# Adjunctive Molecular Hydrogen Capsule Therapy in Empyema Complicated by Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report.
> 膿胸に合併した慢性炎症性脱髄性多発神経炎への分子状水素カプセル併用：症例報告


## Abstract

A 76-year-old male with chronic inflammatory demyelinating polyneuropathy (CIDP) developed acute respiratory failure due to Stage II empyema. After video-assisted thoracoscopic surgery (VATS) decortication, oral molecular hydrogen capsules were introduced during the critical recovery phase. Serial immunophenotyping revealed selective upregulation of Fas receptor on hyperactivated naive and effector cytotoxic T cells, consistent with apoptotic elimination of pro-inflammatory populations, while the helper T-cell compartment remained intact. Concurrent restoration of intermediate and post-germinal center memory B cells was documented, alongside marked expansion of regulatory T and B cells (Tregs and Bregs). This immunological rebalancing was associated with suppression of secondary autoimmune exacerbations and successful clinical discharge, suggesting that molecular hydrogen may modulate immune homeostasis through dual antioxidant and immunoregulatory mechanisms.

### Mechanism

Molecular hydrogen appears to upregulate Fas receptor expression on hyperactivated cytotoxic T cells, promoting their apoptotic clearance, while simultaneously expanding Treg and Breg populations, thereby restoring immune homeostasis and limiting neuroinflammatory relapse.

## Bibliographic

- **Authors**: Li G, Lu J, Ho YJ, Lui SW, Hsieh TY, Wang K, et al.
- **Journal**: In Vivo
- **Year**: 2026
- **PMID**: [42049414](https://pubmed.ncbi.nlm.nih.gov/42049414/)
- **DOI**: [10.21873/invivo.14337](https://doi.org/10.21873/invivo.14337)
- **PMC**: [PMC13133804](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133804/)
- **Study type**: human case report
- **Delivery route**: hydrogen-rich water
- **Effect reported**: positive

## Delivery context

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

## Safety notes

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)
- [Inhalation safety threshold lineage](https://h2-papers.org/en/safety-notes/lineage)

---

> **Cite as**: H2 Papers — PMID 42049414. https://h2-papers.org/en/papers/42049414
> **Source**: PubMed PMID [42049414](https://pubmed.ncbi.nlm.nih.gov/42049414/)