51
|
Tan F, Rui X, Xiang X, Yu Z, Al-Rubeai M. Multimodal treatment combining cold atmospheric plasma and acidic fibroblast growth factor for multi-tissue regeneration. FASEB J 2021; 35:e21442. [PMID: 33774850 DOI: 10.1096/fj.202002611r] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023]
Abstract
Cold atmospheric plasma (CAP) is an emerging technology for biomedical applications, exemplified by its antimicrobial and antineoplastic potentials. On the contrary, acidic fibroblast growth factor (aFGF) has been a long-standing potent mitogen for cells from various origins. In this study, we are the first to develop a multimodal treatment combining the aforementioned physicochemical and pharmacological treatments and investigated their individual and combined effects on wound healing, angiogenesis, neurogenesis, and osteogenesis. This work was performed at the tissue, cellular, protein, and gene levels, using histochemical staining, flow cytometry, ELISA, and PCR, respectively. Depending on the type of target tissue, various combinations of aforementioned methods were used. The results showed that the enhancement on would healing and angiogenesis by CAP and aFGF were synergistic. The former was manifested by increased murine fibroblast proliferation and reduced cutaneous tissue inflammation, whereas the latter by upregulated proangiogenic markers in vivo, for example, CD31, VEGF, and TGF-β, and downregulated antiangiogenic proteins in vitro, for example, angiostatin and angiopoietin-2, respectively. In addition, aFGF outperformed CAP during neurogenesis, which was evidenced by superior neurite outgrowth, while CAP exceeded aFGF in osteogenesis which was demonstrated by more substantial bone nodule formation. These novel findings not only support the fact that CAP and aFGF are both multipotent agents during tissue regeneration, but also highlight the potential of our multimodal treatment combining the individual advantages of CAP and aFGF. The versatile administration route, that is, topical and/or systemic, might further broaden its applications.
Collapse
Affiliation(s)
- Fei Tan
- Department of ORL-HNS, Shanghai East Hospital, Shanghai, China.,School of Medicine, Tongji University, Shanghai, China.,The Royal College of Surgeons of England, London, UK
| | - Xiaoqing Rui
- Department of ORL-HNS, Shanghai East Hospital, Shanghai, China
| | - Xue Xiang
- Research Center for Translational Medicine, Shanghai East Hospital, Shanghai, China
| | - Zuoren Yu
- School of Medicine, Tongji University, Shanghai, China.,Research Center for Translational Medicine, Shanghai East Hospital, Shanghai, China
| | - Mohamed Al-Rubeai
- Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| |
Collapse
|
52
|
Kim YJ, Lim DJ, Lee MY, Lee WJ, Chang SE, Won CH. Prospective, comparative clinical pilot study of cold atmospheric plasma device in the treatment of atopic dermatitis. Sci Rep 2021; 11:14461. [PMID: 34262113 PMCID: PMC8280139 DOI: 10.1038/s41598-021-93941-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
Cold atmospheric plasma generates free radicals through the ionization of air at room temperature. Its effect and safety profile as a treatment modality for atopic dermatitis lesions have not been evaluated prospectively enough. We aimed to investigate the effect and safety of cold atmospheric plasma in patients with atopic dermatitis with a prospective pilot study. Cold atmospheric plasma treatment or sham control treatment were applied respectively in randomly assigned and symmetric skin lesions. Three treatment sessions were performed at weeks 0, 1, and 2. Clinical severity indices were assessed at weeks 0, 1, 2, and 4 after treatment. Additionally, the microbial characteristics of the lesions before and after treatments were analyzed. We included 22 patients with mild to moderate atopic dermatitis presented with symmetric lesions. We found that cold atmospheric plasma can alleviate the clinical severity of atopic dermatitis. Modified atopic dermatitis antecubital severity and eczema area and severity index score were significantly decreased in the treated group. Furthermore, scoring of atopic dermatitis score and pruritic visual analog scales significantly improved. Microbiome analysis revealed significantly reduced proportion of Staphylococcus aureus in the treated group. Cold atmospheric plasma can significantly improve mild and moderate atopic dermatitis without safety issues.
Collapse
Affiliation(s)
- Young Jae Kim
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea
| | - Dong Jun Lim
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea
| | - Mi Young Lee
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, 88, OLYMPIC-RO 43-GIL Songpa-gu, Seoul, 05505, South Korea.
| |
Collapse
|
53
|
Misra N, Bhatt S, Arefi‐Khonsari F, Kumar V. State of the art in nonthermal plasma processing for biomedical applications: Can it help fight viral pandemics like COVID-19? PLASMA PROCESSES AND POLYMERS (PRINT) 2021; 18:2000215. [PMID: 34220401 PMCID: PMC8237024 DOI: 10.1002/ppap.202000215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/07/2021] [Accepted: 05/03/2021] [Indexed: 06/13/2023]
Abstract
Plasma processing finds widespread biomedical applications, such as the design of biosensors, antibiofouling surfaces, controlled drug delivery systems, and in plasma sterilizers. In the present coronavirus disease (COVID-19) situation, the prospect of applying plasma processes like surface activation, plasma grafting, plasma-enhanced chemical vapor deposition/plasma polymerization, surface etching, plasma immersion ion implantation, crosslinking, and plasma decontamination to provide timely solutions in the form of better antiviral alternatives, practical diagnostic tools, and reusable personal protective equipment is worth exploring. Herein, the role of nonthermal plasmas and their contributions toward healthcare are timely reviewed to engage different communities in assisting healthcare associates and clinicians, not only to combat the current COVID-19 pandemic but also to prevent similar kinds of future outbreaks.
Collapse
Affiliation(s)
- Nilanjal Misra
- Radiation Technology Development DivisionBhabha Atomic Research CentreTrombayMumbaiMaharashtraIndia
| | - Sudhir Bhatt
- Department of Engineering and Physical SciencesInstitute of Advanced ResearchGandhinagarGujaratIndia
| | | | - Virendra Kumar
- Radiation Technology Development DivisionBhabha Atomic Research CentreTrombayMumbaiMaharashtraIndia
- Department of Chemical SciencesHomi Bhabha National InstituteAnushaktinagarMumbaiMaharashtraIndia
| |
Collapse
|
54
|
Jensen JO, Schulz L, Schleusser S, Matzkeit N, Stang FH, Mailaender P, Kraemer R, Kleemann M, Deichmann H, Kisch T. The repetitive application of cold atmospheric plasma (CAP) improves microcirculation parameters in chronic wounds. Microvasc Res 2021; 138:104220. [PMID: 34216601 DOI: 10.1016/j.mvr.2021.104220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Chronic wounds, such as venous leg ulcers, diabetic foot ulcers, and pressure ulcers, impose a significant burden on patients and health care systems worldwide. Cold atmospheric plasma (CAP) accelerates wound healing and decreases bacterial load in chronic wounds in both in vitro and in vivo experiments. For the first time, we examined the effects of a repetitive application of CAP on the microcirculation in chronic wounds. HYPOTHESIS The repetitive application of cold atmospheric plasma application further improves microcirculation in chronic wounds. METHODS Twenty patients with chronic wounds were treated repetitively with CAP. The repetitive application consisted of three CAP sessions, each lasting 90 s and separated by a 10-minute microcirculation measuring period. Microcirculation parameters were assessed with combined Laser-Doppler-Flowmetry and spectrophotometry in a tissue depth of 2 mm. RESULTS Tissue oxygen saturation was significantly increased after the first CAP application. The effect amplitude and duration were further increased after the second and third CAP application with a maximum increase by 16,7% (percent change; p = 0,004 vs. baseline) after the third application. There was no significant increase in capillary blood flow until the third CAP application. After the third CAP application, an increase by 22,6% (p = 0,014) was observed. Postcapillary filling pressure was not significantly increased over the measuring period. The repetitive application of CAP further enhances the microcirculation in chronic wounds compared to a single application. CONCLUSION The repetitive application of CAP boosts and prolongs tissue oxygen saturation and capillary blood flow in chronic wounds compared to a single application. This insight could provide an impetus for new treatment protocols.
Collapse
Affiliation(s)
- Jan-Oluf Jensen
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany.
| | - Lysann Schulz
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Sophie Schleusser
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Nico Matzkeit
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Felix H Stang
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Peter Mailaender
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Robert Kraemer
- Department of Plastic, Reconstructive and Aesthetic Surgery, Klinikum Westfalen, Dortmund, Germany
| | - Markus Kleemann
- Department of Surgery, Dr. Erler Kliniken, Nuernberg, Germany
| | - Henriette Deichmann
- Department of Surgery, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Tobias Kisch
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| |
Collapse
|
55
|
Kupke LS, Arndt S, Lenzer S, Metz S, Unger P, Zimmermann JL, Bosserhoff AK, Gruber M, Karrer S. Cold Atmospheric Plasma Promotes the Immunoreactivity of Granulocytes In Vitro. Biomolecules 2021; 11:902. [PMID: 34204360 PMCID: PMC8235417 DOI: 10.3390/biom11060902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/01/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022] Open
Abstract
Cold atmospheric plasma (CAP) reduces bacteria and interacts with tissues and cells, thus improving wound healing. The CAP-related induction of neutrophils was recently described in stained sections of wound tissue in mice. Consequently, this study aimed to examine the functionality of human polymorphonuclear cells (PMN)/granulocytes through either a plasma-treated solution (PTS) or the direct CAP treatment with different plasma modes and treatment durations. PTS analysis yielded mode-dependent differences in the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS) after CAP treatment. Live-cell imaging did not show any chemo-attractive or NETosis-inducing effect on PMNs treated with PTS. The time to maximum ROS production (TmaxROS) in PMNs was reduced by PTS and direct CAP treatment. PMNs directly treated with CAP showed an altered cell migration dependent on the treatment duration as well as decreased TmaxROS without inducing apoptosis. Additionally, flow cytometry showed enhanced integrin and selectin expression, as a marker of activation, on PMN surfaces. In conclusion, the modification of PMN immunoreactivity may be a main supporting mechanism for CAP-induced improvement in wound healing.
