting a potential to treat AD by reducing oxidative stress. However, there is no effective route to realize the continuous and efficient accumulation of administrated hydrogen in AD brain owing to its low solubility. Here, we develop the small-sized Pd hydride (PdH) nanoparticles for high payload of hydrogen and in situ sustained hydrogen release in AD brain. By virtue of the catalytic hydrogenation effect of Pd, the released hydrogen from PdH nanoparticles exhibits high bio-reductivity in favor of effectively scavenging cytotoxic ·OH in a self-catalysis way. Bio-reductive hydrogen is able to recover mitochondrial dysfunction, inhibit Aβ generation and aggregation, block synaptic and neuronal apoptosis and promote neuronal energy metabolism by eliminating oxidative stress and activating the anti-oxidative pathway, consequently ameliorating the cognitive impairment in AD mice. The proposed hydrogen-releasing nanomedicine strategy would open a new window for the treatment of AD.Copyright © 2019 Elsevier Ltd. All rights reserved.), Reference(id=1242113993372930970, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2019, volume=40, issue=6, pageStart=586, pageEnd=589, url=null, language=null, rfNumber=[46], rfOrder=49, authorNames=李超富, 高云姝, 周洲, journalName=解放军医学院学报, refType=null, unstructuredReference=李超富, 高云姝, 周洲, . 富氢水协同金复康口服液阻断硫代乙酰胺诱发大鼠胆管癌上皮癌变的实验研究[J]. 解放军医学院学报, 2019, 40(6): 586-589, 604., articleTitle=富氢水协同金复康口服液阻断硫代乙酰胺诱发大鼠胆管癌上皮癌变的实验研究, refAbstract=null), Reference(id=1242113993435845531, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2019, volume=40, issue=6, pageStart=586, pageEnd=589, url=null, language=null, rfNumber=[46], rfOrder=50, authorNames=Li C F, Gao Y S, Zhou Z, journalName=Academic Journal of Chinese PLA Medical School, refType=null, unstructuredReference=Li C F, Gao Y S, Zhou Z, et al. Synergistic effect of hydrogen-rich water and Jinfukang oral liquid in prevention of cholangiocarcinoma in rats induced by thioacetamide[J]. Academic Journal of Chinese PLA Medical School, 2019, 40(6): 586-589, 604. (in Chinese), articleTitle=Synergistic effect of hydrogen-rich water and Jinfukang oral liquid in prevention