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Milewski MR, Schlottmann F, März V, Dieck T, Vogt PM. The Successful Treatment of Multi-Resistant Colonized Burns with Large-Area Atmospheric Cold Plasma Therapy and Dermis Substitute Matrix-A Case Report. EUROPEAN BURN JOURNAL 2024; 5:271-282. [PMID: 39599949 PMCID: PMC11545062 DOI: 10.3390/ebj5030025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 11/29/2024]
Abstract
The treatment of severe burn injuries, which occur particularly in the context of armed conflicts, is based on a multimodal treatment concept. In addition to complex intensive care therapy, the surgical reconstruction options of plastic surgery and typical antiseptic wound treatment are the main focuses. In recent years, atmospheric cold plasma therapy (ACPT) has also become established for topical, antiseptic wound treatment and for the optimization of re-epithelialization. This case report shows a successful treatment of extensive burn injuries using dermal skin substitute matrix and topical treatment with a large-area cold plasma device to control multi-resistant pathogen colonization. This case report illustrates the importance of ACPT in burn surgery. However, larger case series and randomized controlled trials in specialized centers are needed to assess its place in future clinical practice.
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Wang S, Zhou H, Cui W, Zhang J, Wu D, Zhang N, Xu X. Qi Wei Anti-burn Tincture Remodels Liver Metabolic Pathways and Treats Burn Wounds Efficiently. J Burn Care Res 2024; 45:916-925. [PMID: 36402740 DOI: 10.1093/jbcr/irac175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Indexed: 02/17/2024]
Abstract
This work aims to elucidate the molecular mechanism of Qi Wei anti-burn Tincture (QW) on wound healing in burnt mice using metabolomics and molecular biology techniques. A scald model was first established in Kunming mice. After treatment, biochemical indicators for liver function and burnt skin tissues were then evaluated via biochemical detection and HE staining, respectively. Liver tissues were further analyzed for differential metabolites, inflammatory factors, and mRNA levels of cytokines using metabolomics and molecular biology techniques. Involved metabolic pathways were also identified using software. QW treatment did promote the healing of the burn wounds in Kunming mice with a downregulation of ALP, ALT, and AST to normal levels. In mouse liver tissue, the contents of glutamine, aspartic acid, and citrulline were significantly reduced, while the contents of 5-hydroxyproline, taurine, hypotaurine, and glutamic acid significantly increased. These major differential compounds are involved in the arginine metabolic pathway, nitrogen excretion, and the metabolism of taurine and hypotaurine, suggesting that QW reprogramed the above metabolic processes in the liver. Furthermore, the application of QW increased the expression of TGF-β1 and FGF-2 and reduced the levels of TNF-α, IL-1β, IL-6, and reactive oxygen species in the liver of mice induced by burn injury. This study found that QW treatment promoted metabolic pathway remodeling in the liver, which might be a potential mechanism for QW to treat burn wounds.
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Affiliation(s)
- Shuai Wang
- The First People's Hospital of Zhengzhou, P. R. China
| | - Hui Zhou
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
| | - Weiqi Cui
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
| | - Junwei Zhang
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
| | - Deqiao Wu
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
| | - Nan Zhang
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
| | - Xia Xu
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, P. R. China
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de Oliveira IC, Zanco M, Lopes J, Sambo MP, de Andrade TAM, Dos Santos GMT, Felonato M, Santamaria-Jr M. Analysis of inflammation and bone remodeling of atmospheric plasma therapy in experimental periodontitis. J Periodontal Res 2024; 59:738-748. [PMID: 38566282 DOI: 10.1111/jre.13248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND OBJECTIVE The biological effects of atmospheric plasma (cold plasma) show its applicability for controlling the etiological factors that involve tissue repair. Thus, the study evaluated the effect of atmospheric plasma therapy in the control of tissue inflammation and bone remodeling in experimental periodontitis. METHODS Fifty-six rats were subjected to ligation in the cervical region of the first maxillary molars (8 weeks). The animals were divided into two groups (n = 28): periodontitis without treatment group (P group), and periodontitis with atmospheric plasma treatment group (P + AP group). Tissue samples were collected at 2 and 4 weeks after treatment to analyze the inflammation and bone remodeling by biochemical, histomorphometric, and immunohistochemical analyses. RESULTS Inflammatory infiltration in the gingival and periodontal ligament was lower in the P + AP group than in the P group (p < .05). The MPO and NAG levels were higher in the P + AP group compared to P group (p < .05). At 4 weeks, the TNF-α level was lower and the IL-10 level was higher in the P + AP group compared to P group (p < .05). In the P + AP group, the IL-1β level increased in the second week and decreased in the fourth week (p < .05), the number of blood vessels was high in the gingival and periodontal ligament in the second and fourth week (p < .05); and the number of fibroblasts in the gingival tissue was low in the fourth week, and higher in the periodontal tissue in both period (p < .05). Regarding bone remodeling, the RANK and RANKL levels decreased in the P + AP group (p < .05). The OPG level did not differ between the P and P + AP groups (p > .05), but decreased from the second to the fourth experimental week in P + AP group (p < .05). CONCLUSIONS The treatment of experimental periodontitis with atmospheric plasma for 4 weeks modulated the inflammatory response to favor the repair process and decreased the bone resorption biomarkers, indicating a better control of bone remodeling in periodontal disease.
