医学研究与教育 ›› 2026, Vol. 43 ›› Issue (4): 1-13.DOI: 10.3969/j.issn.1674-490X.2026.04.001
• 基础医学 •
马博1,王红杰1,2
收稿日期:2026-04-20
发布日期:2026-09-02
通讯作者:
王红杰(1968—),女,河北保定人,教授,博士,博士生导师,主要从事神经毒性及脑保护研究。E-mail: hongjiew68@126.com
作者简介:马博(1987—),男,河北衡水人,主治医师,硕士,主要从事神经毒性及脑保护研究。 E-mail: MB8663833@126.com
基金资助:Ma Bo1,Wang Hongjie1,2
Received:2026-04-20
Published:2026-09-02
摘要: 神经退行性疾病是多种原因引起的、以神经元进行性损伤为特征的疾病,包括阿尔茨海默病、帕金森病、肌萎缩侧索硬化症等。其发病机制涉及氧化应激、神经炎症、线粒体功能障碍及蛋白异常聚集等多种过程,当前缺乏有效的治疗手段。氢气通过减轻氧化应激、抑制神经炎症及调控细胞凋亡等多途径发挥神经保护作用,综述氢气在神经保护中的作用机制及临床研究进展,以期为未来的临床应用提供新的思路。
中图分类号:
马博,王红杰. 氢气在神经退行性疾病中的神经保护作用机制及研究进展[J]. 医学研究与教育, 2026, 43(4): 1-13.
Ma Bo,Wang Hongjie. Mechanisms and research progress of hydrogen in neurodegenerative diseases[J]. Journal of Hebei Medical College for Continuing Education, 2026, 43(4): 1-13.
| [1] Kelser B M, Teichner E M, Subtirelu R C, et al. A review of proposed mechanisms for neurodegenerative disease[J]. Front Aging Neurosci, 2024, 16: 1370580. DOI: 10.3389/fnagi.2024.1370580. [2] Yu S X, Chen X, Yang T, et al. Revealing the mechanisms of blood-brain barrier in chronic neurodegenerative disease: an opportunity for therapeutic intervention[J]. Rev Neurosci, 2024, 35(8): 895-916. DOI: 10.1515/revneuro-2024-0040. [3] Dole M, Wilson F R, Fife W P. Hyperbaric hydrogen therapy: a possible treatment for cancer[J]. Science, 1975, 190(4210): 152-154. DOI: 10.1126/science.1166304. [4] Ohsawa I, Ishikawa M, Takahashi K, et al. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals[J]. Nat Med, 2007, 13(6): 688-694. DOI: 10.1038/nm1577. [5] Chaudhary P, Janmeda P, Docea A O, et al. Oxidative stress, free radicals and antioxidants: potential crosstalk in the pathophysiology of human diseases[J]. Front Chem, 2023, 11: 1158198. DOI: 10.3389/fchem.2023.1158198. [6] Cobley J N, Fiorello M L, Bailey D M. 13 reasons why the brain is susceptible to oxidative stress[J]. Redox Biol, 2018, 15: 490-503. DOI: 10.1016/j.redox.2018.01.008. [7] Liu J T, Han X Y, Zhang T Y, et al. Reactive oxygen species(ROS)scavenging biomaterials for anti-inflammatory diseases: from mechanism to therapy[J]. J Hematol Oncol, 2023, 16(1): 116. DOI: 10.1186/s13045-023-01512-7. [8] Sauer H, Wartenberg M, Hescheler J. Reactive oxygen species as intracellular messengers during cell growth and differentiation[J]. Cell Physiol Biochem, 2001, 11(4): 173-186. DOI: 10.1159/000047804. [9] Forman H J, Zhang H Q. Targeting oxidative stress in disease: promise and limitations of antioxidant therapy[J]. Nat Rev Drug Discov, 2021, 20(9): 689-709. DOI: 10.1038/s41573-021-00233-1. [10] Liu M Y, Yuan H, Yin J J, et al. Effect of hydrogen-rich water on radiation-induced cognitive dysfunction in rats[J]. Radiat Res, 2020, 193(1): 16-23. DOI: 10.1667/RR15464.1. [11] Ayala A, Muñoz M F, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal[J]. Oxid Med Cell Longev, 2014, 2014: 360438. DOI: 10.1155/2014/360438. [12] Yu Y, Feng J C, Lian N Q, et al. Hydrogen gas alleviates blood-brain barrier impairment and cognitive dysfunction of septic mice in an Nrf2-dependent pathway[J]. Int Immunopharmacol, 2020, 85: 106585. DOI: 10.1016/j.intimp.2020.106585. [13] Ma