A narrative review of hydrogen therapy for COPD: aging-related insights

Molecular hydrogen (H₂) exhibits selective antioxidant, anti-inflammatory, and anti-senescence properties that may provide therapeutic benefits for chronic obstructive pulmonary disease (COPD), particularly in aging populations where oxidative stress and chronic inflammation are prominent. Given the increasing burden of aging-related COPD and the emerging biological effects of molecular hydrogen, we hypothesized that H₂ therapy may exert beneficial effects by modulating oxidative stress, inflammation, and aging pathways.

Following Ferrari's narrative review framework, PubMed and Ovid MEDLINE were searched through October 2025 for clinical and preclinical studies examining H₂ interventions in COPD, chronic bronchitis, or emphysema, with emphasis on elderly populations or aging-related models.

Three studies met the inclusion criteria: one animal experiment, one prospective clinical study, and one randomized controlled trial. H₂ administration, via inhalation or H₂-rich water, significantly reduced inflammatory cytokines (IL-1β, IL-6, TNF-α), oxidative markers (8-OHdG), and senescence indicators (p16, p21, β-gal). Clinical findings demonstrated improved arterial blood gases, acid-base balance, and exercise tolerance in elderly COPD patients.

H₂ therapy shows consistent antioxidative, anti-inflammatory, and anti-senescence effects across preclinical and clinical settings, suggesting potential as an adjunctive treatment for COPD in aging populations. Further large-scale, long-term trials are warranted to confirm efficacy, optimize dosage, and clarify mechanistic pathways.