Collapse
Affiliation(s)
- Laura S. Kupke
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Stephanie Arndt
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Simon Lenzer
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Sophia Metz
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
| | - Petra Unger
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | | | - Anja-Katrin Bosserhoff
- Emil-Fischer-Center, Institute of Biochemistry, University of Erlangen-Nuernberg (FAU), 91054 Erlangen, Germany;
| | - Michael Gruber
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
| | - Sigrid Karrer
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| |
Collapse
|
56
|
Bekeschus S, Clemen R, Haralambiev L, Niessner F, Grabarczyk P, Weltmann KD, Menz J, Stope M, von Woedtke T, Gandhirajan R, Schmidt A. The Plasma-Induced Leukemia Cell Death is Dictated by the ROS Chemistry and the HO-1/CXCL8 Axis. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2021. [DOI: 10.1109/trpms.2020.3020686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
57
|
Schmidt A, Niesner F, von Woedtke T, Bekeschus S. Hyperspectral Imaging of Wounds Reveals Augmented Tissue Oxygenation Following Cold Physical Plasma Treatment in Vivo. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2021. [DOI: 10.1109/trpms.2020.3009913] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
58
|
Kenari AJ, Siadati SN, Abedian Z, Sohbatzadeh F, Amiri M, Gorji KE, Babapour H, Zabihi E, Ghoreishi SM, Mehraeen R, Monfared AS. Therapeutic effect of cold atmospheric plasma and its combination with radiation as a novel approach on inhibiting cervical cancer cell growth (HeLa cells). Bioorg Chem 2021; 111:104892. [PMID: 33894430 DOI: 10.1016/j.bioorg.2021.104892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/01/2021] [Accepted: 04/02/2021] [Indexed: 01/11/2023]
Abstract
Cervical cancer is one of the important cancers in women. Research on novel treatment approach can reduce the mortality and burden. Although radiotherapy is a common treatment, its negative side effects have concerned physician. In our study, we studied impact of cold atmospheric pressure plasma on the Hela cancer cells, as an alternative treatment. The effect of three different types of such plasma; dielectric barrier discharge (DBD), plasma jet, and afterglow plasma, on the cancer cells were studied. Moreover, some effective operating parameters such as exposure time, applied voltage, composition of working gas in plasma treatment were investigated on the survival of the afterglow plasma. Finally, treatments by the afterglow plasma, gamma radiation (1 Gy), and combination of both were compared. Analysis showed that DBD and plasma jet (direct exposure) effectively killed the cancer cells, even by a minimum applied voltage. But a fraction of the cells survived after the exposure of indirect diffused afterglow plasma. In the case of this plasma, we realized that higher applied voltage and exposure time led to less cell viability. Fewer fractions of survival cells were detected in the case of argon afterglow plasma comparing to oxygen afterglow. Cold atmospheric plasma and its combination with radiation therapy showed a significant decrease in viability of the cells, comparing to the radiation alone. Our research showed that plasma and its combination with radiation therapy have superiority over radiation therapy.
Collapse
Affiliation(s)
- Ali Jamaati Kenari
- Department of Physical Electronics, Faculty of Science, Masaryk University, Kotlarska 267/2, 611 37 Brno, Czech Republic; Atomic and Molecular Physics Department, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Seyedeh Neda Siadati
- Department of Physics, Faculty of Basic Sciences, Azarbaijan Shahid Madani University, Tabriz-Maragheh Road, 53714-161 Tabriz, Iran
| | - Zeinab Abedian
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farshad Sohbatzadeh
- Atomic and Molecular Physics Department, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Mehrangiz Amiri
- Department of Nuclear Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Hamed Babapour
- Department of Radiotherapy Physics, Guilan Oncology Hospital, Rasht, Iran
| | - Ebrahim Zabihi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyedeh Masoumeh Ghoreishi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Rahele Mehraeen
- Departeman of Radiology, Babol University of Medical Sciences, Babol, Iran
| | - Ali Shabestani Monfared
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| |
Collapse
|
59
|
Abstract
Nonthermal atmospheric pressure biocompatible plasma (NBP), alternatively called bio-cold plasma, is a partially ionized gas that consists of charged particles, neutral atoms and molecules, photons, an electric field, and heat. Recently, nonthermal plasma-based technology has been applied to bioscience, medicine, agriculture, food processing, and safety. Various plasma device configurations and electrode layouts has fast-tracked plasma applications in the treatment of biological and material surfaces. The NBP action mechanism may be related to the synergy of plasma constituents, such as ultraviolet radiation or a reactive species. Recently, plasma has been used in the inactivation of viruses and resistant microbes, such as fungal cells, bacteria, spores, and biofilms made by microbes. It has also been used to heal wounds, coagulate blood, degrade pollutants, functionalize material surfaces, kill cancers, and for dental applications. This review provides an outline of NBP devices and their applications in bioscience and medicine. We also discuss the role of plasma-activated liquids in biological applications, such as cancer treatments and agriculture. The individual adaptation of plasma to meet specific medical requirements necessitates real-time monitoring of both the plasma performance and the target that is treated and will provide a new paradigm of plasma-based therapeutic clinical systems.
Collapse
Affiliation(s)
- Eun H. Choi
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul, 01897 Republic of Korea
| | - Han S. Uhm
- Canode # 702, 136-11 Tojeong-ro, Mapo-gu, Seoul, 04081 Republic of Korea
| | - Nagendra K. Kaushik
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul, 01897 Republic of Korea
| |
Collapse
|
60
|
Plasma-Treated Solutions (PTS) in Cancer Therapy. Cancers (Basel) 2021; 13:cancers13071737. [PMID: 33917469 PMCID: PMC8038720 DOI: 10.3390/cancers13071737] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Cold physical plasma is a partially ionized gas generating various reactive oxygen and nitrogen species (ROS/RNS) simultaneously. ROS/RNS have therapeutic effects when applied to cells and tissues either directly from the plasma or via exposure to solutions that have been treated beforehand using plasma processes. This review addresses the challenges and opportunities of plasma-treated solutions (PTSs) for cancer treatment. Abstract Cold physical plasma is a partially ionized gas generating various reactive oxygen and nitrogen species (ROS/RNS) simultaneously. ROS/RNS have therapeutic effects when applied to cells and tissues either directly from the plasma or via exposure to solutions that have been treated beforehand using plasma processes. This review addresses the challenges and opportunities of plasma-treated solutions (PTSs) for cancer treatment. These PTSs include plasma-treated cell culture media in experimental research as well as clinically approved solutions such as saline and Ringer’s lactate, which, in principle, already qualify for testing in therapeutic settings. Several types of cancers were found to succumb to the toxic action of PTSs, suggesting a broad mechanism of action based on the tumor-toxic activity of ROS/RNS stored in these solutions. Moreover, it is indicated that the PTS has immuno-stimulatory properties. Two different routes of application are currently envisaged in the clinical setting. One is direct injection into the bulk tumor, and the other is lavage in patients suffering from peritoneal carcinomatosis adjuvant to standard chemotherapy. While many promising results have been achieved so far, several obstacles, such as the standardized generation of large volumes of sterile PTS, remain to be addressed.
Collapse
|
61
|
Bekeschus S, Meyer D, Arlt K, von Woedtke T, Miebach L, Freund E, Clemen R. Argon Plasma Exposure Augments Costimulatory Ligands and Cytokine Release in Human Monocyte-Derived Dendritic Cells. Int J Mol Sci 2021; 22:3790. [PMID: 33917526 PMCID: PMC8038845 DOI: 10.3390/ijms22073790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023] Open
Abstract
Cold physical plasma is a partially ionized gas expelling many reactive oxygen and nitrogen species (ROS/RNS). Several plasma devices have been licensed for medical use in dermatology, and recent experimental studies suggest their putative role in cancer treatment. In cancer therapies with an immunological dimension, successful antigen presentation and inflammation modulation is a key hallmark to elicit antitumor immunity. Dendritic cells (DCs) are critical for this task. However, the inflammatory consequences of DCs following plasma exposure are unknown. To this end, human monocyte-derived DCs (moDCs) were expanded from isolated human primary monocytes; exposed to plasma; and their metabolic activity, surface marker expression, and cytokine profiles were analyzed. As controls, hydrogen peroxide, hypochlorous acid, and peroxynitrite were used. Among all types of ROS/RNS-mediated treatments, plasma exposure exerted the most notable increase of activation markers at 24 h such as CD25, CD40, and CD83 known to be crucial for T cell costimulation. Moreover, the treatments increased interleukin (IL)-1α, IL-6, and IL-23. Altogether, this study suggests plasma treatment augmenting costimulatory ligand and cytokine expression in human moDCs, which might exert beneficial effects in the tumor microenvironment.
Collapse
Affiliation(s)
- Sander Bekeschus
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
| | - Dorothee Meyer
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
| | - Kevin Arlt
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
| | - Thomas von Woedtke
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
- Institute of Hygiene and Environmental Medicine, Greifswald University Medical Center, 17475 Greifswald, Germany
| | - Lea Miebach
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
- Department of General, Visceral, Thoracic, and Vascular Surgery, Greifswald University Medical Center, 17475 Greifswald, Germany
| | - Eric Freund
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
- Department of General, Visceral, Thoracic, and Vascular Surgery, Greifswald University Medical Center, 17475 Greifswald, Germany
| | - Ramona Clemen
- The Centre for Innovation Competence (ZIK) Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (D.M.); (K.A.); (T.v.W.); (L.M.); (E.F.); (R.C.)
| |
Collapse
|
62
|
Plattfaut I, Besser M, Severing AL, Stürmer EK, Opländer C. Plasma medicine and wound management: Evaluation of the antibacterial efficacy of a medically certified cold atmospheric argon plasma jet. Int J Antimicrob Agents 2021; 57:106319. [PMID: 33716180 DOI: 10.1016/j.ijantimicag.2021.106319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 02/10/2021] [Accepted: 03/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES A major problem for wound healing is contamination with bacteria, often resulting in biofilm formation and wound infection, which, in turn, needs immediate intervention such as surgical debridement and through irrigation. A topical treatment with cold atmospheric pressure plasma (CAP) for wound disinfection may present an alternative and less painful approach. METHODS This study investigated the antibacterial effects of a cold atmospheric pressure argon plasma jet (kINPen® MED) as a CAP source, using the three-dimensional Staphylococcus aureus immunocompetent biofilm system hpBIOM in addition to a standard planktonic test. Furthermore, skin cell compatibility was evaluated using a keratinocyte (HaCat) model. RESULTS CAP treatment (0-240 s) followed by incubation (15, 120 min) within the CAP-treated media showed slight bactericidal efficacy under planktonic conditions but no effect on biofilms. However, indirect CAP treatment of keratinocytes performed under the same conditions resulted in a significant decrease in metabolic activity. Short CAP treatment and exposure time (30 s; 15 min) induced a slight increase in the metabolic activity; however, longer treatments and/or exposure times led to pronounced reductions up to 100%. These effects could partially be reversed by addition of catalase, indicating a dominant role of CAP-generated hydrogen peroxide. CONCLUSIONS These results indicate that plasma treatment does not lead to the desired disinfection or significant reduction in the bacterial burden of Staphylococcus aureus in a wet milieu or in biofilms. Thus, treatment with CAP could not be recommended as a single anti-bacterial therapy for wounds but could be used to support standard treatments.