Q. Role of Nrf2 in oxidative stress and toxicity[J]. Annu Rev Pharmacol Toxicol, 2013, 53: 401-426. DOI: 10.1146/annurev-pharmtox-011112-140320. [14] Bellezza I, Giambanco I, Minelli A, et al. Nrf2-Keap1 signaling in oxidative and reductive stress[J]. Biochim Biophys Acta Mol Cell Res, 2018, 1865(5): 721-733. DOI: 10.1016/j.bbamcr.2018.02.010. [15] Dinkova-Kostova A T, Abramov A Y. The emerging role of Nrf2 in mitochondrial function[J]. Free Radic Biol Med, 2015, 88: 179-188. DOI: 10.1016/j.freeradbiomed.2015.04.036. [16] Jiang Y, Zhang K, Yu Y, et al. Molecular hydrogen alleviates brain injury and cognitive impairment in a chronic sequelae model of murine polymicrobial sepsis[J]. Exp Brain Res, 2020, 238(12): 2897-2908. DOI: 10.1007/s00221-020-05950-4. [17] Zhang X Y, Xie F, Ma S W, et al. Mitochondria: one of the vital hubs for molecular hydrogen's biological functions[J]. Front Cell Dev Biol, 2023, 11: 1283820. DOI: 10.3389/fcell.2023.1283820. [18] Tang C Y, Cai J, Yin X M, et al. Mitochondrial quality control in kidney injury and repair[J]. Nat Rev Nephrol, 2021, 17(5): 299-318. DOI: 10.1038/s41581-020-00369-0. [19] Johnson J, Mercado-Ayon E, Mercado-Ayon Y, et al. Mitochondrial dysfunction in the development and progression of neurodegenerative diseases[J]. Arch Biochem Biophys, 2021, 702: 108698. DOI: 10.1016/j.abb.2020.108698. [20] Xie K L, Wang Y Q, Yin L J, et al. Hydrogen gas alleviates sepsis-induced brain injury by improving mitochondrial biogenesis through the activation of PGC-α in mice[J]. Shock, 2021, 55(1): 100-109. DOI: 10.1097/SHK.0000000000001594. [21] Dumbuya J S, Li S Q, Liang L L, et al. Effects of hydrogen-rich saline in neuroinflammation and mitochondrial dysfunction in rat model of sepsis-associated encephalopathy[J]. J Transl Med, 2022, 20(1): 546. DOI: 10.1186/s12967-022-03746-4. [22] Rozpedek W, Pytel D, Mucha B, et al. The role of the PERK/eIF2α/ATF4/CHOP signaling pathway in tumor progression during endoplasmic reticulum stress[J]. Curr Mol Med, 2016, 16(6): 533-544. DOI: 10.2174/15665240166661605231 43937. [23] Ron D. Translational control in the endoplasmic reticulum stress response[J]. J Clin Invest, 2002, 110(10): 1383-1388. DOI: 10.1172/jci0216784. [24] Gao Y, Gui Q F, Jin L, et al. Hydrogen-rich saline attenuates hippocampus endoplasmic reticulum stress after cardiac arrest in rats[J]. Neurosci Lett, 2017, 640: 29-36. DOI: 10.1016/j.neulet.2017.01.020. [25] Zhang W F, Xiao D, Mao Q W, et al. Role of neuroinflammation in neurodegeneration development[J]. Sig Transduct Target Ther, 2023, 8(1): 267. DOI: 10.1038/s41392-023-01486-5. [26] Dadwal S, Heneka M T. Microglia heterogeneity in health and disease[J]. FEBS Open Bio, 2024, 14(2): 217-229. DOI: 10.1002/2211-5463.13735. [27] Salter M W, Stevens B. Microglia emerge as central players in brain disease[J]. Nat Med, 2017, 23(9): 1018-1027. DOI: 10.1038/nm.4397. [28] Zhuang X Q, Yu Y, Jiang Y, et al. Molecular hydrogen attenuates sepsis-induced neuroinflammation through regulation of microglia polarization through an mTOR-autophagy-dependent pathway[J]. Int Immunopharmacol, 2020, 