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综述

低氘水调控氧化还原稳态治疗重大疾病研究现状与挑战

刘振华1, 闫亚军1, 侯慧娜1, 唐越3,*, 高雯1,*, 唐波1,2,*   

  1. 1.化学化工与材料科学学院,山东师范大学,济南市 250014;
    2.崂山实验室,青岛市 266237;
    3.山东大学齐鲁医院急诊科,急危重症临床研究中心,济南市 250012
  • 投稿日期:2026-07-23
  • 通讯作者: *E-mail: 高雯:gaowen@sdnu.edu.cn;唐波: tangb@sdnu.edu.cn
  • 基金资助:
    国家自然科学基金项目(No.22376128, 22576122, 22306113 和 22404099)资助、山东省自然科学基金(No.ZR2025MS181, 2024HWYQ-014,

DDW in Regulating Redox Homeostasis for Major Disease Therapy: Current Status and Challenges

Zhenhua Liu1, Yajun Yan1, Huina Hou1, Yue Tang3,*, Wen Gao1*, Bo Tang1,2*   

  1. 1. College of Chemistry, Chemical Engineering and Materials Science, Shandong Normal University, Jinan 250014, China;
    2. Laoshan Laboratory, Qingdao 266237, China;
    3. Department of Emergency Medicine, Clinical Research Center For Emergency and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, 250012, China
  • Received:2026-07-23

低氘水(Deuterium-Depleted Water,DDW)是指氘丰度低于天然水标准(约150 ppm)的水。近年来,DDW在肿瘤、神经退行性疾病、内分泌代谢疾病及心血管等重大疾病治疗中显示出一定应用潜力,但其作用机制尚未完全明确。氧化应激是由活性氧(ROS)生成与抗氧化防御失衡所引起的病理状态,是多种慢性疾病发生发展的共同机制之一。线粒体作为细胞能量代谢和ROS生成的核心细胞器,其质子转运、膜电位变化及电子传递效率与细胞内氘/氕比例密切相关。因此,从氧化还原稳态视角阐明DDW的生物学效应,对于理解其疾病治疗作用具有重要意义。本文围绕水的同位素效应、DDW的基本理化特征、细胞摄入方式及其在多种疾病中的研究进展进行系统综述,并重点分析DDW通过调节细胞内氘/氕比例影响细胞内氧化还原稳态及线粒体功能、细胞周期、凋亡、自噬、衰老及炎症反应等过程的潜在机制。现有研究表明,DDW在抗肿瘤、神经保护、红细胞生成、糖脂代谢调节、心血管保护及抗炎解毒等方面表现出积极作用,这些效应多与氧化应激水平改变、线粒体功能重塑及抗氧化防御系统调节密切相关,提示氧化还原稳态调控可能是DDW发挥疾病干预作用的重要切入点。然而,目前DDW相关研究仍存在若干不足,包括不同研究中氘浓度、给药周期和介入时机差异较大,长期安全性证据不足,临床样本量有限,作用机制尚缺乏系统验证,以及制备成本较高等问题。未来应围绕氧化还原稳态调控这一核心科学问题,结合稳定同位素示踪、代谢组学、氧化还原组学、线粒体功能评价及多中心随机双盲临床研究,进一步明确DDW的适应症、最佳剂量、调控机制、安全性及转化潜在应用价值。本文可为从调控氧化还原稳态角度认识DDW潜在辅助治疗重大疾病的研究现状与未来发展挑战提供参考。

关键词: 低氘水, 氧化还原稳态, 线粒体功能, 重大疾病, 治疗

Deuterium-depleted water (DDW) refers to water with a deuterium abundance lower than that of natural water, which is approximately 150 ppm.In recent years, DDW has shown certain therapeutic potential in the treatment of major diseases such as tumors, neurodegenerative diseases, endocrine and metabolic diseases, and cardiovascular diseases, but its mechanisms of action remain incompletely elucidated. Oxidative stress is a pathological state caused by an imbalance between reactive oxygen species (ROS) generation and antioxidant defense, and is a common mechanism underlying the development and progression of multiple chronic diseases. Mitochondria, as the core organelles for cellular energy metabolism and ROS generation, have proton transport, membrane potential changes, and electron transfer efficiency that are closely related to the intracellular deuterium-to-protium (D/H) ratio. Therefore, elucidating the biological effects of DDW from the perspective of redox homeostasis is of great significance for understanding its therapeutic applications. This review systematically summarizes the isotopic effects of water, the fundamental physicochemical properties of DDW, the modes of cellular uptake, and the research progress on DDW in various diseases, with a particular emphasis on analyzing the potential mechanisms by which DDW, through modulating the intracellular deuterium-to-hydrogen (D/H) ratio, affects intracellular redox homeostasis, mitochondrial function, cell cycle progression, apoptosis, autophagy, senescence, and inflammatory responses. Current evidences indicate that DDW exerts positive effects in antitumor, neuroprotection, erythropoiesis, regulation of glucolipid metabolism, cardiovascular protection, as well as anti-inflammatory and detoxification processes. These effects are largely associated with alterations in oxidative stress levels, remodeling of mitochondrial function, and modulation of the antioxidant defense system, suggesting that regulation of redox homeostasis may represent an important entry point for DDW-assisted disease intervention. Nevertheless, current research on DDW still suffers from several limitations, including substantial heterogeneity in deuterium concentrations, administration durations, and timing of intervention across different studies, insufficient evidence for long-term safety, limited clinical sample sizes, a lack of systematic validation of the underlying mechanisms, and relatively high production costs. Future efforts should center on the core scientific question of redox homeostasis regulation, integrating stable isotope tracing, metabolomics, redoxomics, mitochondrial function assessment, and multicenter randomized double-blind clinical trials to further clarify the indications, optimal dosage regimens, regulatory mechanisms, safety profile, and translational potential of DDW. This review may provide a reference for understanding the current research status and future developmental challenges of DDW as a potential adjuvant therapy for major diseases from the perspective of redox homeostasis regulation.

Key words: Deuterium-depleted water, Redox homeostasis, Mitochondrial function, Major diseases, Therapy