静脉动脉化移植是治疗某些血管疾病的重要手段，但这种方法存在一个问题就是再狭窄。静脉动脉化移植后内膜增生是再狭窄的重要原因，可能的原因目前不十分清楚，可能和炎症和机械损伤有关。

大量研究表明，氢气可通过抗炎症抗氧化作用发挥保护器官和细胞的作用。本研究探讨口服氢气水对血管内膜增生是否具有抑制作用。将下腔静脉分离于冷ringer液中保存2小时，取代腹主动脉移植到Lewis大鼠。氢气水采用金属镁和水反应制备。从手术后开始给动物饮用。对照组给脱气处理的氢气水或正常水。6周后，对照组动物移植血管内膜明显增生和氧化应激，氢气水治疗组动物无内膜增生和氧化应激。移植1周时，氢气水治疗组动物内皮细胞更完整，血小板和白细胞黏附减少。明显上调的细胞黏附分子mRNA显著下降。P38MAPK,MMP2,MMP9等均显著下降。采用细胞学研究证明，氢气治疗24小时可降低平滑肌细胞的增殖。研究结果提示，氢气水可以显著降低静脉动脉化移植后内膜增殖。饮用氢气水对预防该疾病是一个有效的简单手段。

尽管本研究检测了细胞黏附分子、P38、MMP2/9等重要分子，这些分子也是血管内膜增殖的重要分子，研究发现氢气能减少血管内膜增殖，从简单道理上讲，这些重要分子都应该参与。因此，本研究总体上仍属于描述性研究，只不过在描述的深度和层次上比较完整，而且也有细胞学证据。从研究中我们可以知道，上述这些分子确实是氢气治疗引起的，可以作为有效性的佐证，但无法清楚知道，这些分子是治疗效果的伴随现象，还是先发生变化，再产生治疗效果。如果是后者，那么采用上述分子的激动剂，或者过表达，是否可以阻断氢气的治疗效果。如果不能阻断，则说明这些分子不过是治疗有效的后果，这些分子是细胞增殖的伴随现象。如果可以阻断，说明就是氢气引起了这些分子的变化，然后发挥治疗作用。我十分不相信这些分子就是氢气治疗有效的原因。因为从基本道理上无法推论。这些分子都是这个疾病的特异分子，而氢气治疗疾病的种类许多，而其他疾病又存在许多特异分子，那么是否他们也是重要的机制。如果他们都是机制，那就等于没有发现机制。相信不久将有大量这类研究出现。我们仍将无法知道分子过程。

无论如何，本研究仍是氢气医学研究领域相对比较完整和系统的研究，非常值得借鉴。

Cardiovasc Res. 2012 Jan 27. [Epub ahead of print]

Oral intake of hydrogen-rich water inhibits intimal hyperplasia in arterialized vein grafts in rats.

Sun Q, Kawamura T, Masutani K, Peng X, Sun Q, Stolz DB, Pribis JP, Billiar TR, Sun X, Bermudez CA, Toyoda Y, Nakao A.

Source

Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Abstract

AIMS: Arterialized vein grafts often fail due to intimal hyperplasia.

Hydrogen potently protects organs and cells from many insults via its anti-inflammatory and antioxidant properties. We investigated the efficacy of oral administration of hydrogen-rich water (HW) for prevention of intimal hyperplasia.Methods and Results The inferior vena cava was excised, stored in cold Ringer solution for 2 hours, and placed as an interposition graft in the abdominal aorta of syngeneic Lewis rats. HW was generated by immersing a magnesium stick in tap water (Mg + 2H(2)O → Mg (OH)(2) + H(2)). Beginning on the day of graft implantation, recipients were given either tap water (RW), HW or HW that had been subsequently degassed (DW). Six weeks after grafting, the grafts in the rats given RW or DW had developed intimal hyperplasia accompanied by increased oxidative injury. HW significantly suppressed intimal hyperplasia.

One week after grafting, the grafts in HW-treated rats exhibited improved endothelial integrity with less platelet and white blood cell aggregation. Upregulation of the mRNAs for intracellular adhesion molecules was attenuated in the vein grafts of the rats receiving HW. Activation of p38 mitogen-activated protein kinase, matrix metalloproteinase (MMP)-2 and MMP-9 was also significantly inhibited in grafts receiving HW. In rat smooth muscle cell (A7r5) cultures, hydrogen treatment for 24 hours reduced smooth muscle cell migration. CONCLUSIONS: Drinking HW significantly reduced neointima formation after vein grafting in rats. Drinking HW may have therapeutic value as a novel therapy for intimal hyperplasia and could easily be incorporated into daily life.

PMID:

22287575

[PubMed - as supplied by publisher]

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