81: 106287. DOI: 10.1016/j.intimp.2020.106287. [29] Hayden M S, Ghosh S. NF-κB in immunobiology[J]. Cell Res, 2011, 21(2): 223-244. DOI: 10.1038/cr.2011.13. [30] Hu Y J, Wang P Z, Han K. Hydrogen attenuated inflammation response and oxidative in hypoxic ischemic encephalopathy via Nrf2 mediated the inhibition of NLRP3 and NF-κB[J]. Neuroscience, 2022, 485: 23-36. DOI: 10.1016/j.neuroscience.2021.12.024. [31] O'Neill L A, Golenbock D, Bowie A G. The history of Toll-like receptors:redefining innate immunity[J]. Nat Rev Immunol, 2013, 13(6): 453-460. DOI: 10.1038/nri3446. [32] Yang W C, Li T T, Wan Q, et al. Molecular hydrogen mediates neurorestorative effects after stroke in diabetic rats: the TLR4/NF-κB inflammatory pathway[J]. J Neuroimmune Pharmacol, 2023, 18(1/2): 90-99. DOI: 10.1007/s11481-022-10051-w. [33] He Y, Hara H, Núñez G. Mechanism and regulation of NLRP3 inflammasome activation[J]. Trends Biochem Sci, 2016, 41(12): 1012-1021. DOI: 10.1016/j.tibs.2016.09.002. [34] Du Y Y, Chen L Y, Qiao H M, et al. Hydrogen-rich saline: a novel neuroprotective agent in a mouse model of experimental cerebral ischemia via the ROS-NLRP3 inflammasome signaling pathway in vivo and in vitro[J]. Brain Sci, 2023, 13(6): 939. DOI: 10.3390/brainsci13060939. [35] Dou C S, Zhang Y, Zhang L, et al. Autophagy and autophagy-related molecules in neurodegenerative diseases[J]. Anim Models Exp Med, 2023, 6(1): 10-17. DOI: 10.1002/ame2.12229. [36] Kim Y C, Guan K L. mTOR: a pharmacologic target for autophagy regulation[J]. J Clin Invest, 2015, 125(1): 25-32. DOI: 10.1172/JCI73939. [37] Chen H G, Zhou C J, Xie K L, et al. Hydrogen-rich saline alleviated the hyperpathia and microglia activation via autophagy mediated inflammasome inactivation in neuropathic pain rats[J]. Neuroscience, 2019, 421: 17-30. DOI: 10.1016/j.neuroscience.2019.10.046. [38] Youle R J, Strasser A. The BCL-2 protein family: opposing activities that mediate cell death[J]. Nat Rev Mol Cell Biol, 2008, 9(1): 47-59. DOI: 10.1038/nrm2308. [39] Jeong E S, Bajgai J, You I S, et al. Therapeutic effects of hydrogen gas inhalation on trimethyltin-induced neurotoxicity and cognitive impairment in the C57BL/6 mice model[J]. Int J Mol Sci, 2021, 22(24): 13313. DOI: 10.3390/ijms222413313. [40] Johnson G L, Lapadat R. Mitogen-activated protein kinase pathways mediated by ERK, JNK, and p38 protein kinases[J]. Science, 2002, 298(5600): 1911-1912. DOI: 10.1126/science.1072682. [41] Guo L L, Liu M, Duan T. Hydrogen suppresses oxidative stress by inhibiting the p38 MAPK signaling pathway in preeclampsia[J]. Adv Clin Exp Med, 2023, 32(3): 357-367. DOI: 10.17219/acem/154623. [42] Long H Z, Cheng Y, Zhou Z W, et al. PI3K/AKT signal pathway: a target of natural products in the prevention and treatment of Alzheimer's disease and Parkinson's disease[J]. Front Pharmacol, 2021, 12: 648636. DOI: 10.3389/fphar.2021.648636. [43] Chen K Y, Wang N, Diao Y G, et al. Hydrogen-rich saline attenuates brain injury induced by cardiopulmonary bypass and inhibits microvascular endothelial cell apoptosis via the PI3K/Akt/GSK3β signaling pathway in rats[J]. Cell Physiol