of cholangiocarcinoma in rats induced by thioacetamide, refAbstract=null), Reference(id=1242113993528120220, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2024, volume=17, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[47], rfOrder=51, authorNames=Artamonov M Y, LeBaron T W, Pyatakovich F A, journalName=Pharmaceuticals, refType=null, unstructuredReference=Artamonov M Y, LeBaron T W, Pyatakovich F A, et al. Mesenchymal stem cell priming: Potential benefits of administration of molecular hydrogen[J]. Pharmaceuticals, 2024, 17(4), doi: 10.3390/ph17040469., articleTitle=Mesenchymal stem cell priming: Potential benefits of administration of molecular hydrogen, refAbstract=null), Reference(id=1242113993624589213, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2022, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[48], rfOrder=52, authorNames=Kong X F, Lu T Y, Lu Y Y, journalName=Frontiers in Medicine, refType=null, unstructuredReference=Kong X F, Lu T Y, Lu Y Y, et al. Effect of hydrogen inhalation therapy on hearing loss of patients with nasopharyngeal carcinoma after radiotherapy[J]. Frontiers in Medicine, 2022, 9, doi: 10.3389/fmed.2022.828370., articleTitle=Effect of hydrogen inhalation therapy on hearing loss of patients with nasopharyngeal carcinoma after radiotherapy, refAbstract=null), Reference(id=1242113993691698078, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, doi=null, pmid=null, pmcid=null, year=2015, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[49], rfOrder=53, authorNames=Runtuwene J, Amitani H, Amitani M, journalName=Peer J, refType=null, unstructuredReference=Runtuwene J, Amitani H, Amitani M, et al. Hydrogen-water enhances 5-fluorouracil-induced inhibition of colon cancer[J]. Peer J, 2015, 3, doi: 10.7717/peerj.859., articleTitle=Hydrogen-water enhances 5-fluorouracil-induced inhibition of colon cancer, refAbstract=null)], funds=[Fund(id=1242113988327183206, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, awardId=21QNPY035, language=CN, fundingSource=军队医学科技青年培养项目(21QNPY035), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1242113985382781772, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, xref=null, ext=[AuthorCompanyExt(id=1242113985391170381, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, companyId=1242113985382781772, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Naval