Medicinal gases for treating central nervous system injuries

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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Publication Details

Journal
Advanced Drug Delivery Reviews
Published
2026-01-22
DOI
https://doi.org/10.1016/j.addr.2026.115782
Primary Topic
Hydrogen's biological and therapeutic effects
Type
article
Field-Weighted Citation Impact
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article

Medicinal gases for treating central nervous system injuries

Rebecca Isabella Sienel, Nikolaus Plesnila
Advanced Drug Delivery Reviews
Hydrogen's biological and therapeutic effects
article

Medicinal gases for treating central nervous system injuries

Rebecca Isabella Sienel, Nikolaus Plesnila
article en

Abstract

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.

Advanced Drug Delivery ReviewsVol. 230
Munich Cluster for Systems Neurology (DE), Ludwig-Maximilians-Universität München (DE)
Openalex Percentile: Top 81%
Hydrogen's biological and therapeutic effects
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