関節リウマチ患者におけるメトトレキサート誘発性骨髄抑制に対する分子状水素の効果：免疫調節マーカーの変化を含む症例報告
A 66-year-old Taiwanese woman with rheumatoid arthritis (RA) diagnosed by 2010 ACR/EULAR criteria presented to the emergency department with oral ulcers, pharyngitis, weakness, and diarrhea following methotrexate (MTX) use. Clinical findings included hypotension, tachycardia, pancytopenia, hepatic insufficiency, and acute kidney injury. After discontinuation of outpatient medications and initiation of molecular hydrogen administration, laboratory parameters normalized and clinical status improved markedly. Flow cytometry revealed progressive increases in PD-1-positive subsets of helper and cytotoxic T cells, along with memory and activated regulatory T cells (Tregs), while B regulatory (Breg) cell proportions remained stable. No adverse events were recorded. This case represents the first documented instance of molecular hydrogen use in severe MTX-induced myelosuppression in an RA patient, with accompanying immune marker changes.
Molecular hydrogen's antioxidant and anti-inflammatory properties are proposed to reduce oxidative stress and modulate immune responses, evidenced by increases in PD-1-positive T-cell subsets and activated regulatory T cells, without affecting B regulatory cell populations.
The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).
See also:
https://h2-papers.org/en/papers/40579028