Hydrogen water baths successfully treat Behçet’s disease, ulcers and skin lesions
Mar 18,2024
Behçet's disease (BD) is a variable vasculitis that causes ulcers in the oral, genital, and intestinal mucosa. The pathogenesis of BD is characterized by excessive production of reactive oxygen species (ROS) and release of neutrophil extracellular traps (NETs). Hydrogen is beneficial due to its ROS scavenging and NETs inhibiting properties. In this report, we provide the first evidence of the use of hydrogen water to successfully treat ulcers and skin lesions in BD.
A 31-year-old female patient with a history of recurrent oral and genital ulcers and painful extremity nodules (Fig. 1a–c) and a positive pathology test was diagnosed according to the International Study Group (ISG) criteria for BD. Have BD. Her skin biopsy showed widening of the subcutaneous tissue, fibrovascular tissue proliferation, and local accumulation of neutrophils. In addition, scattered neutrophil and lymphocyte infiltration was observed around blood vessels and collagen bundles, indicating compartmental panniculitis (Fig. 1d). The patient also underwent brain MRI, cardiac ultrasound, angiography, and antineutrophil cytoplasmic antibody testing, all of which were negative, thus excluding macrovascular disease.
Prior to treatment, the patient presented with multiple clinical symptoms: (a) oral and (b) vulvar ulcers, and (c) lower extremity swelling. Additionally, (d) skin biopsy showed compartmental panniculitis (hematoxylin-eosin stain, ×19). After 8 weeks of treatment, the patient's condition improved significantly, as evidenced by the disappearance of (e) oral and (f) vulvar ulcers, and (g) a significant reduction in the size of the extremity nodules.
The patient had been taking prednisone, teprenone, and azathioprine by mouth for 3 years and had never been able to stop taking them. When oral prednisone was reduced to 20 mg per day, the vulvar ulcer recurred. In addition to physical symptoms, patients also experience depression. Her weight increased by 15 kilograms. Recurrent oral and genital ulcers seriously affect the patient's diet and sexual life.
During the first month of hydrogen water treatment, the dose of prednisone was reduced by 5 mg per week until completely discontinued. Other medications remained unchanged. The patient was started on hydrogen water therapy, which included drinking, local wet compresses on vulvar ulcers (twice a day for 1 hour each time), and bathing. After 2 months of hydrogen water treatment, the oral and vulvar ulcers disappeared, and the limb nodules were significantly reduced (Fig. 1e-g). Six months later, the lower extremity nodules occasionally recurred after prolonged standing, at which time the frequency of hydrogen baths was reduced to once a week. The patient was up for 2 years without obvious recurrence.
Hydrogen bath refers to immersing the whole body in hydrogen water, twice a week, for 10 to 15 minutes each time. The physical and chemical properties of hydrogen water are as follows: pH 6.8-7.32; temperature between 38 and 42 degrees Celsius, adjusted according to patient preference; dissolved hydrogen concentration 1.0 ppm; redox potential -580 to -650 mV.
The therapeutic mechanism of hydrogen in ulcer treatment has been confirmed in studies. In the face of inflammatory stimuli, neutrophils release mesh-like structures called neutrophil extracellular traps (NETs). Recent studies have shown that NETs and NET markers are increased in BD patients. H2 therapy may be a new strategy for treating NETs associated with excessive neutrophil activation. Both in vitro and in animal models, hydrogen was observed to inhibit the formation and release of NETs from human neutrophils by neutralizing hypochlorous acid produced during the oxidative burst. Furthermore, H2 significantly inhibited histone citrating and NET formation, a mechanism independent of ROS scavenging. Moreover, hydrogen shows excellent selectivity against certain cytotoxic oxygen radicals compared with other antioxidants.
Overall, the treatment of BD is complex and challenging, and hydrogen proposes a new approach. We believe hydrogen water is a promising new treatment worthy of further promotion and research.