Medicine, Naval Medical University, Shanghai 200433, China), AuthorCompanyExt(id=1242113985399558990, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, companyId=1242113985382781772, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=海军军医大学海军医学系,上海 200433)])], figs=[ArticleFig(id=1242113988121662308, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, language=EN, label=Table 1, caption=

Milestone events in evolution of hydrogen medicine

, figureFileSmall=null, figureFileBig=null, tableContent=
时间 代表性工作 研究团队 贡献
1941年 氢气应用于大深度饱和潜水[6] Case和Haldane 证实了氢气的生物安全性
1975年 高压氢气治疗小鼠皮肤鳞状细胞癌[9] Dole等 发现氢气具有治疗疾病的作用
2007年 低浓度氢气通过选择性清除羟自由基改善大鼠脑缺血再灌注后的脑损伤[10] 太田成男等 提出氢气的选择性抗氧化作用,开启了现代氢医学研究热潮
2008年 富氢生理盐水对脑缺血再灌注后的神经保护作用[11] 孙学军等 国内首个氢医学研究,引领并带动国内氢医学发展
2013年 富氢水改善血脂的临床试验[12] 秦树存等 国内首次双盲对照试验
2018年 利用纳米钯材料的氢热协同效应治疗肿瘤[13] 何前军等 开启了氢医学和材料领域的交叉研究
2020年 氢氧雾化吸入设备获批三类医疗器械 相关企业 标志着氢医学正式进入临床应用
2021年 多中心随机对照试验研究证明氢氧混合气能够改善慢性阻塞性肺疾病急性加重期症状[14] 钟南山等 氢气医学迈入高水平临床研究
2024年 氢气可作为肠道菌群甾体激素21去羟化酶的底物[15] Devlin等 为氢气参与机体生化反应提供了直接证据
), ArticleFig(id=1242113988201354085, tenantId=1146029695717560320, journalId=1146032081894723586, articleId=1157002945280693081, language=CN, label=表1, caption=

氢医学发展中的代表性工作

, figureFileSmall=null, figureFileBig=null, tableContent=
时间 代表性工作 研究团队 贡献
1941年 氢气应用于大深度饱和潜水[6] Case和Haldane 证实了氢气的生物安全性
1975年 高压氢气治疗小鼠皮肤鳞状细胞癌[9] Dole等 发现氢气具有治疗疾病的作用
2007年 低浓度氢气通过选择性清除羟自由基改善大鼠脑缺血再灌注后的脑损伤[10] 太田成男等 提出氢气的选择性抗氧化作用,开启了现代氢医学研究热潮
2008年 富氢生理盐水对脑缺血再灌注后的神经保护作用[11] 孙学军等 国内首个氢医学研究,引领并带动国内氢医学发展
2013年 富氢水改善血脂的临床试验[12] 秦树存等 国内首次双盲对照试验
2018年 利用纳米钯材料的氢热协同效应治疗肿瘤[13] 何前军等 开启了氢医学和材料领域的交叉研究
2020年 氢氧雾化吸入设备获批三类医疗器械 相关企业 标志着氢医学正式进入临床应用
2021年 多中心随机对照试验研究证明氢氧混合气能够改善慢性阻塞性肺疾病急性加重期症状[14] 钟南山等 氢气医学迈入高水平临床研究
2024年 氢气可作为肠道菌群甾体激素21去羟化酶的底物[15] Devlin等 为氢气参与机体生化反应提供了直接证据
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卢宏涛 , 孙学军
前瞻科技 | 综述与述评 2024,3(4): 69-78
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前瞻科技 | 综述与述评 2024, 3(4): 69-78