Collapse
Affiliation(s)
- Isabell Plattfaut
- Department of Virology and Microbiology, Centre for Biomedical Education and Research (ZBAF), University Witten/Herdecke, Witten, Germany
| | - Manuela Besser
- Clinic for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Anna-Lena Severing
- Department of Dermatology, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ewa K Stürmer
- Department of Vascular Medicine, University Heart Center, Translational Wound Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Opländer
- Department of Virology and Microbiology, Centre for Biomedical Education and Research (ZBAF), University Witten/Herdecke, Witten, Germany; Institute for Research in Operative Medicine (IFOM), Cologne-Merheim Medical Center, University Witten/Herdecke, Witten, Germany.
| |
Collapse
|
63
|
Gan L, Jiang J, Duan JW, Wu XJZ, Zhang S, Duan XR, Song JQ, Chen HX. Cold atmospheric plasma applications in dermatology: A systematic review. JOURNAL OF BIOPHOTONICS 2021; 14:e202000415. [PMID: 33231354 DOI: 10.1002/jbio.202000415] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 06/11/2023]
Abstract
Cold atmospheric plasma (CAP) applications can potentially lead to effective therapy for numerous skin diseases. Our aim is to systematically review the available data and map the use of CAP in dermatology. PubMed, Embase and Web of science were explored before 2020 for studies regarding the use of CAP in dermatology. A total of 166 studies were finally included. 74.1% of these studies used indirect CAP sources. Most studies used plasma jet (67.5%). Argon was the mostly used working gas (48.2%). Plasma application itself could be direct (89.2%) and indirect (16.3%). The proportion of studies with in vivo results remained 57.2%, of which most concerned direct plasma treatment (97.9%). Analyses performed indicate that CAP has been beneficial in many skin disorders. While, most CAP applications were focused on wound healing and melanoma treatment. This study provides a brief overview of CAP sources and relative medical applications in dermatology.
Collapse
Affiliation(s)
- Lu Gan
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jian Jiang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiang Wei Duan
- The International Joint Research Laboratory for Innovative Design and Manufacturing of Advanced Mechanical Systems, Jihua Laboratory, Foshan, China
| | - Xue Jing Zi Wu
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Song Zhang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao Ru Duan
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ji Quan Song
- Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Xiang Chen
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Dermatology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
64
|
Glover K, Stratakos AC, Varadi A, Lamprou DA. 3D scaffolds in the treatment of diabetic foot ulcers: New trends vs conventional approaches. Int J Pharm 2021; 599:120423. [PMID: 33647412 DOI: 10.1016/j.ijpharm.2021.120423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/20/2021] [Accepted: 02/20/2021] [Indexed: 12/22/2022]
Abstract
Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus, affecting roughly 25% of diabetic patients and resulting in lower limb amputation in over 70% of known cases. In addition to the devastating physiological consequences of DFU and its impact on patient quality of life, DFU has significant clinical and economic implications. Various traditional therapies are implemented to effectively treat DFU. However, emerging technologies such as bioprinting and electrospinning, present an exciting opportunity to improve current treatment strategies through the development of 3D scaffolds, by overcoming the limitations of current wound healing strategies. This review provides a summary on (i) current prevention and treatment strategies available for DFU; (ii) methods of fabrication of 3D scaffolds relevant for this condition; (iii) suitable materials and commonly used molecules for the treatment of DFU; and (iv) future directions offered by emerging technologies.
Collapse
Affiliation(s)
- Katie Glover
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Alexandros Ch Stratakos
- Faculty of Health and Applied Sciences, Center for Research in Biosciences, University of the West of England, Bristol BS16 1QY, UK
| | - Aniko Varadi
- Faculty of Health and Applied Sciences, Center for Research in Biosciences, University of the West of England, Bristol BS16 1QY, UK
| | - Dimitrios A Lamprou
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK.
| |
Collapse
|
65
|
Boekema B, Stoop M, Vlig M, van Liempt J, Sobota A, Ulrich M, Middelkoop E. Antibacterial and safety tests of a flexible cold atmospheric plasma device for the stimulation of wound healing. Appl Microbiol Biotechnol 2021; 105:2057-2070. [PMID: 33587156 PMCID: PMC7906937 DOI: 10.1007/s00253-021-11166-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 12/14/2022]
Abstract
Cold atmospheric plasma (CAP) devices generate an ionized gas with highly reactive species and electric fields at ambient air pressure and temperature. A flexible dielectric barrier discharge (DBD) was developed as an alternative antimicrobial treatment for chronic wounds. Treatment of Staphylococcus aureus in collagen-elastin matrices with CAP for 2 min resulted in a 4 log reduction. CAP treatment was less effective on S. aureus on dermal samples. CAP did not affect cellular activity or DNA integrity of human dermal samples when used for up to 2 min. Repeated daily CAP treatments for 2 min lowered cellular activity of dermal samples to 80% after 2 to 4 days, but this was not significant. Repeated treatment of ex vivo human burn wound models with CAP for 2 min did not affect re-epithelialization. Intact skin of 25 healthy volunteers was treated with CAP for 3× 20" to determine safety. Although participants reported moderate pain scores (numerical rating scale 3.3), all volunteers considered the procedure to be acceptable. Severe adverse events did not occur. CAP treatment resulted in a temporarily increased local skin temperature (≈3.4°C) and increased erythema. Lowering the plasma power resulted in a significantly lower erythema increase. Good log reduction (2.9) of bacterial load was reached in 14/15 volunteers artificially contaminated with Pseudomonas aeruginosa. This study demonstrated the in vitro and in vivo safety and efficacy in bacterial reduction of a flexible cold plasma device. Trial registration number NCT03007264, January 2, 2017 KEY POINTS: • CAP strongly reduced bacterial numbers both in vitro and in vivo. • Re-epithelialization of burn wound models was not affected by repeated CAP. • CAP treatment of intact skin was well tolerated in volunteers.
Collapse
Affiliation(s)
- Bouke Boekema
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.
| | - Matthea Stoop
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
| | - Jos van Liempt
- Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ana Sobota
- Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Magda Ulrich
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.,Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
66
|
Could cold plasma act synergistically with allogeneic mesenchymal stem cells to improve wound skin regeneration in a large size animal model? Res Vet Sci 2021; 136:97-110. [PMID: 33596495 DOI: 10.1016/j.rvsc.2021.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/05/2021] [Accepted: 01/24/2021] [Indexed: 02/06/2023]
Abstract
Skin wound healing may sometimes lead to open sores that persist for long periods and expensive hospitalization is needed. Among different kinds of therapeutic innovative approaches, mesenchymal stem cells (MSCs) and low-temperature atmospheric pressure cold plasma (ionized gas) have been recently tested to improve this regenerative process. To optimize wound healing the present study intended to combine, for the first time, these two novel approaches in a large size animal wound healing model with the aim of assessing the putative dual beneficial effects. Based on clinical, histopathological, and molecular results a synergistic action in a second intention healing wound in sheep has been observed. Experimental wounds treated with cold plasma and MSCs showed a slower but more effective healing compared to the single treatment, as observed in previous studies. The combined treatment improved the correct development of skin appendages and structural proteins of the dermis showing the potential of the dual combination as a safe and effective tool for skin regeneration in the veterinary clinical field.
Collapse
|
67
|
Akter M, Lim JS, Choi EH, Han I. Non-Thermal Biocompatible Plasma Jet Induction of Apoptosis in Brain Cancer Cells. Cells 2021; 10:cells10020236. [PMID: 33530311 PMCID: PMC7911799 DOI: 10.3390/cells10020236] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/12/2022] Open
Abstract
Glioblastoma multiforme (GBM) is a highly malignant and rapidly advancing astrocytic brain tumor in adults. Current therapy possibilities are chemotherapy, surgical resection, and radiation. The complexity of drug release through the blood-brain barrier, tumor reaction to chemotherapy, and the inherent resistance of tumor cells present challenges. New therapies are needed for individual use or combination with conventional methods for more effective treatment and improved survival for patients. GBM is difficult to treat because it grows quickly, spreads finger-shaped tentacles, and creates an irregular margin of normal tissue surrounding the tumor. Non-thermal biocompatible plasma (NBP) has recently been shown to selectively target cancer cells with minimal effects on regular cells, acting by generating reactive oxygen species (ROS) and reactive nitrogen species (RNS). We applied a soft jet plasma device with a syringe shape to U87 MG cells and astrocytes. Our results show that NBP-J significantly inhibits cell proliferation and changes morphology, induces cell cycle arrest, inhibits the survival pathway, and induces apoptosis. Our results indicate that NBP-J may be an efficient and safe clinical device for brain cancer therapy.
Collapse
Affiliation(s)
- Mahmuda Akter
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Korea;
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Korea;
| | - Jun Sup Lim
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Korea;
- Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea
| | - Eun Ha Choi
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Korea;
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Korea;
- Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea
- Correspondence: (E.H.C.); (I.H.); Tel.: +82-2-940-5666 (I.H.); Fax: +82-2-940-5664 (I.H.)
| | - Ihn Han
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Korea;
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Korea;
- Correspondence: (E.H.C.); (I.H.); Tel.: +82-2-940-5666 (I.H.); Fax: +82-2-940-5664 (I.H.)
| |
Collapse
|
68
|
Lin A, Biscop E, Breen C, Butler SJ, Smits E, Bogaerts A. Critical Evaluation of the Interaction of Reactive Oxygen and Nitrogen Species with Blood to Inform the Clinical Translation of Nonthermal Plasma Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:9750206. [PMID: 33343810 PMCID: PMC7728471 DOI: 10.1155/2020/9750206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/14/2020] [Accepted: 11/04/2020] [Indexed: 11/22/2022]
Abstract
Non-thermal plasma (NTP), an ionized gas generated at ambient pressure and temperature, has been an emerging technology for medical applications. Through controlled delivery of reactive oxygen and nitrogen species (ROS/RNS), NTP can elicit hormetic cellular responses, thus stimulating broad therapeutic effects. To enable clinical translation of the promising preclinical research into NTP therapy, a deeper understanding of NTP interactions with clinical substrates is profoundly needed. Since NTP-generated ROS/RNS will inevitably interact with blood in several clinical contexts, understanding their stability in this system is crucial. In this study, two medically relevant NTP delivery modalities were used to assess the stability of NTP-generated ROS/RNS in three aqueous solutions with increasing organic complexities: phosphate-buffered saline (PBS), blood plasma (BP), and processed whole blood. NTP-generated RNS collectively (NO2 -, ONOO-), H2O2, and ONOO- exclusively were analyzed over time. We demonstrated that NTP-generated RNS and H2O2 were stable in PBS but scavenged by different components of the blood. While RNS remained stable in BP after initial scavenging effects, it was completely reduced in processed whole blood. On the other hand, H2O2 was completely scavenged in both liquids over time. Our previously developed luminescent probe europium(III) was used for precision measurement of ONOO- concentration. NTP-generated ONOO- was detected in all three liquids for up to at least 30 seconds, thus highlighting its therapeutic potential. Based on our results, we discussed the necessary considerations to choose the most optimal NTP modality for delivery of ROS/RNS to and via blood in the clinical context.
