Adjuvant Molecular Hydrogen Therapy in SLE-associated Pulmonary Arterial Hypertension: A Case Report on Immunomodulatory Effects on Regulatory and Effector Lymphocytes

Background/Aim: Pulmonary arterial hypertension (PAH) is a significant and challenging complication for patients with systemic lupus erythematosus (SLE). It is thought to arise from immune dysregulation and vascular remodeling, ultimately leading to progressive right heart failure. Molecular hydrogen therapy, a selective antioxidant and antiinflammatory agent, may modulate the immune responses seen in autoimmune diseases. This case report details the use of adjuvant hydrogen capsule therapy in a patient with SLE with PAH, suggesting its potential as a novel approach for this difficult clinical condition. Case Report: A 42-year-old Taiwanese woman with SLE-PAH received hydrogen capsule therapy, during which serial immunophenotyping revealed dynamic changes in suppressive markers including programmed cell death protein 1 (PD1) and Fas cell surface death receptor (FAS), as well as regulatory T- and B-cell subsets. Notably, the populations of double negative and class-switched memory B-cells decreased during therapy, suggesting durable immune suppression. These results support the effect of hydrogen capsule therapy in achieving immune tolerance and inflammation modulation. Conclusion: This case study suggests that molecular hydrogen therapy may be a promising treatment for patients with SLE-PAH, particularly due to its immunomodulatory effects.