氢医学研究现状、趋势与发展建议
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卢宏涛 , 孙学军
作者信息
  • 海军军医大学海军医学系,上海 200433
  • 卢宏涛,讲师。主要从事氢医学与代谢性疾病研究。入选全军医学科技青年培育计划、上海市扬帆计划。主持各类科研与人才项目5项。出版专著3部,发表论文10余篇。电子信箱:

    孙学军,教授,博士研究生导师。上海交通大学氢科学中心兼职教授。中国医疗保健国际交流促进会常务理事,中国医疗保健国际交流促进会氢分子生物医学分会主任委员,中国健康促进基金会氢分子生物医学发展专项基金副理事长和专家委员会主席。主要从事气体生物学研究。主持国家自然科学基金项目3项。出版专著3部,发表论文260余篇。电子信箱:

通信作者:

Research Progress, Trends, and Suggestion in Hydrogen Medicine
Hongtao LU , Xuejun SUN
Affiliations
  • Department of Naval Medicine, Naval Medical University, Shanghai 200433, China
出版时间: 2024-12-20 doi: 10.3981/j.issn.2097-0781.2024.04.006
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氢作为自然界中最简单的元素,无论是在宇宙的起源还是在生命的进化过程中,都扮演着至关重要的角色。近年来,氢医学领域迅速崛起,展现出新的发展趋势,同时也遭遇了诸多挑战。文章通过回顾氢医学发展历程中的关键事件,梳理其发展的总体趋势。从氢医学的效应证据、分子机制、研究范围与模式等方面总结现状及研判趋势,并针对氢医学目前所面临的挑战提出相应的发展建议。

氢医学  /  选择性抗氧化  /  临床研究  /  机制研究  /  学科交叉

Hydrogen, the universe’s most elementary element, plays a crucial role in cosmic genesis and the evolution of life. In recent times, the field of hydrogen medicine has experienced rapid advancements, revealing novel trends and challenges. This review delineated significant milestone events in the evolution of hydrogen medicine and sorted out the general trend of its development. It evaluated the present state and emerging trends of hydrogen medicine in terms of therapeutic effects, molecular mechanisms, research domains, and models. The review also provides recommendations for addressing current challenges in hydrogen medicine.

hydrogen medicine  /  selective oxidation resistance  /  clinical research  /  mechanism research  /  interdiscipline
卢宏涛, 孙学军. 氢医学研究现状、趋势与发展建议. 前瞻科技, 2024 , 3 (4) : 69 -78 . DOI: 10.3981/j.issn.2097-0781.2024.04.006
Hongtao LU, Xuejun SUN. Research Progress, Trends, and Suggestion in Hydrogen Medicine[J]. Science and Technology Foresight, 2024 , 3 (4) : 69 -78 . DOI: 10.3981/j.issn.2097-0781.2024.04.006
氢位于元素周期表之首,自宇宙诞生以来,氢气就在宇宙演化进程中扮演关键角色。18世纪至今,人们对氢气进行了长期、全面的研究,对氢气的化学与物理性质及其在宇宙物质演化中的核心地位已有深刻的认识。作为一种终极清洁能源载体,氢气正受到全球范围内的广泛重视。