Collapse
Affiliation(s)
- Abraham Lin
- PLASMANT-Research Group, University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
- Center for Oncological Research―Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
| | - Eline Biscop
- PLASMANT-Research Group, University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
- Center for Oncological Research―Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
| | - Colum Breen
- Department of Chemistry, Loughborough University, LE11 3TU Loughborough, UK
| | - Stephen J. Butler
- Department of Chemistry, Loughborough University, LE11 3TU Loughborough, UK
| | - Evelien Smits
- Center for Oncological Research―Integrated Personalized & Precision Oncology Network (IPPON), University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
- Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, 2650 Antwerp-Edegem, Belgium
| | - Annemie Bogaerts
- PLASMANT-Research Group, University of Antwerp, 2601 Antwerpen-Wilrijk, Belgium
| |
Collapse
|
69
|
Busco G, Robert E, Chettouh-Hammas N, Pouvesle JM, Grillon C. The emerging potential of cold atmospheric plasma in skin biology. Free Radic Biol Med 2020; 161:290-304. [PMID: 33039651 DOI: 10.1016/j.freeradbiomed.2020.10.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/25/2022]
Abstract
The maintenance of skin integrity is crucial to ensure the physiological barrier against exogenous compounds, microorganisms and dehydration but also to fulfill social and aesthetic purposes. Besides the development of new actives intended to enter a formulation, innovative technologies based on physical principles have been proposed in the last years. Among them, Cold Atmospheric Plasma (CAP) technology, which already showed interesting results in dermatology, is currently being studied for its potential in skin treatments and cares. CAP bio-medical studies gather several different expertise ranging from physics to biology through chemistry and biochemistry, making this topic hard to pin. In this review we provide a broad survey of the interactions between CAP and skin. In the first section, we tried to give some fundamentals on skin structure and physiology, related to its essential functions, together with the main bases on cold plasma and its physicochemical properties. In the following parts we dissected and analyzed each CAP parameter to highlight the already known and the possible effects they can play on skin. This overview aims to get an idea of the potential of cold atmospheric plasma technology in skin biology for the future developments of dermo-cosmetic treatments, for example in aging prevention.
Collapse
Affiliation(s)
- Giovanni Busco
- Centre de Biophysique Moléculaire, UPR4301, CNRS, 45071, Orléans, France; Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France.
| | - Eric Robert
- Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France
| | | | - Jean-Michel Pouvesle
- Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France
| | - Catherine Grillon
- Centre de Biophysique Moléculaire, UPR4301, CNRS, 45071, Orléans, France.
| |
Collapse
|
70
|
Comprehensive biomedical applications of low temperature plasmas. Arch Biochem Biophys 2020; 693:108560. [PMID: 32857998 PMCID: PMC7448743 DOI: 10.1016/j.abb.2020.108560] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
The main component of plasma medicine is the use of low-temperature plasma (LTP) as a powerful tool for biomedical applications. LTP generates high reactivity at low temperatures and can be activated with noble gases with molecular mixtures or compressed air. LTP reactive species are quickly produced, and are a remarkably good source of reactive oxygen and nitrogen species including singlet oxygen (O2), ozone (O3), hydroxyl radicals (OH), nitrous oxide (NO), and nitrogen dioxide (NO2). Its low gas temperature and highly reactive non-equilibrium chemistry make it appropriate for the alteration of inorganic surfaces and delicate biological systems. Treatment of oral biofilm-related infections, treatment of wounds and skin diseases, assistance in cancer treatment, treatment of viruses' infections (e.g. herpes simplex), and optimization of implants surfaces are included among the extensive plasma medicine applications. Each of these applications will be discussed in this review article.
Collapse
|
71
|
Genotypic and Phenotypic Changes in Candida albicans as a Result of Cold Plasma Treatment. Int J Mol Sci 2020; 21:ijms21218100. [PMID: 33143065 PMCID: PMC7663045 DOI: 10.3390/ijms21218100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 01/12/2023] Open
Abstract
We treated Candida albicans cells with a sublethal dose of nonequilibrium (cold) atmospheric-pressure He plasma and studied alterations in the genome of this fungus as well as changes in the phenotypic traits, such as assimilation of carbon from carbohydrates, hydrolytic enzyme activity, and drug susceptibility. There is a general problem if we use cold plasma to kill microorganism cells and some of them survive the process—whether the genotypic and phenotypic features of the cells are significantly altered in this case, and, if so, whether these changes are environmentally hazardous. Our molecular genetic studies have identified six single nucleotide variants, six insertions, and five deletions, which are most likely significant changes after plasma treatment. It was also found that out of 19 tested hydrolytic enzymes, 10 revealed activity, of which nine temporarily decreased their activity and one (naphthol-AS-BI- phosphohydrolase) permanently increased activity as a result of the plasma treatment. In turn, carbon assimilation and drug susceptibility were not affected by plasma. Based on the performed studies, it can be concluded that the observed changes in C. albicans cells that survived the plasma action are not of significant importance to the environment, especially for the drug resistance and pathogenicity of this fungus.
Collapse
|
72
|
Moelleken M, Jockenhöfer F, Wiegand C, Buer J, Benson S, Dissemond J. Pilotstudie zum Einfluss von kaltem atmosphärischem Plasma auf bakterielle Kontamination und Heilungstendenz chronischer Wunden. J Dtsch Dermatol Ges 2020; 18:1094-1102. [DOI: 10.1111/ddg.14294_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/15/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Maurice Moelleken
- Abteilung für Dermatologie Venerologie & Allergologie Universitätsklinikum Essen
| | - Finja Jockenhöfer
- Abteilung für Dermatologie Venerologie & Allergologie Universitätsklinikum Essen
| | | | - Jan Buer
- Abteilung für Medizinische Mikrobiologie Universitätsklinikum Essen
| | - Sven Benson
- Abteilung für Medizinische Psychologie und Verhaltensimmunbiologie Universitätsklinikum Essen
| | - Joachim Dissemond
- Abteilung für Dermatologie Venerologie & Allergologie Universitätsklinikum Essen
| |
Collapse
|
73
|
Frescaline N, Duchesne C, Favier M, Onifarasoaniaina R, Guilbert T, Uzan G, Banzet S, Rousseau A, Lataillade JJ. Physical plasma therapy accelerates wound re-epithelialisation and enhances extracellular matrix formation in cutaneous skin grafts. J Pathol 2020; 252:451-464. [PMID: 32918753 DOI: 10.1002/path.5546] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/09/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
Skin grafting is a surgical method of cutaneous reconstruction, which provides volumetric replacement in wounds unable to heal by primary intention. Clinically, full-thickness skin grafts (FTSGs) are placed in aesthetically sensitive and mechanically demanding areas such as the hands, face, and neck. Complete or partial graft failure is the primary complication associated with this surgical procedure. Strategies aimed at improving the rate of skin graft integration will reduce the incidence of graft failure. Cold atmospheric plasma (CAP) is an emerging technology offering innovative clinical applications. The aim of this study was to test the therapeutic potential of CAP to improve wound healing and skin graft integration into the recipient site. In vitro models that mimic wound healing were used to investigate the ability of CAP to enhance cellular migration, a key factor in cutaneous tissue repair. We demonstrated that CAP enhanced the migration of epidermal keratinocytes and dermal fibroblasts. This increased cellular migration was possibly induced by the low dose of reactive oxygen and nitrogen species produced by CAP. Using a mouse model of burn wound reconstructed with a full-thickness skin graft, we showed that wounds treated with CAP healed faster than did control wounds. Immunohistochemical wound analysis showed that CAP treatment enhanced the expression of the dermal-epidermal junction components, which are vital for successful skin graft integration. CAP treatment was characterised by increased levels of Tgfbr1 mRNA and collagen I protein in vivo, suggesting enhanced wound maturity and extracellular matrix deposition. Mechanistically, we show that CAP induced the activation of the canonical SMAD-dependent TGF-β1 pathway in primary human dermal fibroblasts, which may explain the increased collagen I synthesis in vitro. These studies revealed that CAP improved wound repair and skin graft integration via mechanisms involving extracellular matrix formation. CAP offers a novel approach for treating cutaneous wounds and skin grafts. © 2020 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Nadira Frescaline
- INSERM UMRS-MD 1197, Institut de Recherche Biomédicale des Armées, Centre de Transfusion Sanguine des Armées, Clamart, France.,Laboratoire de Physique des Plasmas, École Polytechnique, Sorbonne Université, Université Paris Saclay, CNRS, Palaiseau, France
| | - Constance Duchesne
- INSERM UMRS-MD 1197, Institut de Recherche Biomédicale des Armées, Centre de Transfusion Sanguine des Armées, Clamart, France.,Laboratoire de Physique des Plasmas, École Polytechnique, Sorbonne Université, Université Paris Saclay, CNRS, Palaiseau, France
| | - Maryline Favier
- Institut Cochin, INSERM U1016, CNRS UMR8104, Université de Paris, Paris, France
| | | | - Thomas Guilbert
- Institut Cochin, INSERM U1016, CNRS UMR8104, Université de Paris, Paris, France
| | - Georges Uzan
- INSERM UMRS-MD 1197, Hôpital Paul Brousse, Villejuif, France
| | - Sébastien Banzet
- INSERM UMRS-MD 1197, Institut de Recherche Biomédicale des Armées, Centre de Transfusion Sanguine des Armées, Clamart, France
| | - Antoine Rousseau
- Laboratoire de Physique des Plasmas, École Polytechnique, Sorbonne Université, Université Paris Saclay, CNRS, Palaiseau, France
| | - Jean-Jacques Lataillade
- INSERM UMRS-MD 1197, Institut de Recherche Biomédicale des Armées, Centre de Transfusion Sanguine des Armées, Clamart, France
| |
Collapse
|
74
|
Cold Atmospheric Pressure Plasma in Wound Healing and Cancer Treatment. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10196898] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Plasma medicine is gaining increasing attention and is moving from basic research into clinical practice. While areas of application are diverse, much research has been conducted assessing the use of cold atmospheric pressure plasma (CAP) in wound healing and cancer treatment—two applications with entirely different goals. In wound healing, a tissue-stimulating effect is intended, whereas cancer therapy aims at killing malignant cells. In this review, we provide an overview of the latest clinical and some preclinical research on the efficacy of CAP in wound healing and cancer therapy. Furthermore, we discuss the current understanding of molecular signaling mechanisms triggered by CAP that grant CAP its antiseptic and tissue regenerating or anti-proliferative and cell death-inducing properties. For the efficacy of CAP in wound healing, already substantial evidence from clinical studies is available, while evidence for therapeutic effects of CAP in oncology is mainly from in vitro and in vivo animal studies. Efforts to elucidate the mode of action of CAP suggest that different components, such as ultraviolet (UV) radiation, electromagnetic fields, and reactive species, may act synergistically, with reactive species being regarded as the major effector by modulating complex and concentration-dependent redox signaling pathways.
