Hydrogen capsule therapy demonstrates a biphasic immunomodulatory effect in SLE-PAH patients, initially suppressing immune activation markers (KLRG1+ T cells, CD39+Helios- Tregs, and Bregs) followed by regulatory immune rebalancing upon therapy cessation. This novel adjunctive approach shows potential for managing the complex immune dysregulation and vascular complications associated with SLE-PAH, though further controlled studies are needed to establish clinical efficacy and optimal treatment protocols.
Plain-Language Summary
This case report describes one 45-year-old woman with systemic lupus erythematosus (SLE, an autoimmune disease) who also had pulmonary arterial hypertension (PAH, high blood pressure in the lungs). She received hydrogen capsules as an additional treatment, and researchers tracked changes in her immune cells over time. They found that certain immune cells decreased while she was taking hydrogen, then increased again after she stopped—suggesting hydrogen may have a two-phase effect on the immune system.
Abstract
Background/aim: Pulmonary arterial hypertension (PAH) is a severe complication of systemic lupus erythematosus (SLE), marked by vascular remodeling, immune dysregulation, and progressive right heart failure. Molecular hydrogen therapy, a selective antioxidant and anti-inflammatory agent, has the capacity to modulate immune responses in these autoimmune disease patients. This case report details the clinical improvement in an SLE patient with PAH after starting adjunctive hydrogen capsule therapy, highlighting its potential as a novel approach for this challenging complication. Case report: A 45-year-old Taiwanese woman with SLE-PAH who received hydrogen capsule therapy, during which serial immunophenotyping revealed dynamic changes in T cell exhaustion markers, regulatory T cell (Treg) subsets, and regulatory B cells (Breg). Notably, KLRG1+ T cells and CD39+Helios- Tregs were suppressed during therapy but rebounded after cessation, suggesting transient immune suppressing followed by regulatory rebalancing. Bregs also showed a similar pattern, declining during therapy and recovering after discontinuation. Conclusion: These findings suggest a biphasic immunomodulatory effect of hydrogen therapy, that is, initially dampening immune activation, followed by a regulatory rebound after hydrogen therapy.