在生命起源的原始地球大气中,氢气占比极高[1]。研究表明,氢气是生命起源的基本环境因素。20世纪关于有机物化学进化过程的米勒实验等研究揭示了氢气是参与前生命有机分子进化的必需物质基础[2]。作为最简单的还原底物分子,氢气为原始生命的产生提供了能量基础。原核细胞到真核细胞的转变是地球生命进化中的最重大转折点,是地球真菌、动植物等复杂生命形式形成的进化原点,而线粒体的出现是真核细胞能量代谢的结构基础和多细胞生物进化的基本条件。目前学术界认为,线粒体起源于一种古老的α变形菌[3],这种作为线粒体祖先的细菌也恰好是合成氢气的细菌[4-5]。无论从生命诞生的物质基础,还是到进化过程中低等生物对氢气的利用,都充分展现了氢气对生命体的独特性,氢无疑是一种“生命元素”。
然而,氢的生物医学效应长期被大众乃至学术界所忽视。在大多情况下,人们对氢气的认知存在“刻板印象”,难以接受其具有显著的生物学效应。进入21世纪以来,生命科学发展迅速,氢这种最简单的元素偶然进入了生物学和医学家的视野。由于人们对氢气性质的全面了解,特别是潜水医学领域对氢气的生物安全性的系统研究,当氢气生物效应发现后,其医学价值迅速受到重视。仅仅在过去17年里,氢气的生物医学效应就被广泛研究,已有超过2 000篇同行评议论文先后发表,并形成独特的氢医学理论体系。
中国学者在氢气生物医学领域也作出了重要贡献。2020年,氢气吸入设备也获得了中国医疗器械的认证,批准用于慢性阻塞性肺病急性期的辅助治疗。同时,在中国工程院院士钟南山等专家的支持下,该设备被应用于新冠肺炎患者的治疗。中国氢医学学术和相关产业已从过去的跟随者和空白状态,发展成为该领域的国际领先者。近年来,氢医学研究出现了新变化和新趋势,包括研究内容和研究模式上的创新。因此,文章从氢医学的现状、发展趋势及未来展望等方面进行综述,旨在帮助对该领域有兴趣的读者对这一新兴领域有初步准确的了解。
高气压是潜水活动所独有的挑战,而经典的压缩空气潜水面临着三大难以逾越的生理极限,即氧气毒性、氮气麻醉性及压缩空气的呼吸阻力增加。人们尝试用氦气解决以上问题,然而氦气在潜水应用中的最大障碍是其资源稀缺性,同时氦气潜水也无法避免大深度潜水时的高压神经综合征的问题。为突破氦气潜水的局限性,自20世纪40年代起,欧洲潜水医学界先驱率先开展氢气应用于大深度潜水的系列研究[6]。后续研究发现,即使在数十个大气压的高压氢气条件下,除了对心率有抑制作用和轻微中枢神经系统麻醉作用外,几乎不存在毒性[7-8]。相较而言,氢气的疾病治疗作用几乎被忽视。1975年,美国学者在Science上发表文章,证明8 atm(1 atm=1.013×105 Pa)氢气吸入能治疗小鼠的皮肤鳞状细胞癌[9]。然而,这一研究并未引起学术界的关注,主要原因可能是考虑到使用高压氢气存在爆燃的风险,几乎无法实现临床应用。
氢医学研究的转折点出现在2007年。一家从事氢水商业推广的日本东京企业,偶然发现氢气可能具有健康促进效应,之后委托日本医科大学老年病研究所教授太田成男开展这一研究。该研究发现氢气具有抗细胞氧化损伤和动物脑缺血损伤的治疗作用。2007年,该团队在Nature Medicine上发表了氢气生物学效应的重要研究成果。他们发现,即使在2%~4%的低含量下,氢气依然能够通过选择性清除羟自由基来改善大鼠脑缺血再灌注后的脑损伤[10]。由于空气中含量低于4%的氢气没有燃烧和爆炸风险,这一发现为氢气的安全使用提供了新的可能性。
随后,国内具有潜水医学背景的海军军医大学教授孙学军意识到氢气作为最简单气体,其在生物学应用中具有广泛前景。2008年,孙学军团队发表了国内第1篇氢气医学研究论文[11],并在往后的十几年间开展了一系列研究工作,这也为包括山东第一医科大学教授秦树存、北京工业大学教授马雪梅、西安交通大学教授刘健康等在内的中国学者在氢气医学领域的重要贡献奠定了基础。2013年,秦树存发表了第1篇双盲对照临床试验,证明饮用氢水对人类高血脂患者的有益作用[12]。早期阶段,氢气应用的形式主要为气体或其饱和水溶液。在氢气应用方式方面,深圳大学和上海交通大学氢科学中心教授何前军做了大量创新性和突破性的工作。2018年,何前军团队在Nature Communications发表氢医学领域重要研究进展,利用纳米钯材料的氢热协同效应治疗肿瘤,此后何前军将氢医学带入了氢材料的交叉领域[13]。2020年2月,氢氧雾化吸入设备获批三类医疗器械,这是国际上第1家获得监管机构批准的氢气医疗设备,标志着中国在氢气临床技术研发领域处于国际领先地位,也意味着氢医学从基础走向临床跨出了一大步。2021年,钟南山团队通过多中心双盲安慰剂对照临床试验证明氢氧混合气能够改善慢性阻塞性肺疾病急性加重期症状,这也代表着氢气医学迈入高水平临床研究[14]。与此同时,在基础研究方面,2024年Cell发表的文章非常明确地证明氢气是甾体激素21去羟化酶的底物,可以直接参与生命体物质代谢[15],这为解决氢医学领域的核心问题,也就是氢气的生物学效应分子提供了非常有价值的参考。2022年,国际氢医学组织授予秦树存、何前军、孙学军“氢分子研究杰出领导力”奖,足以说明中国学者在氢医学领域的贡献得到充分认可。笔者基于个人观点,梳理了氢医学发展中的代表性工作(表1),然而中国氢医学发展水平在国际处于领先地位离不开所有氢医学研究学者们的共同努力。