Collapse
|
75
|
Eggers B, Marciniak J, Memmert S, Kramer FJ, Deschner J, Nokhbehsaim M. The beneficial effect of cold atmospheric plasma on parameters of molecules and cell function involved in wound healing in human osteoblast-like cells in vitro. Odontology 2020; 108:607-616. [PMID: 32030565 PMCID: PMC7438292 DOI: 10.1007/s10266-020-00487-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/19/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to analyse the effect of cold atmospheric plasma (CAP) on human osteoblast-like cells in vitro. Additionally, underlying intracellular mechanisms were to be studied. Human osteoblast-like (MG63) cells were exposed to CAP for 60 s. The effects of CAP on key molecules essential for the wound healing response were studied using real-time PCR, ELISA and immunocytochemistry. For studying intracellular signalling pathways, MAP kinase MEK 1/2 was blocked. Cell viability was analysed by an XTT assay and with an EVE automated cell counter. Cell migration was examined by an in vitro wound healing assay.CAP exposition on osteoblast-like cells caused a significant upregulation of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)α, cyclooxygenase (COX)2, collagen (COL) 1α, matrix metalloproteinase (MMP)1, Ki67, proliferating-cell-nuclear-antigen (PCNA) and chemokine ligand (CCL)2 mRNA expression at 1 day. Interestingly, after blocking of MAP kinase, CAP-induced upregulation of Ki67 was inhibited by 57%. Moreover, CAP treatment improved significantly osteoblast-like cell viability as compared to untreated cells at 1 day. Beneficial effect of CAP treatment was shown by an in vitro wound healing assay, displaying a significant faster wound closure. Our findings provide evidence that CAP exposure effects gene and protein regulation in human osteoblast-like cells. Furthermore, CAP treatment has a positive impact on wound closure in an in vitro setting and might improve existing concepts of hard tissue regeneration in the future.
Collapse
Affiliation(s)
- B Eggers
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany.
| | - J Marciniak
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - S Memmert
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - F J Kramer
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Craniomaxillofacial Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - J Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| |
Collapse
|
76
|
Moelleken M, Jockenhöfer F, Wiegand C, Buer J, Benson S, Dissemond J. Pilot study on the influence of cold atmospheric plasma on bacterial contamination and healing tendency of chronic wounds. J Dtsch Dermatol Ges 2020; 18:1094-1101. [PMID: 32989866 DOI: 10.1111/ddg.14294] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cold atmospheric plasma (CAP) has been used successfully for wound treatment, with thrice weekly treatment intervals. In this study, we wished to investigate whether comparably beneficial results can be achieved even with once weekly CAP treatment. PATIENTS AND METHODS In this randomized clinical pilot study (RCT) patients with therapy-refractory chronic wounds were examined over a maximum of twelve weeks. Groups 1 and 2 were treated with CAP once and twice a week, respectively. Patients in Group 3 received placebo therapy once a week. RESULTS Wound area decreased significantly by 63.0 % in Group 1 (n = 14, P = 0.005) and by 46.8 % in Group 2 (n = 13, P = 0.007). In Group 3 (n = 10) the wounds grew on average 17.5 % larger. A significant reduction in pain was measured in both CAP-treated groups (Group 1: P = 0.042; Group 2: P = 0.027). Only in Group 2 was there a significant improvement in wound-specific quality of life (P = 0.005). After the 12-week CAP treatment, the reduction in bacterial load compared to the day of study inclusion averaged 50.4 % for Group 1 and 35.0 % for Group 2. CONCLUSIONS Our RCT shows that treatment with CAP improves various aspects of wound healing in patients with therapy-refractory chronic wounds. The results obtained for once weekly treatment with CAP were not inferior to those obtained when CAP treatment was three times a week. Treatment once a week is also easier and more economical to implement in clinical routine.
Collapse
Affiliation(s)
- Maurice Moelleken
- Department of Dermatology, Venereology and Allergology, Essen University Medical Center
| | - Finja Jockenhöfer
- Department of Dermatology, Venereology and Allergology, Essen University Medical Center
| | | | - Jan Buer
- Department of Medical Microbiology, Essen University Medical Center
| | - Sven Benson
- Department of Medical Psychology and Behavioral Immunobiology, Essen University Medical Center
| | - Joachim Dissemond
- Department of Dermatology, Venereology and Allergology, Essen University Medical Center
| |
Collapse
|
77
|
Emmert S, van Welzen A, Masur K, Gerling T, Bekeschus S, Eschenburg C, Wahl P, Bernhardt T, Schäfer M, Semmler ML, Grabow N, Fischer T, Thiem A, Jung O, Boeckmann L. Kaltes Atmosphärendruckplasma zur Behandlung akuter und chronischer Wunden. Hautarzt 2020; 71:855-862. [DOI: 10.1007/s00105-020-04696-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
78
|
Deposition of Cell Culture Coatings Using a Cold Plasma Deposition Method. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10196670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Collagen coatings were applied onto polystyrene microplates using a cold atmospheric pressure plasma process. The coatings were compared to standard wet chemical collagen thin films using microscopy, surface energy, infra-red spectroscopy, electrophoresis, and cell culture techniques. Thin films were also deposited on gold electrodes using both coating methods and their structural and barrier properties probed using cyclic voltammetry. While the wet chemical technique produced a thicker deposit, both films appear equivalent in terms of coverage, porosity, structure, and chemistry. Significantly, the cold plasma method preserves both the primary and secondary structure of the protein and this results in high biocompatibility and cell activity that is at least equivalent to the standard wet chemical technique. The significance of these results is discussed in relation to the benefits of a single step plasma coating in comparison to the traditional multi-step aseptic coating technique.
Collapse
|
79
|
Madigan CD, O'Sullivan D, O'Neill L, Kavanagh DF. A comparison of two cold atmospheric helium plasma devices which utilise the same RF power generator. CLINICAL PLASMA MEDICINE 2020. [DOI: 10.1016/j.cpme.2020.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
80
|
Argon Atmospheric Plasma Treatment Promotes Burn Healing by Stimulating Inflammation and Controlling the Redox State. Inflammation 2020; 43:2357-2371. [PMID: 32860165 DOI: 10.1007/s10753-020-01305-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Burns are a public health problem, with second-degree burns as one of the most common types. Although intense inflammation worsens burn healing, effective therapies are scarce. Thus, infections and hypertrophic scars may occur, which compromise patient quality of life and may delay healing. Argon atmospheric plasma (AP) has been shown to positively influence wound healing. In the context of identifying effective and alternative therapies for the treatment of second-degree burns, the present study evaluated AP in the treatment of second-degree burns in rats compared to that for sham treatment on the 2nd, 7th, 14th, and 21st days post-injury. Our results revealed proinflammatory effect for AP by recruiting predominantly neutrophils on the 7th day and macrophages on the 21st day compared to sham treatment, allowing a greater production of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and IL-17, and also controlled the inflammation by IL-10 and transforming growth factor (TGF)-β1. AP also showed antioxidant activity important for controlling oxidative damage on the 2nd day. This favored the induction of angiogenesis from the 2nd day and induction fibroplasia and fibrillogenesis after the 14th day, which enhanced burn healing with the formation of a thinner burn eschar before the 21st day post-burn. Thus, AP effectively modulated the inflammatory phase of second-degree burn healing through the control of oxidative damage that favored the following phases. Therefore, AP is a relevant alternative in the treatment of second-degree burns.
Collapse
|
81
|
Smolková B, Frtús A, Uzhytchak M, Lunova M, Kubinová Š, Dejneka A, Lunov O. Critical Analysis of Non-Thermal Plasma-Driven Modulation of Immune Cells from Clinical Perspective. Int J Mol Sci 2020; 21:ijms21176226. [PMID: 32872159 PMCID: PMC7503900 DOI: 10.3390/ijms21176226] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 02/07/2023] Open
Abstract
The emerged field of non-thermal plasma (NTP) shows great potential in the alteration of cell redox status, which can be utilized as a promising therapeutic implication. In recent years, the NTP field considerably progresses in the modulation of immune cell function leading to promising in vivo results. In fact, understanding the underlying cellular mechanisms triggered by NTP remains incomplete. In order to boost the field closer to real-life clinical applications, there is a need for a critical overview of the current state-of-the-art. In this review, we conduct a critical analysis of the NTP-triggered modulation of immune cells. Importantly, we analyze pitfalls in the field and identify persisting challenges. We show that the identification of misconceptions opens a door to the development of a research strategy to overcome these limitations. Finally, we propose the idea that solving problems highlighted in this review will accelerate the clinical translation of NTP-based treatments.
Collapse
Affiliation(s)
- Barbora Smolková
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Adam Frtús
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Mariia Uzhytchak
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Mariia Lunova
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Institute for Clinical & Experimental Medicine (IKEM), 14021 Prague, Czech Republic
| | - Šárka Kubinová
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Department of Biomaterials and Biophysical Methods, Institute of Experimental Medicine of the Czech Academy of Sciences, 14220 Prague, Czech Republic
| | - Alexandr Dejneka
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Oleg Lunov
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Correspondence: ; Tel.: +420-2660-52131
| |
Collapse
|
82
|
Dijksteel GS, Ulrich MMW, Vlig M, Sobota A, Middelkoop E, Boekema BKHL. Safety and bactericidal efficacy of cold atmospheric plasma generated by a flexible surface Dielectric Barrier Discharge device against Pseudomonas aeruginosa in vitro and in vivo. Ann Clin Microbiol Antimicrob 2020; 19:37. [PMID: 32814573 PMCID: PMC7439657 DOI: 10.1186/s12941-020-00381-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Cold atmospheric plasma (CAP), which is ionized gas produced at atmospheric pressure, could be a novel and potent antimicrobial therapy for the treatment of infected wounds. Previously we have shown that CAP generated with a flexible surface Dielectric Barrier Discharge (sDBD) is highly effective against bacteria in vitro and in ex vivo burn wound models. In the current paper, we determined the in vitro and in vivo safety and efficacy of CAP generated by this sDBD device. Methods The effect of CAP on DNA mutations of V79 fibroblasts was measured using a hypoxanthine–guanine-phosphoribosyltransferase (HPRT) assay. Furthermore, effects on cell proliferation, apoptosis and DNA damage in ex vivo burn wound models (BWMs) were assessed using immunohistochemistry. Next, 105 colony forming units (CFU) P. aeruginosa strain PAO1 were exposed to CAP in a 3D collagen-elastin matrix environment to determine the number of surviving bacteria in vitro. Finally, rat excision wounds were inoculated with 107 CFU PAO1 for 24 h. The wounds received a single CAP treatment, repeated treatments on 4 consecutive days with CAP, 100 µL of 1% (wt/wt) silver sulfadiazine or no treatment. Wound swabs and punch biopsies were taken to determine the number of surviving bacteria. Results Exposure of V79 fibroblasts to CAP did not increase the numbers of mutated colonies. Additionally, the number of proliferative, apoptotic and DNA damaged cells in the BWMs was comparable to that of the unexposed control. Exposure of PAO1 to CAP for 2 min resulted in the complete elimination of bacteria in vitro. Contrarily, CAP treatment for 6 min of rat wounds colonized with PAO1 did not effectively reduce the in vivo bacterial count. Conclusions CAP treatment was safe but showed limited efficacy against PAO1 in our rat wound infection model.
