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Text from PDF Page: 001Shen et al. Medical Gas Research 2014, 4:17 http://www.medicalgasresearch.com/content/4/1/17 MEDICAL GAS RESEARCH REVIEW Open Access A review of experimental studies of hydrogen as a new therapeutic agent in emergency and critical care medicine Meihua Shen1†, Hongying Zhang2†, Congjun Yu1, Fan Wang3 and Xuejun Sun4* Abstract Hydrogen is the most abundant chemical element in the Universe, but is seldom regarded as a therapeutic agent. Recent evidence has shown that hydrogen is a potent antioxidative, antiapoptotic and anti-inflammatory agent and so may have potential medical applications in cells, tissues and organs. There are several methods to administer hydrogen, such as inhalation of hydrogen gas, aerosol inhalation of a hydrogen-rich solution, drinking hydrogen dissolved in water, injecting hydrogen-rich saline (HRS) and taking a hydrogen bath. Drinking hydrogen solution (saline/pure water/other solutions saturated with hydrogen) may be more practical in daily life and more suitable for daily consumption. This review summarizes the findings of recent studies on the use of hydrogen in emergency and critical care medicine using different disease models. Keywords: Hydrogen, Reactive oxygen species, Antioxidant, Emergency, Critical care medicine Introduction Hydrogen is the lightest element in the Periodic Table and the most abundant chemical substance in the Universe. Most hydrogen is employed near its production site, with the two largest uses being fossil fuel processing and ammonia production, mostly for the fertilizer market. Hydrogen is seldom regarded as an important agent in medical use, especially as a therapeutic gas. However, in July 2007 researchers from the Japan Medical University Institute of Geriatrics reported that inhaled hydrogen gas has antioxidant and antiapoptotic properties that protect the brain against ischemia–reperfusion (I/R) injury and stroke by selectively reducing hydroxyl radicals (·OH) and ONOO− in cell-free systems . This study aroused inter- est worldwide and scientists have explored the therapeutic value of hydrogen in many disease models. Accumulating evidence suggests that hydrogen can protect various cells, tissues and organs against oxidative injury . This review focuses on the findings of recent studies of the effects of hydrogen in different disease models in * Correspondence: firstname.lastname@example.org †Equal contributors 4Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, 800XiangYin Road, Shanghai 200433, PR China Full list of author information is available at the end of the article emergency and critical care medicine, as shown in Figure 1. The possible mechanisms involved in its protective effects are summarized. Review Hydrogen therapy in the nervous system It was first reported in 2007 that inhaled hydrogen gas has antioxidant and antiapoptotic properties that protect the brain against I/R injury and stroke. In an in vitro study, researchers demonstrated that hydrogen functions as a scavenger of ·OH. Then in a neonatal hypoxia–is- chemia rat model, we found that 2% hydrogen gas or HRS therapy reduced apoptosis [3,4]. However, another group has reported that 2.9% hydrogen gas therapy does not ameliorate moderate-to-severe ischemic damage in a neonatal hypoxia–ischemia rat model , al- though they did find that hydrogen gas reduced in- farction and hemorrhage and improved neurologic function in a rat model of middle cerebral artery oc- clusion. Inhalation of hydrogen gas ameliorated intracere- bral hemorrhage in mice , and hydrogen saline protected against brain injury from experimental sub- arachnoid hemorrhage  and spinal cord I/R injury . It has been reported that HRS attenuated neuronal I/R injury by preserving mitochondrial function . Hong and © 2014 Shen et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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