氢医学之所以能够在不到20年的时间里发展到如今的规模和体量,很大的原因就是得益于氢医学的基础研究工作。动物实验是氢医学基础研究中最为重要的部分,不同的模式动物,包括但不限于大小鼠、家兔、线虫、果蝇等被应用于氢气治疗疾病的效应评价中。目前,氢医学研究几乎涵盖了所有系统的各类疾病,超过170种疾病模型。北京工业大学教授马雪梅团队对氢气治疗动物模型的疾病谱进行了全面且系统的总结,其可归纳为七大类28种疾病,包括代谢性疾病、神经系统疾病、心血管疾病、呼吸系统疾病、皮肤病及各类肿瘤等[16]
随着氢医学基础研究对疾病种类的趋于饱和,以及氢医学转化应用的需要,高质量的临床研究逐步受到重视。目前,氢医学的临床研究论文总量已经突破160篇,包括呼吸、循环、消化在内的人体主要系统。不同的氢气治疗手段对于不同系统的疾病具有各自的优势。例如,呼吸系统适合氢气吸入,消化系统适合氢水饮用。在呼吸系统临床研究中,有证据表明氢氧混合气能够减少气道呼吸阻力,缓解慢性阻塞性肺疾病患者急性加重期症状[14]。此外,另一项研究表明氢气对2019冠状病毒病(COVID-19)引起的急性呼吸窘迫同样具有改善作用,可提高缺氧患者的氧饱和度[17]。对于呼吸系统而言,氢气吸入具有天然的优势,氢气分子量小、气道阻力低,同时其能够直接作用肺泡上皮细胞,并迅速通过气体交换进入循环。氢气在消化系统的临床应用,早期主要利用氢气呼气试验作为胃肠道疾病的诊断,随后逐渐有研究者关注到富氢水能够增加肠道双歧杆菌水平,从而发挥对机体的潜在益处[18]。除了直接使用富氢水干预之外,有研究巧妙地利用肠道菌群可以利用益生元产氢的原理,使用阿卡波糖内源性增加氢气产生,从而改善2型糖尿病患者的炎症水平,该效应可能不基于血糖调控[19]。以肠道菌群作为媒介研究氢气对消化系统疾病的作用给临床研究打开了新思路。日本一直处于氢医学的临床研究前列,特别是开创性地利用血液透析和腹膜透析高通量的液体交换,将氢气输送进入机体内,临床研究发现,富氢血液透析可以有效降低在透析过程中的氧化应激水平,并改善患者的营养状况[20]。更为重要的是,富氢血液透析能够改善患者的预后,降低患者心血管事件的发生[21-22]。以上部分典型的氢医学临床研究为推动氢医学走向应用起到了引领性的作用,而未来氢医学需要的是更多高水平的临床研究为氢气的有效性提供强有力的证据。
得益于氢气独特的理化性质,氢分子能够快速穿透生物膜,到达细胞及亚细胞内并发挥效能。逐渐增多的证据表明,氢气具有显著的抗氧化、抗炎、减少细胞死亡等作用。氧化应激是指在某些特殊状态下,如压力、吸烟、饮酒、辐射、空气污染等导致机体氧化产物与抗氧化防御系统失衡,引起机体器官系统受损[23-24]。其中,机体氧化产物包括活性氧、活性氮等在组织脏器中蓄积,可能造成DNA、蛋白质和脂质氧化损害。
氢气发挥抗氧化作用的机制可归纳为以下两点:一是氢分子通过随机碰撞与自由基发生非酶促相互作用。这种相互作用具有强选择性,即氢气容易与氧化能力较强的氧化剂发生反应,如羟自由基、过氧亚硝基阴离子,这两种强氧化剂易与核酸、脂质和蛋白质反应,导致DNA断裂、脂质过氧化和蛋白质失活。而氢气对于那些氧化能力较弱的信号氧化剂,如超氧阴离子、一氧化氮、过氧化氢等反应性较低[10]。氢气的这种选择抗氧化性能很好避免强氧化剂对生物大分子造成的氧化应激损伤,且不影响机体本身信号转导相关的活性氧。由此从调节氧化应激的角度来看,氢气比普通氧化剂,如维生素C、维生素E等更具优势。二是氢气可能通过激活内源性抗氧化系统实现抗氧化作用,如氢气能通过增加过氧化氢酶、超氧化物歧化酶或血红素氧合酶-1的表达来提高细胞保护效应[25-26]
氢气可以通过直接下调炎症细胞因子阻止中性粒细胞和巨噬细胞的浸润来抑制组织损伤[27-29]。同时,氢气减轻炎症的反应也可能与其调节细胞信号传导和基因表达相关。有学者利用脓毒血症的小鼠肺脏、肝脏、肠道多脏器转录组芯片联合分析发现,氢气能显著调控多个急性炎症期反应信号通路[30]。此外,氢气也被证明具有抗凋亡、调节能量代谢及细胞信号通路等作用。
随着氢气有效性证据的不断增多,随之而来的问题是氢气作用的靶分子是什么。氢气通过清除羟自由基发挥抗氧化的作用是明确的,而氢气是否能够通过影响自由基水平进而调控生物大分子的表观修饰值得探讨。以上机制都是基于氢气和自由基的直接反应,特别是羟自由基。有研究表明,铁卟啉可以作为氢气分子催化剂,介导催化加氢反应[31]。此外,也有学者提出氢气是否能够通过类似惰性气体的形式作用蛋白质分子[32],但氢气足够小,存在类似氙气口袋可能性极小。最近,哈佛大学研究人员在Cell发表关于氢气作为21脱羟基酶底物参与肠道内孕激素的生成的研究,提示这种酶可能是氢气发挥生物作用的调控分子,这一线索将有助于人们寻找到氢气的特异性生理效应靶向分子[15]。无论如何,对于氢气直接作用靶点的探索必然是氢医学未来需要攻克的难题。
过去的氢医学无论是基础研究还是临床研究,更多的关注点还是在疾病的治疗上。然而无论是氢气的生物学效应的特点,还是氢气的应用形式,人们使用氢气更理想的是一种以日常生活方式的形式融入到整个生命周期。氢气与药物最大的不同点在于,其对生物体极高的安全性,客观上保证了氢气能够长期使用。此外,经济性方面,其以极低的成本换取潜在的健康,是氢气能够作为日常健康维护重要手段的原因。
