Exploring the Potential of H2 Therapy in Reducing Surgical Complications: A Review on Anti-inflammatory, Antioxidant, and Anti-fibrotic Mechanisms

Objective: This review demonstrates the potential role of hydrogen in post-surgical adhesion prevention and calls for further investigation of its molecular pathways, as well as clinical studies to assess its efficacy and safety in a therapeutic setting. Methods: PubMed and Google Scholar were extensively queried to investigate the potential role of hydrogen in preventing post-surgical adhesions and its underlying mechanisms. Results: Molecular hydrogen exhibits selective antioxidant, anti-inflammatory, and anti-fibrotic properties, holding potential for the treatment and prevention of various disorders, including acute pancreatitis, respiratory diseases, and ischemia-reperfusion damage conditions, among others. Postoperative adhesion is associated with chronic pain, organ dysfunction, and acute complications, fundamentally rooted in inflammation, oxidative stress, and fibrosis. The surgical injury initiates an inflammatory response characterized by immune cell mobilization and an increase in pro-inflammatory cytokine levels, thereby promoting adhesion formation. Conclusion: Hydrogen is demonstrated to attenuate the early inflammatory response by down-regulating proinflammatory cytokines alongside its anti-oxidative and anti-fibrotic effects. As a potential therapeutic agent for post-surgical adhesions, hydrogen warrants additional investigation to elucidate the exact molecular pathways responsible for its observed efficacy and safety.