Collapse
Affiliation(s)
- Gabrielle S Dijksteel
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands. .,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Magda M W Ulrich
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Dept. of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marcel Vlig
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
| | - Ana Sobota
- Dept. of Applied Physics, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Esther Middelkoop
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands.,Dept. of Plastic, Reconstructive & Hand Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Bouke K H L Boekema
- Association of Dutch Burn Centres, Zeestraat 29, 1941 AJ, Beverwijk, The Netherlands
| |
Collapse
|
83
|
Friedman PC. Cold atmospheric pressure (physical) plasma in dermatology: where are we today? Int J Dermatol 2020; 59:1171-1184. [PMID: 32783244 DOI: 10.1111/ijd.15110] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 12/12/2022]
Abstract
Cold atmospheric pressure plasma is physical plasma (essentially ionized gas) created at room temperature and atmospheric pressure, and it has complex effects on cells, tissues, and living organisms. These effects are studied extensively for medical and dermatological use. This article reviews current achievements and new trends in clinical dermatological cold plasma research, discusses the basics of plasma physics and plasma engineering, and describes the most important areas of laboratory plasma research to provide a well-rounded understanding of the nature, present applications, and future promise of this exciting, emerging technology.
Collapse
|
84
|
The Emerging Role of Cold Atmospheric Plasma in Implantology: A Review of the Literature. NANOMATERIALS 2020; 10:nano10081505. [PMID: 32751895 PMCID: PMC7466481 DOI: 10.3390/nano10081505] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
In recent years, cold atmospheric plasma (CAP) technologies have received increasing attention in the field of biomedical applications. The aim of this article is to review the currently available literature to provide an overview of the scientific principles of CAP application, its features, functions, and its applications in systemic and oral diseases, with a specific focus on its potential in implantology. In this narrative review, PubMed, Medline, and Scopus databases were searched using key words like “cold atmospheric plasma”, “argon plasma”, “helium plasma”, “air plasma”, “dental implants”, “implantology”, “peri-implantitis”, “decontamination”. In vitro studies demonstrated CAP’s potential to enhance surface colonization and osteoblast activity and to accelerate mineralization, as well as to determine a clean surface with cell growth comparable to the sterile control on both titanium and zirconia surfaces. The effect of CAP on biofilm removal was revealed in comparative studies to the currently available decontamination modalities (laser, air abrasion, and chlorhexidine). The combination of mechanical treatments and CAP resulted in synergistic antimicrobial effects and surface improvement, indicating that it may play a central role in surface “rejuvenation” and offer a novel approach for the treatment of peri-implantitis. It is noteworthy that the CAP conditioning of implant surfaces leads to an improvement in osseointegration in in vivo animal studies. To the best of our knowledge, this is the first review of the literature providing a summary of the current state of the art of this emerging field in implantology and it could represent a point of reference for basic researchers and clinicians interested in approaching and testing new technologies.
Collapse
|
85
|
Anticancer Effects of Plasma-Activated Medium Produced by a Microwave-Excited Atmospheric Pressure Argon Plasma Jet. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:4205640. [PMID: 32802265 PMCID: PMC7415084 DOI: 10.1155/2020/4205640] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/12/2020] [Indexed: 12/13/2022]
Abstract
Cold atmospheric plasma (CAP) has been reported to have strong anticancer effects in vitro and in vivo. CAP has been known to induce apoptosis in most cancer cells by treatment to cells using direct and indirect treatment methods. There are many reports of apoptosis pathways induced by CAP, but for indirect treatment, there is still a lack of fundamental research on how CAP can cause apoptosis in cancer cells. In this study, we applied an indirect treatment method to determine how CAP can induce cancer cell death. First, plasma-activated medium (PAM) was produced by a 2.45 GHz microwave-excited atmospheric pressure plasma jet (ME-APPJ). Next, the amounts of various reactive species in the PAM were estimated using colorimetric methods. The concentration of NO2– and H2O2 in PAM cultured with cancer cells was measured, and intracellular reactive oxidative stress (ROS) changes were observed using flow cytometry. When PAM was incubated with A549 lung cancer cells, there was little change in NO2– concentration, but the concentration of H2O2 gradually decreased after 30 min. While the intracellular ROS of A549 cells was rapidly increased at 2 hours, there was no significant change in that of PAM-treated normal cells. Furthermore, PAM had a significant cytotoxic effect on A549 cells but had little effect on normal cell viability. In addition, using flow cytometry, we confirmed that apoptosis of A549 cells occurred following flow cytometry and western blot analysis. These results suggest that among various reactive species produced by PAM, hydrogen peroxide plays a key role in inducing cancer cell apoptosis.
Collapse
|
86
|
Kletschkus K, Gelbrich N, Burchardt M, Kramer A, Bekeschus S, Stope MB. Emission of Ultraviolet Radiation from 220 to 280 NM by a Cold Physical Plasma Generating Device. HEALTH PHYSICS 2020; 119:153-159. [PMID: 32483047 DOI: 10.1097/hp.0000000000001276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The generation of cold physical plasma at atmospheric pressure (cold atmospheric plasma: CAP) generates different reactive molecular species as well as radiation in the ultraviolet (UV) range. The therapy of tumor diseases has proven to be a new promising area of application for CAP treatment. With regard to the routine use of CAP in cancer therapy, however, application safety must be ensured both for the patient and for the operator. In this study, the intensity of UVC radiation of the CAP device MiniJet-R (HF Technik, Aachen, Germany) was measured in the range from 220 to 280 nm depending on various device-specific parameters. Depending on the distance to the CAP flame, the UVC intensity reaches values up to 124.5±11 mW m. It should be noted here that the UVC radiation generated by the CAP is emitted in all orientations in the room but is also shielded by the geometry of the handpiece of the CAP device. The device-specific settings for the flow rate of the carrier gas, argon, and the power level at the high-frequency (HF) generator of the CAP device also influence the intensity of the UVC radiation. With regard to the medical use of the CAP device, it can be stated that there is an exposure to UVC radiation, which, depending on the duration of treatment, can also be above the maximum value legally specified in Europe. Shielding components on the CAP device can reduce UVC exposure to the operator as well as adverse side effects to the patient.
Collapse
Affiliation(s)
- Karsten Kletschkus
- Plasma Oncology Laboratory, Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Nadine Gelbrich
- Plasma Oncology Laboratory, Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Martin Burchardt
- Plasma Oncology Laboratory, Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP Greifswald), Greifswald, Germany
| | - Matthias B Stope
- Plasma Oncology Laboratory, Department of Urology, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
87
|
Cold atmospheric plasma as an effective method to treat diabetic foot ulcers: A randomized clinical trial. Sci Rep 2020; 10:10440. [PMID: 32591594 PMCID: PMC7319950 DOI: 10.1038/s41598-020-67232-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/04/2020] [Indexed: 12/01/2022] Open
Abstract
Cold atmospheric plasma (CAP) was shown to decrease bacterial load in chronic wounds. It was also presented as a novel approach to healing wounds in both in vitro and in vivo experiments. We aimed to examine the first randomized clinical trial for the use of CAP in diabetic foot ulcers. Patients (n = 44) were randomly double-blinded, and assigned to receive standard care (SC, n = 22) without or with CAP, to be applied three times a week for three consecutive weeks (SC + CAP, n = 22), using block randomization with mixing block sizes of four. The trial was conducted at the Diabetes Research Center in Tehran, Iran. CAP was generated from ionized helium gas in ambient air, and driven by a high voltage (10 kV) and high frequency (6 kHz) power supply. Primary outcomes were wound size, number of cases reaching wound size of <0.5, and a bacterial load after over three weeks of treatment. CAP treatment effectively reduced the fraction of wound size (p = 0.02). After three weeks, the wounds to reach fraction wound size of ≤0.5 was significantly greater in the SC + CAP group (77.3%) compared to the SC group (36.4%) (p = 0.006). The mean fraction of bacterial load counted in each session ‘after CAP exposure’ was significantly less than ‘before exposure’ measures. CAP can be an efficient method to accelerate wound healing in diabetic foot ulcers, with immediate antiseptic effects that do not seem to last long.
Collapse
|
88
|
Indirect, Non-Thermal Atmospheric Plasma Promotes Bacterial Killing in vitro and Wound Disinfection in vivo Using Monogenic and Polygenic Models of Type 2 Diabetes (Without Adverse Metabolic Complications). Shock 2020; 54:681-687. [PMID: 32496417 DOI: 10.1097/shk.0000000000001583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A novel atmospheric plasma device that uses indirect, non-thermal plasma generated from room air is being studied for its effects on wound disinfection in animal wounds of monogenic and polygenic murine models of type 2 diabetes. As a proof-of-concept report, the goal of this study was to demonstrate the efficacy and safety of the indirect non-thermal plasma (INTP) device in disinfecting polycarbonate filters established with Pseudomonas aeruginosa (PAO1) biofilms as well as wound disinfection in diabetic murine wounds. Dorsal excisional wounds in BALB/c, polygenic TALLYHO, and monogenic db/db mice established with PAO1 infection all demonstrated a 3-log colony-forming unit (CFU) reduction when subjected to a course of 20-min INTP treatments. Importantly, blood glucose and body weights in these animals were not significantly impacted by plasma treatment over the study period. Plasma safety was also analyzed via complete blood count and comprehensive metabolic panels, showing no deleterious systemic effects after 3 consecutive days of 20-min plasma applications. Therefore, the results obtained demonstrated the Pseudomonas aeruginosa isolates were highly sensitive to INTP in vitro, CFU reduction of infectious Pseudomonas in wounds of diabetic mice after INTP treatment is far superior to that of non-treated infected wounds, and the application of INTP shows no indication of toxic effects. Our results are consistent with indirect non-thermal atmospheric plasma as a promising adjunct to disinfecting wounds.
