Tokyo and Kanagawa, Japan.
From the Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Graduate School of Medicine; the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital; the Department of Neuroregenerative Medicine, Juntendo University Graduate School of Medicine; and the Department of Biochemistry and Cell Biology, Graduate School of Medicine, Nippon Medical School.
Plast Reconstr Surg. 2017 Dec;140(6):1195-1206. doi: 10.1097/PRS.0000000000003878.
Ischemia-reperfusion injury is one of the leading causes of tissue damage and dysfunction, in particular, free tissue transfer, traumatically amputated extremity, and prolonged tourniquet application during extremity surgery. In this study, the authors investigated the therapeutic effects of hydrogen gas on skeletal muscle ischemia-reperfusion injury.
The authors compared the concentration of hydrogen in a muscle on intraperitoneal administration of hydrogen-rich saline and on inhalation of hydrogen gas. Animals were subjected to ischemia-reperfusion. Mice were treated with inhalation of hydrogen gas, and the hind gastrocnemius muscle was collected. Muscle morphology and inflammatory change were evaluated after ischemia-reperfusion. Moreover, a footprint test was performed to assess the functional effect of hydrogen.
Hydrogen concentration of tissue was significantly higher, and the elevated level was maintained longer by hydrogen gas inhalation than by intraperitoneal administration of hydrogen-rich saline. Infarct zone and area with loss of tissue structure and marked cellular infiltration were significantly decreased in groups treated by hydrogen gas inhalation during ischemia-reperfusion; however, these effects were not observed by posttreatment of hydrogen. One week after ischemia-reperfusion, mice that had been pretreated with hydrogen gas recovered faster and achieved smoother walking in appearance compared with mice in the other groups as assessed by the footprint test.
Inhalation of hydrogen gas attenuates muscle damage, inhibits inflammatory response, and enhances functional recovery. These findings suggest that the optimal route for hydrogen delivery is continuous inhalation of hydrogen gas, which could be a novel clinical mode of treatment in ischemia-reperfusion injury.
缺血再灌注损伤是导致组织损伤和功能障碍的主要原因之一，特别是在游离组织移植、创伤性截肢和肢体手术中长时间使用止血带的情况下。在这项研究中，作者研究了氢气对骨骼肌缺血再灌注损伤的治疗作用。
作者比较了腹腔内给予富氢生理盐水和吸入氢气后肌肉中氢气的浓度。动物经历了缺血再灌注。对吸入氢气的小鼠进行治疗，并采集后肢腓肠肌。在缺血再灌注后评估肌肉形态和炎症变化。此外，还进行了足迹试验以评估氢气的功能效果。
与腹腔内给予富氢生理盐水相比，吸入氢气时组织中的氢气浓度更高，升高水平维持时间更长。在缺血再灌注期间接受氢气吸入治疗的组中，梗塞区和组织结构丧失及明显细胞浸润的区域显著减少；然而，在氢气后处理组中未观察到这些效果。在缺血再灌注后 1 周，与其他组相比，接受氢气预处理的小鼠恢复更快，外观行走更平稳，通过足迹试验评估。
吸入氢气可减轻肌肉损伤、抑制炎症反应并增强功能恢复。这些发现表明，氢气输送的最佳途径是连续吸入氢气，这可能是缺血再灌注损伤的一种新型临床治疗模式。
