原発性胆汁性胆管炎（IgG4高値例）における分子状水素カプセル投与後の免疫マーカー正常化：症例報告
A 44-year-old male diagnosed with primary biliary cholangitis (PBC), splenomegaly, and elevated IgG4 presented with acute cholestatic hepatitis. Despite ongoing ursodeoxycholic acid (UDCA) administration, liver enzymes remained markedly elevated (AST 279 U/l; ALT 183 U/l). Molecular hydrogen capsules were introduced as an adjunct in August 2024. Over the subsequent four months, AST declined to 95 U/l and ALT to 70 U/l, with no adverse events recorded. Immune checkpoint markers—KLRG-1, PD-1, and Tim3—which had been suppressed during disease flares, returned toward normal ranges. IgG4 concentrations also decreased, indicating reduced autoimmune activity, while imaging showed stable hepatic fibrosis. The patient additionally noted subjective relief from fatigue and pruritus. This case suggests that molecular hydrogen capsules may complement standard UDCA regimens in PBC by supporting liver enzyme normalization and immune regulation, though controlled studies are needed to confirm these observations.
Molecular hydrogen is proposed to reduce oxidative stress and immune dysregulation through its antioxidant and anti-inflammatory properties, leading to normalization of immune checkpoint markers (KLRG-1, PD-1, Tim3) and decreased IgG4-mediated autoimmune activity in PBC.
Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).
See also:
https://h2-papers.org/en/papers/40295001