Collapse
|
89
|
Braný D, Dvorská D, Halašová E, Škovierová H. Cold Atmospheric Plasma: A Powerful Tool for Modern Medicine. Int J Mol Sci 2020; 21:E2932. [PMID: 32331263 PMCID: PMC7215620 DOI: 10.3390/ijms21082932] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/15/2022] Open
Abstract
Cold atmospheric plasma use in clinical studies is mainly limited to the treatment of chronic wounds, but its application in a wide range of medical fields is now the goal of many analyses. It is therefore likely that its application spectrum will be expanded in the future. Cold atmospheric plasma has been shown to reduce microbial load without any known significant negative effects on healthy tissues, and this should enhance its possible application to any microbial infection site. It has also been shown to have anti-tumour effects. In addition, it acts proliferatively on stem cells and other cultivated cells, and the highly increased nitric oxide levels have a very important effect on this proliferation. Cold atmospheric plasma use may also have a beneficial effect on immunotherapy in cancer patients. Finally, it is possible that the use of plasma devices will not remain limited to surface structures, because current endeavours to develop sufficiently miniature microplasma devices could very likely lead to its application in subcutaneous and internal structures. This study summarises the available literature on cold plasma action mechanisms and analyses of its current in vivo and in vitro use, primarily in the fields of regenerative and dental medicine and oncology.
Collapse
Affiliation(s)
| | - Dana Dvorská
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia; (D.B.); (E.H.); (H.Š.)
| | | | | |
Collapse
|
90
|
He R, Li Q, Shen W, Wang T, Lu H, Lu J, Lu F, Luo M, Zhang J, Gao H, Wang D, Xing W, Jia W, Liu F. The efficacy and safety of cold atmospheric plasma as a novel therapy for diabetic wound in vitro and in vivo. Int Wound J 2020; 17:851-863. [PMID: 32168435 DOI: 10.1111/iwj.13341] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/21/2020] [Accepted: 03/04/2020] [Indexed: 12/30/2022] Open
Abstract
Cold atmospheric plasma (CAP) is a group of various chemical active species, such as ozone and nitric oxide, generated by working gas. CAP was demonstrated to have an effect on tissue regeneration and wound healing. We conducted this study to evaluate the efficacy and safety of CAP as a novel therapy for diabetic wounds in vitro and in vivo. The plasma consists of ionised helium gas that is produced by a high-voltage and high-frequency power supply. Eight-week-old male db/db mice and C57BL mice were treated with helium gas (control group), 90s' CAP (low-dose group), and 180s' CAP (high-dose group). Mice were treated and observed for 2 weeks. Skin samples from around the wound and blood samples were collected. Our in vitro analysis included scratch wound-healing assays by using human HaCaT immortalised human epidermal cells. After 14 days of treatment, CAP could obviously promote diabetic wound healing. Wound closure rates were significantly higher in the low-dose group and high-dose groups compared with the control group. Meanwhile, compared with the control group, the protein expression of IL-6, tumour necrosis factor-α, inducible nitric oxide synthase, and superoxide dismutase in two CAP groups significantly decreased, while the protein expression of vascular endothelial growth factor and transforming growth factor-β in two CAP groups significantly increased (all P < .05); these data show good agreement with the change in mRNA level (all P < .05). In vitro, scratch wound-healing assays showed that plasma treatment could effectively ensure healing within 3 minutes of exposure (all P < .05). In addition, no difference was found in histological observations of normal skin and the level of serum alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, and white blood cells among the CAP groups and control group. CAP treatment for 3 minutes every day improves wound healing in diabetic mice by suppressing inflammation, reducing oxidative stress, and enhancing angiogenesis, involving several proteins signalling, and it is safe for the liver and kidney.
Collapse
Affiliation(s)
- Rui He
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qin Li
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Wenqi Shen
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Tao Wang
- Department of Vascular Surgery, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Huijuan Lu
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Junxi Lu
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Fendi Lu
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ming Luo
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Jiankang Zhang
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Haiwei Gao
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Dong Wang
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Wanli Xing
- Capital Bio Corporation, National Engineering Research Center for Beijing Biochip Technology, Beijing, China
| | - Weiping Jia
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Fang Liu
- Shanghai Key Laboratory of Diabetes, Shanghai Institute for Diabetes, Shanghai Clinical Medical Centre of Diabetes, Shanghai Key Clinical Centre of Metabolic Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| |
Collapse
|
91
|
Wound healing improvement in large animals using an indirect helium plasma treatment. CLINICAL PLASMA MEDICINE 2020. [DOI: 10.1016/j.cpme.2020.100095] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
92
|
Boeckmann L, Bernhardt T, Schäfer M, Semmler ML, Kordt M, Waldner AC, Wendt F, Sagwal S, Bekeschus S, Berner J, Kwiatek E, Frey A, Fischer T, Emmert S. [Current indications for plasma therapy in dermatology]. Hautarzt 2020; 71:109-113. [PMID: 31965204 DOI: 10.1007/s00105-019-04530-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Plasma medicine is gaining increasing interest and provides a multitude of dermatological applications. Cold atmospheric pressure plasma (CAP) can be used in clinical applications without harming the treated tissue or in a tissue destructive manner. It consists of a complex mixture of biologically active agents, which can act synergistically on the treated material or tissue. OBJECTIVES A summary of the current research findings regarding dermatological applications of CAP is provided. METHODS Literature on CAP applications in dermatology has been screened and summarized. RESULTS CAP exerts antimicrobial, tissue-stimulating, blood-flow-stimulating but also pro-apoptotic effects. By exploiting these properties, CAP is successfully applied for disinfection and treatment of chronic ulcerations. Furthermore, positive effects of CAP have been shown for the treatment of tumors, actinic keratosis, scars, ichthyosis, atopic eczema as well as for alleviation of pain and itch. CONCLUSIONS While the use of CAP for disinfection and wound treatment has already moved into clinical practice, further applications such as cancer treatment are still exploratory.
Collapse
Affiliation(s)
- L Boeckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - T Bernhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Schäfer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Luise Semmler
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Kordt
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - A-C Waldner
- Arbeitsbereich Zellbiologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - F Wendt
- Institut für Pharmakologie und Toxikologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - S Sagwal
- Leibniz-Institut für Plasmaforschung und Technologie e. V., Greifswald, Deutschland
| | - S Bekeschus
- Leibniz-Institut für Plasmaforschung und Technologie e. V., Greifswald, Deutschland
| | - J Berner
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie/Plastische Operationen, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - E Kwiatek
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie/Plastische Operationen, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - A Frey
- Institut für Chemie, Universität Rostock, Rostock, Deutschland
| | - T Fischer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - S Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland.
| |
Collapse
|
93
|
Wang L, Xia C, Guo Y, Yang C, Cheng C, Zhao J, Yang X, Cao Z. Bactericidal efficacy of cold atmospheric plasma treatment against multidrug-resistant Pseudomonas aeruginosa. Future Microbiol 2020; 15:115-125. [PMID: 31989838 DOI: 10.2217/fmb-2019-0265] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: The global of spread multidrug-resistant Pseudomonas aeruginosa has become a public health threat. Cold atmospheric plasma (CAP) is reported to have bactericidal efficacy; however, its effects on clinical super multidrug-resistant P. aeruginosa are unclear. The aim of this study was to investigate the bactericidal efficacy of CAP on a strain of super multidrug-resistant P. aeruginosa. Materials & methods: The effects of CAP treatments were evaluated using assays for the detection of growth, viability, metabolism, virulence factors and reactive oxygen species (ROS) levels. Results: Both CAP treatments dose-dependently inhibited cell viability and metabolic activity, and decreased the expression of several virulence factors. CAP treatment induced a significant increase in intracellular ROS levels, and ROS scavengers inhibited this effect. Conclusion: CAP treatment is a promising option for the clinical inhibition of multidrug-resistant P. aeruginosa, and the development of CAP technologies might be the key to solving the long-standing problem of drug-resistant bacteria.
Collapse
Affiliation(s)
- Liyun Wang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Chuankai Xia
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Yajun Guo
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Chunjun Yang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Cheng Cheng
- The Institute of Plasma Physics, Chinese Academy of Science, Hefei 230000, Anhui, PR China
| | - Jun Zhao
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Xingyu Yang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| | - Zhicheng Cao
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei 23000, Anhui, PR China
| |
Collapse
|
94
|
Wende K, Bruno G, Lalk M, Weltmann KD, von Woedtke T, Bekeschus S, Lackmann JW. On a heavy path – determining cold plasma-derived short-lived species chemistry using isotopic labelling. RSC Adv 2020; 10:11598-11607. [PMID: 35496584 PMCID: PMC9051657 DOI: 10.1039/c9ra08745a] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 02/25/2020] [Indexed: 12/14/2022] Open
Abstract
Cold atmospheric plasmas (CAPs) are promising medical tools and are currently applied in dermatology and epithelial cancers. While understanding of the biomedical effects is already substantial, knowledge on the contribution of individual ROS and RNS and the mode of activation of biochemical pathways is insufficient. Especially the formation and transport of short-lived reactive species in liquids remain elusive, a situation shared with other approaches involving redox processes such as photodynamic therapy. Here, the contribution of plasma-generated reactive oxygen species (ROS) in plasma liquid chemistry was determined by labeling these via admixing heavy oxygen 18O2 to the feed gas or by using heavy water H218O as a solvent for the bait molecule. The inclusion of heavy or light oxygen atoms by the labeled ROS into the different cysteine products was determined by mass spectrometry. While products like cysteine sulfonic acid incorporated nearly exclusively gas phase-derived oxygen species (atomic oxygen and/or singlet oxygen), a significant contribution of liquid phase-derived species (OH radicals) was observed for cysteine-S-sulfonate. The role, origin, and reaction mechanisms of short-lived species, namely hydroxyl radicals, singlet oxygen, and atomic oxygen, are discussed. Interactions of these species both with the target cysteine molecule as well as the interphase and the liquid bulk are taken into consideration to shed light onto several reaction pathways resulting in observed isotopic oxygen incorporation. These studies give valuable insight into underlying plasma–liquid interaction processes and are a first step to understand these interaction processes between the gas and liquid phase on a molecular level. Cold atmospheric plasmas (CAPs) are promising medical tools producing short-lived reactive species.![]()
Collapse
Affiliation(s)
- Kristian Wende
- ZIK Plasmatis
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
| | - Giuliana Bruno
- ZIK Plasmatis
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
| | - Michael Lalk
- Cellular Biochemistry & Metabolomics
- University of Greifswald
- Greifswald 17487
- Germany
| | - Klaus-Dieter Weltmann
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
- Institute for Hygiene and Environmental Medicine
- Greifswald University Medical Center
| | - Sander Bekeschus
- ZIK Plasmatis
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
| | - Jan-Wilm Lackmann
- ZIK Plasmatis
- Leibniz Institute for Plasma Science and Technology (INP Greifswald)
- Greifswald 17489
- Germany
| |
Collapse
|
95
|
VON Woedtke T, Schmidt A, Bekeschus S, Wende K, Weltmann KD. Plasma Medicine: A Field of Applied Redox Biology. In Vivo 2019; 33:1011-1026. [PMID: 31280189 DOI: 10.21873/invivo.11570] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/25/2022]
Abstract
Plasma medicine comprises the application of physical plasma directly on or in the human body for therapeutic purposes. Three most important basic plasma effects are relevant for medical applications: i) inactivation of a broad spectrum of microorganisms, including multidrug-resistant pathogens, ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and iii) inactivation of cells by initialization of cell death with higher plasma treatment intensity, above all in cancer cells. Based on own published results as well as on monitoring of relevant literature the aim of this topical review is to summarize the state of the art in plasma medicine and connect it to redox biology. One of the most important results of basic research in plasma medicine is the insight that biological plasma effects are mainly mediated via reactive oxygen and nitrogen species influencing cellular redox-regulated processes. Plasma medicine can be considered a field of applied redox biology.