Biochem, 2017, 43(4): 1634-1647. DOI: 10.1159/000484024. [44] Rahman M H, Jeong E S, You H S, et al. Redox-mechanisms of molecular hydrogen promote healthful longevity[J]. Antioxidants(Basel), 2023, 12(5): 988. DOI: 10.3390/antiox12050988. [45] McCarty M F. Potential ghrelin-mediated benefits and risks of hydrogen water[J]. Med Hypotheses, 2015, 84(4): 350-355. DOI: 10.1016/j.mehy.2015.01.018. [46] Matsumoto A, Yamafuji M, Tachibana T, et al. Oral ‘hydrogen water' induces neuroprotective ghrelin secretion in mice[J]. Sci Rep, 2013, 3: 3273. DOI: 10.1038/srep03273. [47] Yoshii Y, Inoue T, Uemura Y, et al. Complexity of stomach-brain interaction induced by molecular hydrogen in Parkinson's disease model mice[J]. Neurochem Res, 2017, 42(9): 2658-2665. DOI: 10.1007/s11064-017-2281-1. [48] Barde Y A, Edgar D, Thoenen H. Purification of a new neurotrophic factor from mammalian brain[J]. EMBO J, 1982, 1(5): 549-553. DOI: 10.1002/j.1460-2075.1982.tb01207.x. [49] Fransquet P D, Ritchie K, Januar V, et al. Is peripheral BDNF promoter methylation a preclinical biomarker of dementia?[J]. J Alzheimers Dis, 2020, 73(2): 645-655. DOI: 10.3233/JAD-190738. [50] Halder R, Hennion M, Vidal R O, et al. DNA methylation changes in plasticity genes accompany the formation and maintenance of memory[J]. Nat Neurosci, 2016, 19(1): 102-110. DOI: 10.1038/nn.4194. [51] Yu M D, Qin C, Li P, et al. Hydrogen gas alleviates sepsis-induced neuroinflammation and cognitive impairment through regulation of DNMT1 and DNMT3a-mediated BDNF promoter Ⅳ methylation in mice[J]. Int Immunopharmacol, 2021, 95: 107583. DOI: 10.1016/j.intimp.2021.107583. [52] Ji J F, Ji S J, Sun R, et al. Forced running exercise attenuates hippocampal neurogenesis impairment and the neurocognitive deficits induced by whole-brain irradiation via the BDNF-mediated pathway[J]. Biochem Biophys Res Commun, 2014, 443(2): 646-651. DOI: 10.1016/j.bbrc.2013.12.031. [53] Fu Y, Ito M, Fujita Y, et al. Molecular hydrogen is protective against 6-hydroxydopamine-induced nigrostriatal degeneration in a rat model of Parkinson's disease[J]. Neurosci Lett, 2009, 453(2): 81-85. DOI: 10.1016/j.neulet.2009.02.016. [54] Ito M, Hirayama M, Yamai K, et al. Drinking hydrogen water and intermittent hydrogen gas exposure, but not lactulose or continuous hydrogen gas exposure, prevent 6-hydroxydopamine-induced Parkinson's disease in rats[J]. Med Gas Res, 2012, 2(1): 15. DOI: 10.1186/2045-9912-2-15. [55] Zhang Z Q, Sun X, Wang K, et al. Hydrogen-saturated saline mediated neuroprotection through autophagy via PI3K/AKT/mTOR pathway in early and medium stages of rotenone-induced Parkinson's disease rats[J]. Brain Res Bull, 2021, 172: 1-13. DOI: 10.1016/j.brainresbull.2021.04.003. [56] Fujita K, Seike T, Yutsudo N, et al. Hydrogen in drinking water reduces dopaminergic neuronal loss in the 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine mouse model of Parkinson's disease[J]. PLoS One, 2009, 4(9): e7247. DOI: 10.1371/journal.pone.0007247. [57] Yoritaka A, Takanashi M, Hirayama M, et al. Pilot study of H2 therapy in Parkinson's disease: a randomized double-blind