2024年6月,国家卫生健康委员会发布了《关于开展全面健康素养提升3年行动(2024—2027年)的通知》,重点强调进一步推动卫生健康工作从“以治病为中心”向“以健康为中心”转变。氢医学的内在属性决定了其要坚持“以健康为中心”,发挥疾病预防与健康促进的作用。从三级预防的角度,氢医学在各级预防中都能发挥有效作用。从氢气的效应和机制上看,氢气可以达到“治未病”的效果,实现病因预防。氢气在疾病早期同样可以起到逆转或者减缓进展的效果,发挥临床前的预防作用。在临床预防上,氢气的使用可以配合药物或者临床治疗手段,不仅可以提高治疗效果,还可以改善生活质量减少临床治疗的副作用。
从健康促进或疾病预防的手段上来说,营养、运动、心理和康复是非常重要的环节。目前,研究发现氢气对于食物营养价值及人体营养代谢都可产生影响。食品安全是讨论食物营养价值的前提,同时也是食物营养价值的一部分。例如,油脂氧化后酸度值会增加,不仅影响口感,同时也会对机体造成潜在危害。一项研究表明,富氢水洗涤黄油可以降低其酸度值[33],在保证口感的同时增加安全性。气调保鲜技术是果蔬运输储存延长保鲜时间的重要手段。氢气气调对于延长果蔬保质期、维持活性营养素成分有显著价值[34]。氢气对人体营养物质代谢的影响可以总结为两大方面:一方面氢气能够调控营养物质的消化吸收和代谢,特别是脂代谢方面,秦树存团队做了大量工作,如发现氢气能够调控胆固醇转运等[35],对脂代谢紊乱具有预防价值;另一方面,氢气能够协同营养物质更好地发挥后者的生理功能,如氢气能够协同维生素C发挥效应[36]。运动在维持机体健康当中的地位是任何其他手段无法取代的,诸多的因素可能会限制或者影响运动的健康效益。氢气在提高运动表现及加快能力恢复上展现出卓越的效果,这能够为运动者增强信心并激发动力,同时氢气可以防治运动伤的发生,延长运动员职业生涯[37]。心理作为健康表现的另一维度,重要性也不容忽视。氢气被证明能够改善使用者的心理状况,如焦虑、抑郁等情绪[38]。从“以治病为中心”向“以健康为中心”转变过程中,氢医学大有可为。笔者认为氢医学研究的方向需要向疾病预防倾斜。
回顾氢医学的发展之路,研究者对于氢气的认知是在不断突破的。当氢气出现在生物医学领域时,必然面对很多的质疑。因此,氢医学研究者按照传统医学研究的规律和方法,逐步摸索和探究氢气的生物学效应。以往的氢医学研究大多聚焦在以药理学研究为代表的经典研究。然而,当以经典思路探索氢气的规律时,氢气独一无二的性质导致很难用常规的手段对其进行评价。因此,近年来,研究者不断在尝试用新的手段、新的理论、新的工具去解决氢医学问题。
为了解决氢气给药的局限性,固态氢载体被用于氢医学研究,其中,以氢化镁[39]、氢化钙[40]及纳米硅[41]为代表的固态氢载体被用于各类疾病模型。固态氢载体最大的优势在于能够有效控制剂量且实现高剂量给氢,为氢气的剂量效应研究提供了新手段。在提高氢气剂量上,有研究采用完全不同的思路,将氢气以纳米气泡(1 µm以下)的形式分散在水中,一方面增加了水中的氢含量,另一方面延长了氢气在水中的时间[42]。氢医学基础研究的困境很大程度上是受限于氢气检测技术,由于氢分子足够小,现有的检测设备很难完成氢气的体内检测。因此,环境检测中的氢电极被应用于监测动物体内氢含量的变化。但由于该方法对检测对象的稳定性要求较高,而活体检测对象是动态变化的,因此该方法在动物体内检测时存在局限性。近年来,生物传感器被广泛地应用于生物医学研究。基于此思路,何前军团队利用铁卟啉作为氢气分子的生物传感器开发了氢探针,可以用于检测体内氢气含量[31]。除了技术上的突破与创新外,在氢医学理论层面,马雪梅教授提出了线粒体I氢化酶活性假说,核心观点为线粒体复合物I仍然保留氢化酶活性,能够直接利用或者生成氢气,进而维持氧化还原稳态[43]。2024年,发表在Cell的研究发现肠道菌群在甾体激素21去羟化酶参与下以氢气作为辅基调控物质代谢[15],该研究为氢气、肠道菌群和健康效应之间的联系开创了新的理论基础。氢医学理论和技术上的创新,是其发展的原动力,国内外学者也在积极探索,期望在氢医学的基础研究上取得突破性进展。
学科的交叉融合是未来氢医学突破的一个重要方向,也是推动氢医学应用的重要途径。近年来,材料学和纳米技术的发展也给氢医学带来了机遇,结合药物的靶向传递技术,研究人员利用纳米载体(如纳米颗粒、纳米棒等)实现了局部产生和释放氢气的目的。典型研究包括光催化TiO2释氢治疗糖尿病伤口愈合[44]、纳米钯催化[45]产氢治疗阿尔茨海默病、热疗联合PdH0.2纳米材料释氢治疗乳腺癌[13]等。氢医学效应特点与中医药有许多相似之处,国内学者将氢医学与中医相结合,提出了氢中医理论;氢气联合中药实现了疗效的倍增[46]。氢气联合干细胞、氢气联合营养素、氢气联合放化疗等都被证明取得了显著的效果[47-49]。氢医学与其他学科领域的交叉融合是其实践过程中的重要探索。但要实现更大的突破,需要创造性地理解和深化这种交叉的形式与深度。