Collapse
Affiliation(s)
- Thomas VON Woedtke
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany .,Greifswald University Medicine, Greifswald, Germany
| | - Anke Schmidt
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany
| | | | | | - Klaus-Dieter Weltmann
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany
| |
Collapse
|
96
|
Latańska I, Kozera-Żywczyk A, Paluchowska EB, Owczarek W, Kaszuba A, Noweta M, Tazbir J, Kolesińska B, Draczyński Z, Sujka W. Characteristic Features of Wound Dressings Based on Butyric-Acetic Chitin Copolyesters-Results of Clinical Trials. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E4170. [PMID: 31842270 PMCID: PMC6947344 DOI: 10.3390/ma12244170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 01/22/2023]
Abstract
The article presents the results of clinical trials of wound dressings whose main ingredient is butyric-acetic chitin copolyester (BAC 90:10). It is a chitin derivative soluble in typical organic solvents. During the trial, the dressings were used on wounds resulting from venous insufficiency or diabetes. The trial evaluated the safety of use and efficacy of three forms of the dressing including porous membrane (Medisorb R Membrane), porous membrane with silver (Medisorb R Ag), and powder (Medisorb R Powder). The clinical trial had a multi-centre character. Three medical units were engaged in the study. The trial included 36 patients (12 men and 24 women). The mean age of the participants was 65 years of age (age range: 26-96). The choice of dressings was made on the basis of preliminary evaluation of the wound, clinical signs of infection, or risk of infection. Medisorb R Membrane dressing was used in 23 patients, Medisorb R Ag dressing was used in 15 patients, and Medisorb R powder was used in two patients. During the course of the trial, there were 10 control visits planned. The obtained results prove the safety and efficacy of dressings in question. The efficacy of treatment was evaluated as good. In the majority of patients, the ulceration was decreased both on the surface and in depth. The success of the treatment relied not only on the applied dressing, but also the stage of the basic disease, the accompanying diseases, and the age of the patient.
Collapse
Affiliation(s)
- Ilona Latańska
- Tricomed SA, Świętojańska Street 5/9, 93-493 Lodz, Poland;
| | - Anna Kozera-Żywczyk
- Military Institute of Medicine, Ministry of National Defense Central Clinical Hospital, Dermatology Clinic, Szaserów Street 128, 04-141 Warsaw, Poland; (A.K.-Ż.); (E.B.P.); (W.O.)
| | - Elwira Beata Paluchowska
- Military Institute of Medicine, Ministry of National Defense Central Clinical Hospital, Dermatology Clinic, Szaserów Street 128, 04-141 Warsaw, Poland; (A.K.-Ż.); (E.B.P.); (W.O.)
| | - Witold Owczarek
- Military Institute of Medicine, Ministry of National Defense Central Clinical Hospital, Dermatology Clinic, Szaserów Street 128, 04-141 Warsaw, Poland; (A.K.-Ż.); (E.B.P.); (W.O.)
| | - Andrzej Kaszuba
- Wł. Biegański Provincial Specialised Hospital, Dermatology, Paediatric Dermatology and Oncologic Dermatology Ward, Dermatology, UM Paediatric Dermatology and Oncologic Dermatology Clinic, Kniaziewicza Street 1/5, 91-347 Lodz, Poland; (A.K.); (M.N.)
| | - Marcin Noweta
- Wł. Biegański Provincial Specialised Hospital, Dermatology, Paediatric Dermatology and Oncologic Dermatology Ward, Dermatology, UM Paediatric Dermatology and Oncologic Dermatology Clinic, Kniaziewicza Street 1/5, 91-347 Lodz, Poland; (A.K.); (M.N.)
| | - Józef Tazbir
- Citonet Lodz Limited Company, Wound Treatment Clinic., Świętojańska Street 5/9, 93-493 Lodz, Poland;
| | - Beata Kolesińska
- Organic Chemistry Unit, Lodz University of Technology, Żeromskiego Street 116, 90-924 Lodz, Poland;
| | - Zbigniew Draczyński
- Institute of Material Science of Textiles and Polymer Composites, Lodz University of Technology, Żeromskiego Street 116, 90-924 Lodz, Poland;
| | - Witold Sujka
- Tricomed SA, Świętojańska Street 5/9, 93-493 Lodz, Poland;
| |
Collapse
|
97
|
Wolff CM, Steuer A, Stoffels I, von Woedtke T, Weltmann KD, Bekeschus S, Kolb JF. Combination of cold plasma and pulsed electric fields – A rationale for cancer patients in palliative care. CLINICAL PLASMA MEDICINE 2019. [DOI: 10.1016/j.cpme.2020.100096] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
98
|
ROS from Physical Plasmas: Redox Chemistry for Biomedical Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9062098. [PMID: 31687089 PMCID: PMC6800937 DOI: 10.1155/2019/9062098] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/17/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022]
Abstract
Physical plasmas generate unique mixes of reactive oxygen and nitrogen species (RONS or ROS). Only a bit more than a decade ago, these plasmas, operating at body temperature, started to be considered for medical therapy with considerably little mechanistic redox chemistry or biomedical research existing on that topic at that time. Today, a vast body of evidence is available on physical plasma-derived ROS, from their spatiotemporal resolution in the plasma gas phase to sophisticated chemical and biochemical analysis of these species once dissolved in liquids. Data from in silico analysis dissected potential reaction pathways of plasma-derived reactive species with biological membranes, and in vitro and in vivo experiments in cell and animal disease models identified molecular mechanisms and potential therapeutic benefits of physical plasmas. In 2013, the first medical plasma systems entered the European market as class IIa devices and have proven to be a valuable resource in dermatology, especially for supporting the healing of chronic wounds. The first results in cancer patients treated with plasma are promising, too. Due to the many potentials of this blooming new field ahead, there is a need to highlight the main concepts distilled from plasma research in chemistry and biology that serve as a mechanistic link between plasma physics (how and which plasma-derived ROS are produced) and therapy (what is the medical benefit). This inevitably puts cellular membranes in focus, as these are the natural interphase between ROS produced by plasmas and translation of their chemical reactivity into distinct biological responses.
Collapse
|
99
|
Jiao Y, Tay FR, Niu LN, Chen JH. Advancing antimicrobial strategies for managing oral biofilm infections. Int J Oral Sci 2019; 11:28. [PMID: 31570700 PMCID: PMC6802668 DOI: 10.1038/s41368-019-0062-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/02/2019] [Accepted: 08/04/2019] [Indexed: 02/06/2023] Open
Abstract
Effective control of oral biofilm infectious diseases represents a major global challenge. Microorganisms in biofilms exhibit increased drug tolerance compared with planktonic cells. The present review covers innovative antimicrobial strategies for controlling oral biofilm-related infections published predominantly over the past 5 years. Antimicrobial dental materials based on antimicrobial agent release, contact-killing and multi-functional strategies have been designed and synthesized for the prevention of initial bacterial attachment and subsequent biofilm formation on the tooth and material surface. Among the therapeutic approaches for managing biofilms in clinical practice, antimicrobial photodynamic therapy has emerged as an alternative to antimicrobial regimes and mechanical removal of biofilms, and cold atmospheric plasma shows significant advantages over conventional antimicrobial approaches. Nevertheless, more preclinical studies and appropriately designed and well-structured multi-center clinical trials are critically needed to obtain reliable comparative data. The acquired information will be helpful in identifying the most effective antibacterial solutions and the most optimal circumstances to utilize these strategies.
Collapse
Affiliation(s)
- Yang Jiao
- Department of Stomatology, the 7th Medical Center of PLA General Hospital, Beijing, PR China
| | - Franklin R Tay
- Department of Endodontics, the Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, PR China.
| | - Ji-Hua Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, PR China.
| |
Collapse
|
100
|
Cooper R, Kirketerp-Møller K. Non-antibiotic antimicrobial interventions and antimicrobial stewardship in wound care. J Wound Care 2019; 27:355-377. [PMID: 29883284 DOI: 10.12968/jowc.2018.27.6.355] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of those antiseptics are still used today, and others have become available. A diverse variety of non-antibiotic antimicrobial interventions are found on modern formularies. Unlike the mode of action of antibiotics, which affect specific cellular target sites of pathogens, many non-antibiotic antimicrobials affect multiple cellular target sites in a non-specific way. Although this reduces the likelihood of selecting for resistant strains of microorganisms, some have emerged and cross-resistance between antibiotics and antiseptics has been detected. With the prospect of a post-antibiotic era looming, ways to maintain and extend our antimicrobial armamentarium must be found. In this narrative review, current and emerging non-antibiotic antimicrobial strategies will be considered and the need for antimicrobial stewardship in wound care will be explained.
Collapse
Affiliation(s)
- Rose Cooper
- Professor of Microbiology, Department of Biomedical Science, Cardiff School of Health Sciences, Cardiff Metropolitan University, Western Avenue, Cardiff, UK
| | - Klaus Kirketerp-Møller
- Orthopaedic Surgeon, Copenhagen Wound Healing Center, Department of Dermatology and Wounds, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV
| |
Collapse
|