我們自從2008年發表第一篇研究論文以來,中國學者在這個領域共發表研究論文已經達到110多篇,而國際上這個領域的總數量仍不超過400篇,在疾病種類研究上,中國學者為主的研究幾乎占50%,儘管我們起少比較晚,但我們在國際上的研究規律已經是最大的。參與氫氣生物學效應的中國各個醫科大學和研究所數量迅速增加。根據初步統計,目前有復旦大學上海醫學院、上海交通大學醫學院、同濟大學醫學院、第二軍醫大學、第四軍醫大學、第三軍醫大學、南京大學醫學院、天津醫科大學、華西大學醫學院、陝西師範大學、中國醫科大學、首都醫科大學、哈爾濱醫科大學、蘇州大學、泰山醫學院、溫州醫學院等以及上述部分大學的多家附屬醫院。
國家自然科學基金項目數量能間接反映中國學者在這個領域的關注程度。統計數據顯示,2009年關於氫氣治療疾病的項目有2項,2010年達到4項,2011年已經達到6項,2012年已經達到10項。相信將來國家自然科學基金中關於氫分子生物學研究的項目會逐年增加。
從目前發表論文的情況看,中國學者在氫分子生物學研究方面需要注意的問題依然存在。一是研究的深度不夠,與美國和日本學者相比存在明顯差距,具體表現在我們的研究大多數停留在觀察治療效果,用常規的指標確認治療效果,很少能涉及分子機制的研究。另一個是沒有開展臨床治療的研究,儘管氫氣仍沒有作為藥物用於臨床,但作為保健品,人們仍可以使用,美國和日本學者已經在這方面進行了有益的探索。由於氫氣水和氫水棒已經商品化,可以飲用,日本和東南亞各國都有大量人群使用的報導,在糖尿病、腎衰竭、動脈硬化等疾病方面進行了初步探索。但中國的臨床研究相對滯後,關鍵原因是沒有受到臨床上的真正重視。由於我們國家人口多,疾病種類廣泛,開展臨床研究有很多優勢,只要規範選擇合適的疾病類型,我們理應在氫氣的臨床研究方面取得更好的成績。
從國際上看,氫分子生物學領域有一些重要問題仍沒有引起足夠關注。如內源性氫氣效應的研究,食用人體不吸收的營養素,如甘露醇、乳果糖和許多中藥成分等可能具有促進腸道細菌產生氫氣的作用,這種能增加內源性氫氣產生的手段也應該具有呼吸氫氣同樣的效果。電針本質上就是一種直流電刺激,電針治療過程中由於組織液被電解,在正極可產生氧氣,而在負極可產生氫氣。因此,電針治療過程中體內氫氣的水平會增加,電針的治療效果是否與氫氣有關值得探討。金屬鎂被用於可溶性生物材料如骨材料和血管支架,在含金屬鎂生物材料溶解過程是因為金屬鎂與水發生反應,產生氫氧化鎂和氫氣。因此,在分析這類生物材料對疾病的影響時也可探討氫氣在其中發揮的作用。
總之,將來氫分子生物學效應的發展將可能出現在如下這些方面。
1.氫分子的生物學作用的分子機制研究。這方面主要尋找氫氣的生物分子效應靶點、作用原理。2.氫氣的臨床應用研究。主要是選擇合適的疾病類型,開展嚴格雙盲隨機多中心的臨床研究,重點是對疾病治療效果的確認。近年有望取得突破的疾病類型包括類風濕關節炎等自身免疫性疾病、阿爾茨海默病等神經退行性疾病、糖尿病等代謝性疾病。3.氫氣的臨床使用方法研究。重點是尋找合理的臨床應用方案、氫氣相關藥物的進入、劑量-效應關係、各類使用氫氣的特殊方式有效性研究。4.氫氣在細菌、真菌、植物等多種生物體系中的作用研究。儘管氫氣在細菌和原蟲等肯定可發揮重要作用,但真菌和植物是否存在氫氣的生物學效應目前尚缺乏證據。5.其他類似氣體分子的生物學效應研究。其他一些類似氣體分子,如甲烷、氦氣、其共同特點是結構簡單,沒有毒性作用,應用前景廣泛。氫氣的生物學效應研究給這些氣體的研究提供了借鑒,有望形成一股氣體生物學研究熱潮。許多經典的“小”分子化學物質,例如小分子肽只能靠接觸和其他分子發生反應,許多維生素和金屬離子只能結合在大分子的規定部位發揮輔酶的作用。在生物的液體微觀環境中,氣體分子不僅可以在水相分布,也可以在脂相分布,更重要的是可以深入生物大分子的內部。這是許多傳統的大分子物質所不具備的特點,也許這些氣體的生物學效應秘密恰好就隱藏在這些最簡單的化學性質中。
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