氢医学的特点和优势决定了其在人们追求更高健康水平的道路上能够扮演重要的角色。氢医学具有突出优势。一是安全性。经过潜水医学及氢医学的验证,氢气具有极高的生物安全性。二是经济性。随着中国老龄化的不断加剧,国家的医疗负担也在不断加重,任何一种医疗手段都需要考虑卫生经济学,氢气来源广、易获取的特点,造就了其作为一种健康促进手段,具有极高的经济性。三是便捷性。氢气吸入和饮用氢水作为最常规的两种氢气使用方式,其可以在多个场景下实现;最为重要的是,目前的氢产品已经实现用氢的家庭化和智能化。基于以上特点和优势,氢医学才有了广泛的应用性与实用性。氢医学已经实现了从无到有、从小到大的转变,但尚未实现从弱到强的蜕变,在发展过程中仍然存在一些问题与挑战。
(1)尽管氢医学的科学性得到了一些支持,但公众和部分学者仍对其持怀疑态度。由于氢医学研究起步较晚,研究人员相对较少,加之人们对氢气应用的固有偏见,以及非专业人士对氢气效应的夸大,加剧了公众对氢医学的质疑。
(2)氢医学的理论体系尚未成熟,存在不确定性,无法全面解释所有氢生物学效应。一方面,作为一门新兴学科,氢医学需要时间来发展,许多关键的科学问题尚未得到解答;另一方面,现有的生物医学理论体系尚不能完全阐释氢气的生物学效应。
(3)氢医学的基础研究面临技术挑战和限制,氢气的检测、追踪和定位难题阻碍了该领域的发展。氢气分子量小、易于扩散,难以在体内长时间保持,加之使用条件和灵敏度的限制,导致现有的氢气检测设备无法满足生物体内氢气检测的需求。
(4)氢医学缺乏高等级的临床证据,迫切需要投入大量资源进行高质量的临床研究。这类研究需要大量的人力、物力和财力支持,而氢气作为最简单的分子,其作为药物的商业潜力似乎不足以吸引足够的投资。
(5)氢健康产业在规模和质量上面临挑战,恶性竞争阻碍了良好产业生态的形成。对氢医学的认知影响了公众对相关产品的接受程度,导致氢医学相关产品的市场需求较低,难以形成有效的产业集群。
氢医学作为医学领域的一股新兴力量,其发展自然伴随着一系列问题与挑战。文章提出以下5点发展建议。
(1)整合优势资源,明确关键科学问题。面对氢医学当前的难题,迫切需要跨学科、跨领域的专家团队共同攻关。建议整合氢医学研究的优质资源,消除学科间的障碍,联合相关学科,吸引高水平研究者,集中各方面的力量,共同识别并列出氢医学的核心科学问题,形成一份详尽的问题清单。
(2)以问题为中心,组织科研活动。针对氢医学的关键科学问题,参考其他关键领域的成功研究模式,制定专项任务指南。建议在各级政府的支持下,设立氢医学领域的“揭榜挂帅”项目,采用更开放的方式,有针对性地解决氢医学的瓶颈问题。
(3)构建专业平台,加快人才队伍建设。鉴于氢医学的独特性,现有的医学研究平台无法完全满足其研究需求。建议以现有的优势平台为基础,建立一个更为完善、合理、专业的氢医学研究平台,并加速氢医学专业人才的培养,从而提升氢医学的整体实力。
(4)推广科普知识,增强氢医学的社会影响力。以国内氢医学专家为核心,组建专业的氢医学科普团队,并培养科普人才。建议设立专门的科普项目,并利用有影响力的科普平台,加快氢医学知识的普及。
(5)制定行业标准,推动产业的良性发展。建议建立行业标准,鼓励有实力的国有企业参与氢健康领域,树立行业典范,引领行业发展。通过整合国内的优质资源,形成氢健康产业链,促进产业的良性循环。
氢气的人体安全性高,医学效应明确,广泛适用于大众的健康维护与疾病预防。虽然当前仍然存在诸多困难,但随着大众对健康需求的不断提高,氢医学也将迎来发展的黄金期。氢医学应立足于产学研一体化发展思路,在有组织科研思想的指导下,携手氢能源氢农业,在氢科学领域发挥更大贡献。
  • 军队医学科技青年培养项目(21QNPY035)
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doi: 10.3981/j.issn.2097-0781.2024.04.006
  • 接收时间:2024-10-15
  • 出版时间:2024-12-20
  • 发布时间:2024-12-24
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  • 收稿日期:2024-10-15
  • 修回日期:2024-10-30
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军队医学科技青年培养项目(21QNPY035)
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    海军军医大学海军医学系,上海 200433

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表12种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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