Improved brain MRI indices in the acute brain stem infarct sites treated with hydroxyl radical scavengers, Edaravone and hydrogen, as compared to Edaravone alone. A non-controlled study

Abstract

BackgroundIn acute stage of cerebral infarction, MRI indices (rDWI & rADC) deteriorate during the first 3-7 days after the ictus and then gradually normalize in approximately 10 days (pseudonormalization time), although the tissue is already infarcted. Since effective treatments improve these indices significantly and in less than the natural pseudonormalization time, a combined analysis of these changes provides an opportunity for objective evaluation on the effectiveness of various treatments for cerebral infarction. Hydroxyl radicals are highly destructive to the tissue and aggravate cerebral infarction. We treated brainstem infarction patients in acute stage with hydroxyl radical scavengers (Edaravone and hydrogen) by intravenous administration and evaluated the effects of the treatment by a serial observation and analysis of these MRI indices. The effects of the treatment were evaluated and compared in two groups, an Edaravone alone group and a combined group with Edaravone and hydrogen, in order to assess beneficial effects of addition of hydrogen.MethodsThe patients were divided in Edaravone only group (E group. 26 patients) and combined treatment group with Edaravone and hydrogen enriched saline (EH group. 8 patients). The extent of the initial hump of rDWI, the initial dip of rADC and pseudo-normalization time were determined in each patient serially and averages of these data were compared in these two groups and also with the natural course in the literatures.ResultsThe initial hump of rDWI reached 2.0 in the E group which was better than 2.5 of the natural course but was not as good as 1.5 of the EH group. The initial dip of rADC was 0.6 in the E group which was close to the natural course but worse than 0.8 of the EH group. Pseudonormalization time of rDWI and rADC was 9 days only in EH group but longer in other groups. Addition of hydrogen caused no side effects.ConclusionsAdministration of hydroxyl radical scavengers in acute stage of brainstem infarction improved MRI indices against the natural course. The effects were more obvious and significant in the EH group. These findings may imply the need for more frequent daily administration of hydroxyl scavenger, or possible additional hydrogen effects on scavenger mechanisms.

Hydrogen(H2) treatment for acute erythymatous skin diseases. A report of 4 patients with safety data and a non-controlled feasibility study with H2 concentration measurement on two volunteers

“…Co, Patent No.4486157, Patent Gazette of Japan 2010). ), as has been reported elsewhere [7]. H2 gets in the bag by diffusion through the bag wall.…”

Effectiveness of Oral and Topical Hydrogen for Sports-Related Soft Tissue Injuries

“…Previous studies found no serious adverse events of oral hydrogen administration, which is reported to be safe and easily applicable to humans. [10][11][12][13][14][15][16]30 This aligns with the results of the present study, in which there were no reports of severe side effects that might have limited participation, although 2 participants from the HYD1 group reported early diarrhea that was resolved after a few days of treatment. Although the diarrhea was reported to be mild in intensity, the abdominal side effects of hydrogen need further investigation.…”

“…Although research on the health benefits of hydrogen remains limited, with scant data on long-term effects, hydrogen has been identified as beneficial in the prevention and treatment of a wide range of diseases. [10][11][12][13][14][15][16] The therapeutic effects of hydrogen have been attributed to 4 major molecular mechanisms: specific scavenging activities of hydroxyl radical and of peroxynitrite, alterations of gene expression, and signal-modulating activities. 7 Because hydrogen is known to scavenge toxic ROS and to induce a number of antioxidant proteins during inflammation, 22 its use is likely to have a significant impact, especially on oxidative stress-mediated disorders and inflammatory diseases in humans.…”

A basic study on molecular hydrogen (H2) inhalation in acute cerebral ischemia patients for safety check with physiological parameters and measurement of blood H2 level

“…When the result of HC measurement was reported to be very low in these two patients, the following inhalation was supplemented with slow intravenous infusion of hydrogen-enriched saline solution at the rate of 200cc /hr (or total of 100ml in 30 min) for concern of aggravating their pulmonary congestion. This speed of infusion was in the range of routine IV fluid administration but much slower than usual hydrogen-enriched saline administration in our previous study [5,6]. Some patients were excluded from the study immediately when the patient declined the venous puncture and/or complained of any discomfort/dissatisfaction.…”