Stroke is the most important disease that threatens human life in today’s world. A new study published in the “New England Journal of Medicine” shows that about a quarter of people over the age of 25 in the world may suffer a stroke in their lifetime.
Stroke has the characteristics of high morbidity, high mortality, high disability rate, high recurrence rate and many complications. Having a stroke, it not only brings great misfortune to the patients themselves, but also to the whole family.
Once a stroke caused by cerebral ischemia or cerebral hemorrhage occurs, even if it recovers as soon as possible, damage to brain tissue cells cannot be avoided, so protecting nerve cells is an important work in stroke research.
The pathological process of cerebral ischemia is complex, and it is difficult for a single molecule to successfully block apoptosis and cytotoxic effects at the same time. Another difficulty is that these neuroprotective agents are difficult to spread across the semi-dark area of cerebral ischemic tissue to the target tissue. Potentially successful neuroprotective drugs must be: easy to spread in tissues, possess multiple pathological intervention effects, and rarely have toxic and negative effects. Therefore, the study of the neuroprotective effect of hydrogen has gradually become a new topic that interests many people.
Hydrogen has many advantages, such as ease of use, ease of manufacture, diffusion across cell membranes, relatively inertness, and only reacts with toxic reactive oxygen. And hydrogen can affect a variety of pathophysiological pathways.
Adrian Marchidann of Stony Brook University Hospital in the USA published an Editorial article in “Future Neurol”, proving that hydrogen can reduce the hydroxyl radicals to protect PC12 in the cultivation of cells, while not affecting the active oxygen with signaling effect. Hydrogen has also been shown to reduce lipid peroxidation, avoid DNA oxidation, and reduce glutamate-induced neuronal cell death. Hydrogen can also regulate cellular oxidative stress, inflammation, and apoptosis pathways.
Edaravone is currently the only antioxidant drug approved for stroke treatment. Japanese scholar Ono et al. carried out a clinical study of intravenous hydrogen-saturated saline combined with edaravone in the treatment of brainstem infarction, and compared it with the drug edaravone alone. Among them, 8 patients were treated with intravenous hydrogen-saturated saline. 26 patients were treated with Edaravone. MRI diffusion-weighted imaging technique was used to observe the local apparent diffusion coefficient and pseudo-diffusion imaging and coefficient normal time (a clinical indicator to evaluate the degree of brain injury), etc. to evaluate the treatment effect.
It was found that the above-mentioned nuclear magnetic resonance detection indexes of hydrogen combined with edaravone were better than those using edaravone alone. The main principle of the action of edaravone is anti-oxidation, which is very similar to the effect of hydrogen. The combined effect of the two exceeds the results of edaravone and has a more ideal therapeutic effect.
Also, in a prospective randomized clinical trial of 25 patients with cerebral ischemia, 3% hydrogen was inhaled for 1 hour, 2 times a day, for 7 consecutive days. The hydrogen level reached the platform after 20 minutes, and the inhalation fell to 10% after 6-18 minutes. Most of the vital indicators and blood tests did not change, but the oxygen saturation of the hydrogen treatment group increased significantly, and the clinical improvement rate also significantly exceeded the control group.
Evidence from the cell, animal, and human studies has shown that hydrogen can be safely used as a neuroprotective agent for revascularization, and there is enough research data to summon large-scale double-blind placebo studies to confirm and evaluate the effect of hydrogen on acute stroke.