placebo-controlled trial[J]. Mov Disord, 2013, 28(6): 836-839. DOI: 10.1002/mds.25375. [58] Yoritaka A, Abe T, Ohtsuka C, et al. Erratum to: a randomized double-blind multi-center trial of hydrogen water for Parkinson's disease: protocol and baseline characteristics[J]. BMC Neurol, 2017, 17(1): 35. DOI: 10.1186/s12883-017-0817-2. [59] Yoritaka A, Ohtsuka C, Maeda T, et al. Randomized, double-blind, multicenter trial of hydrogen water for Parkinson's disease[J]. Mov Disord, 2018, 33(9): 1505-1507. DOI: 10.1002/mds.27472. [60] Hirayama M, Ito M, Minato T, et al. Inhalation of hydrogen gas elevates urinary 8-hydroxy-2'-deoxyguanine in Parkinson's disease[J]. Med Gas Res, 2018, 8(4): 144-149. DOI: 10.4103/2045-9912.248264. [61] Yoritaka A, Kobayashi Y, Hayashi T, et al. Randomized double-blind placebo-controlled trial of hydrogen inhalation for Parkinson's disease: a pilot study[J]. Neurol Sci, 2021, 42(11): 4767-4770. DOI: 10.1007/s10072-021-05489-4. [62] Hong C T, Hu C J, Lin H Y, et al. Effects of concomitant use of hydrogen water and photobiomodulation on Parkinson disease: a pilot study[J]. Medicine, 2021, 100(4): e24191. DOI: 10.1097/MD.0000000000024191. [63] Liu C, Kurokawa R, Fujino M, et al. Estimation of the hydrogen concentration in rat tissue using an airtight tube following the administration of hydrogen via various routes[J]. Sci Rep, 2014, 4: 5485. DOI: 10.1038/srep05485. [64] Li M, Ma B, Liang S, et al. Hydrogen activated the Nrf2/HO pathway to alleviate the cognitive decline in PD Drosophila after long-term sevoflurane exposure[J]. Neurotoxicol Teratol, 2025, 112: 107560. DOI: 10.1016/j.ntt.2025.107560. [65] 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. DOI: 10.1016/j.biomaterials.2019.01.037. [66] Hou C, Peng Y H, Qin C, et al. Hydrogen-rich water improves cognitive impairment gender-dependently in APP/PS1 mice without affecting Aβ clearance[J]. Free Radic Res, 2018, 52(11/12): 1311-1322. DOI: 10.1080/10715762.2018.1460749. [67] Zhang Y, Li H, Yang C, et al. Treatment with hydrogen-rich saline delays disease progression in a mouse model of amyotrophic lateral sclerosis[J]. Neurochem Res, 2016, 41(4): 770-778. DOI: 10.1007/s11064-015-1750-7. |
| [1] | 李诗黛,王红杰. 天麻对神经退行性疾病的作用及其机制研究进展[J]. 医学研究与教育, 2025, 42(4): 1-9. |
| [2] | 阿迪莱·艾比布力,姜乐,白静. AMPK信号传导在帕金森病中的研究进展[J]. 医学研究与教育, 2025, 42(3): 1-7. |
| [3] | 魏浩然,陈冲,张红杰. 某社区人群对阿尔茨海默病早期筛查意愿分析[J]. 医学研究与教育, 2024, 41(1): 56-61. |
| [4] | 李艳霞,曹梦媛,李艳萌,张庆云,邵海锐,董晓东. 阿尔茨海默病中Tau蛋白与相关分子作用的探究[J]. 医学研究与教育, 2014, 31(3): 72-75,87. |
| [5] | 张庆云,李佳林,郑培,李艳霞,车雨轩,董晓东. 大脑神经递质多巴胺检测方法研究[J]. 医学研究与教育, 2014, 31(1): 87-90. |
| [6] | 张庆云,董晓东,郝媛,陈玉敏. 帕金森病发病机制研究[J]. 医学研究与教育, 2013, 30(3): 85-88,99. |
| [7] | 卢会茹,,高愈希,张金超,胡毅. G-四链体在抗肿瘤药物和神经退行性疾病方面的研究进展[J]. 医学研究与教育, 2013, 30(2): 1-7. |
| [8] | 刘春蕾,赵木昆. 阿尔茨海默病的中西医结合护理[J]. 医学研究与教育, 2013, 30(1): 78-80. |
| [9] | 张庆云,杨慧,董晓东. 铁在帕金森病发病机制中的作用[J]. 医学研究与教育, 2012, 29(4): 55-58. |
| [10] | 张平,李晓芳,李靖华,王鹏,代瑞廷. 移植骨髓间充质干细胞对帕金森大鼠旋转行为的影响[J]. 医学研究与教育, 2012, 29(4): 1-5. |
| [11] | 张杏红,李建恒,张平,苏立凯. 替勃龙对阿尔茨海默病模型大鼠的学习记忆能力及神经元凋亡的影响[J]. 医学研究与教育, 2010, 27(2): 11-13. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||