This is an animal experimental study from the Department of Orthopedics of the Third Affiliated Hospital of Hebei Medical University, with the paper published in Front Endocrinol.

Osteoporosis (OP) is a common disease characterized by loss of bone mass and deterioration of bone microstructure. Patients with osteoporosis are more likely to fracture, and nonunion of osteoporotic fractures is a common complication that may impose a heavy burden on patients’ families. Osteoporotic fracture is difficult to treat, and in order to minimize its negative effects or poor functional rehabilitation, it is crucial to take active preventive measures as early as possible. In addition to anti-osteoporosis drugs and autologous bone graft widely used in clinical practice, other natural molecules have been reported to have potential applications in animal models.

 

Osteoporosis-and-hydrogen


The hydrogen molecule is small, nontoxic, electroneutral, nonpolar, and can be freely diffused through all cell membranes, such as the blood-brain barrier and placental barrier. Over the past 10 years, molecular hydrogen has been comprehensively studied and has attracted great interest for its antioxidant, anti-apoptotic and anti-inflammatory properties. Hydrogen gas has anti-inflammatory effects and can selectively react with hydroxyl radicals to effectively target intracellular inflammatory factors. Since the excellent therapeutic efficacy of hydrogen in a rat model of cerebral infarction, increasing evidence suggests that many diseases can be ameliorated by hydrogen therapy. In previous studies, in streptozotocin-induced diabetic rats, bone structure was altered due to increased oxidative stress levels, and hydrogen water (HRW) maintained bone volume and reduced the risk of fracture. However, the specific mechanism of the effect of hydrogen treatment under high oxidative stress needs further study.

Autophagy is a self-autophagy process in which double-membrane autophagosomes engulf cytosolic material and intracellular organelles. Recently, the relationship between oxidative stress and autophagy has been recognized, and it is generally believed that ROS can induce autophagy, and then reduce the damage to the body caused by oxidative stress. Recently, research on the relationship between hydrogen and autophagy. However, the role of hydrogen in autophagy remains controversial, although it can reduce the level of oxidative stress. Some studies have shown that hydrogen water can downregulate autophagy, but some studies have shown that hydrogen can induce autophagy. Moreover, although menopausal OP is more common than diabetic OP, there are no studies on the mechanism of hydrogen water action on menopausal OP. The aim of this study was to investigate the effect of hydrogen water on the healing of postmenopausal osteoporotic fractures and its regulation on autophagy, and to reveal the potential mechanism of the effect of hydrogen water on osteoporotic fractures.

QINGHEGUZHISUSONG

Guo J, Tian S, Wang Z, Wang Y, Zhang X, Zhang Y, Hou Z, Dong Hydrogen saline water accelerates fracture healing by suppressing autophagy in ovariectomized rats. Front Endocrinol (Lausanne).2022 Sep 2;13:962303. doi: 10.3389/fendo.2022.962303.

The treatment of osteoporotic fractures is difficult, and in order to minimize negative outcomes or poor functional rehabilitation, this study focused on the effect of hydrogen water on the healing process of postmenopausal osteoporotic fractures and its relationship with autophagy, in an attempt to reveal the potential mechanism of action of hydrogen water on osteoporotic fractures.

A rat osteoporotic fracture model was established, and hydrogen and water were systematically applied with or without 3MA. Results were obtained by x-ray slides, micros-CT scan, serum biomarker analysis, biomechanical testing, histopathology, immunohistochemistry, and Western blot analysis. It was divided into sham operation group, OVX group, OH (OVX + hydrogen water) group and OHA (OVX + hydrogen water + 3MA) group.

Oxidative stress and elevated levels of autophagy are necessary physiological responses during fracture healing. We found that hydrohydrate systemic treatment mildly inhibited autophagy and then activated Keap 1-Nrf 2 signaling pathway by improving the osteoporotic fracture healing process.

Hydrogen water treatment that activated the Keap 1-Nrf 2 signaling pathway by inhibiting autophagy levels antagonizes cellular stress, especially in the early stages of the fracture healing process, favoring osteoporotic fracture healing in rats.

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