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Medicinal gases for treating central nervous system injuries
Rebecca I Sienel1, Nikolaus Plesnila1
1Institute for Stroke and Dementia Research, Klinikum der Universität München and Ludwig Maximilian University (LMU) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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Central nervous system (CNS) injuries-such as stroke, traumatic brain injury, and perinatal hypoxia-trigger complex secondary cascades involving oxidative stress, inflammation, and apoptosis that limit recovery and therapeutic efficacy. Recent advances in medical gas delivery offer a novel, multifaceted approach to modulate these pathological processes. Gases including hydrogen, nitric oxide, carbon monoxide, xenon, and argon demonstrate potent neuroprotective, anti-inflammatory, and vasomodulatory properties in preclinical models. This review synthesizes current evidence on gas-based interventions across CNS pathologies, elucidates their molecular mechanisms, and evaluates translational challenges related to timing, dosing, and delivery technologies. Gas therapeutics represent a promising frontier in neurocritical care with potential to transform outcomes in otherwise intractable neurological injuries.
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