Current Pharmaceutical Design - Volume 31, Issue 32, 2025

This review demonstrates the potential role of hydrogen in post-surgical adhesion prevention and calls for further investigation of its molecular pathways, as well as clinical studies to assess its efficacy and safety in a therapeutic setting.

PubMed and Google Scholar were extensively queried to investigate the potential role of hydrogen in preventing post-surgical adhesions and its underlying mechanisms.

Molecular hydrogen exhibits selective antioxidant, anti-inflammatory, and anti-fibrotic properties, holding potential for the treatment and prevention of various disorders, including acute pancreatitis, respiratory diseases, and ischemia-reperfusion damage conditions, among others. Postoperative adhesion is associated with chronic pain, organ dysfunction, and acute complications, fundamentally rooted in inflammation, oxidative stress, and fibrosis. The surgical injury initiates an inflammatory response characterized by immune cell mobilization and an increase in pro-inflammatory cytokine levels, thereby promoting adhesion formation.

Hydrogen is demonstrated to attenuate the early inflammatory response by down-regulating pro-inflammatory cytokines alongside its anti-oxidative and anti-fibrotic effects. As a potential therapeutic agent for post-surgical adhesions, hydrogen warrants additional investigation to elucidate the exact molecular pathways responsible for its observed efficacy and safety.

The increasing use of antibiotics coupled with the lack of innovative and effective antimicrobial agents has increased the development of antimicrobial resistance (AMR) worldwide. To overcome the AMR-associated prolonged disease duration and increased mortality rates, new antimicrobial agents are in high demand. In this context, hydrazone and oxadiazole derivatives are endowed with remarkable biocidal activity, becoming profitable scaffolds in the design of antimicrobial candidates.

In this study, the antimicrobial effects of N-acyl hydrazones 1-15 and 2,5-disubstituted 1,3,4-oxadiazoles 16-27 against Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, Bacillus subtilis ATCC 6633, and clinically isolated Shigella sonnei, Klebsiella pneumoniae, and Candida albicans were evaluated. For this purpose, Kirby-Bauer disc diffusion and MIC tests were carried out, indicating that most of these compounds were active against tested microorganisms. Particularly, several compounds proved active against E. coli, whereas S. aureus showed higher resistance. The genotoxic potential of most active compounds was determined by in vitro alkaline comet assay, and they were found to be non-toxic at studied concentrations.

Finally, molecular docking and dynamics (MD) studies identified four compounds as potential inhibitors of bacterial DNA gyrase B (GyrB).

Further exploration of molecular determinants revealed favourable drug-like properties, highlighting the potential of these molecules for subsequent hit-to-lead optimization studies.