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Affiliation(s)
- Ildamara Canoa de Oliveira
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
| | - Mariana Zanco
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
| | - Juliana Lopes
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
| | - Milena Paloma Sambo
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
| | - Thiago Antonio Moretti de Andrade
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
- University of Victoria - Uvic, Victoria, British Columbia, Canada
| | | | - Maira Felonato
- Graduate Program in Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
| | - Milton Santamaria-Jr
- Graduate Program in Orthodontics and Biomedical Sciences, University Center of Hermínio Ometto Foundation - FHO, São Paulo, Brazil
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, São Paulo State University - Unesp, São José dos Campos, Brazil
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Förster S, Niu Y, Eggers B, Nokhbehsaim M, Kramer FJ, Bekeschus S, Mustea A, Stope MB. Modulation of the Tumor-Associated Immuno-Environment by Non-Invasive Physical Plasma. Cancers (Basel) 2023; 15:cancers15041073. [PMID: 36831415 PMCID: PMC9953794 DOI: 10.3390/cancers15041073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Over the past 15 years, investigating the efficacy of non-invasive physical plasma (NIPP) in cancer treatment as a safe oxidative stress inducer has become an active area of research. So far, most studies focused on the NIPP-induced apoptotic death of tumor cells. However, whether NIPP plays a role in the anti-tumor immune responses need to be deciphered in detail. In this review, we summarized the current knowledge of the potential effects of NIPP on immune cells, tumor-immune interactions, and the immunosuppressive tumor microenvironment. In general, relying on their inherent anti-oxidative defense systems, immune cells show a more resistant character than cancer cells in the NIPP-induced apoptosis, which is an important reason why NIPP is considered promising in cancer management. Moreover, NIPP treatment induces immunogenic cell death of cancer cells, leading to maturation of dendritic cells and activation of cytotoxic CD8+ T cells to further eliminate the cancer cells. Some studies also suggest that NIPP treatment may promote anti-tumor immune responses via other mechanisms such as inhibiting tumor angiogenesis and the desmoplasia of tumor stroma. Though more evidence is required, we expect a bright future for applying NIPP in clinical cancer management.
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Affiliation(s)
- Sarah Förster
- Department of Pathology, University Hospital Bonn, 35127 Bonn, Germany
| | - Yuequn Niu
- Department of Pathology, University Hospital Bonn, 35127 Bonn, Germany
| | - Benedikt Eggers
- Department of Oral, Maxillofacial and Plastic Surgery, University Hospital Bonn, 53111 Bonn, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, University Hospital Bonn, 53111 Bonn, Germany
| | - Franz-Josef Kramer
- Department of Oral, Maxillofacial and Plastic Surgery, University Hospital Bonn, 53111 Bonn, Germany
| | - Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany
| | - Matthias B. Stope
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany
- Correspondence: ; Tel.: +49-228-287-11361
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Modulation of Inflammatory Responses by a Non-Invasive Physical Plasma Jet during Gingival Wound Healing. Cells 2022; 11:cells11172740. [PMID: 36078148 PMCID: PMC9454534 DOI: 10.3390/cells11172740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Gingival wound healing plays an important role in the treatment of a variety of inflammatory diseases. In some cases, however, wound healing is delayed by various endogenous or exogenous factors. In recent years, non-invasive physical plasma (NIPP), a highly reactive gas, has become the focus of research, because of its anti-inflammatory and wound healing-promoting efficacy. So far, since NIPP application has been poorly elucidated in dentistry, the aim of this study was to further investigate the effect of NIPP on various molecules associated with inflammation and wound healing in gingival cells. Human gingival fibroblasts (HGF) and human gingival keratinocytes (HGK) were treated with NIPP at different application times. Cell viability and cell morphology were assessed using DAPI/phalloidin staining. Cyclooxygenase (COX)2; tumour necrosis factor (TNF); CC Motif Chemokine Ligand (CCL)2; and interleukin (IL)1B, IL6 and IL8 were analysed at the mRNA and protein level by a real-time PCR and ELISA. NIPP did not cause any damage to the cells. Furthermore, NIPP led to a downregulation of proinflammatory molecules. Our study shows that NIPP application does not damage the gingival tissue and that the promotion of wound healing is also due to an anti-inflammatory component.
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do Amparo Manoel C, de Sousa Mariano S, da Silva Ramos E, Paolillo FR, de Aro AA, Mendes C, Venturini LM, Silveira PCL, Bagnato VS, de Andrade TAM. Photobiomodulation and photodynamic therapy applied after electrocauterization for skin healing optimization in rats. JOURNAL OF BIOPHOTONICS 2022; 15:e202100239. [PMID: 35092174 DOI: 10.1002/jbio.202100239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Photobiomodulation-PBM and Photodynamic Therapy-PDT have been used to induce healing. However, the effects of these therapies on skin-lesions induced by electrocautery are unknown, aiming at more favorable clinical and esthetic results. Electrocauterization was done in 78-female Wistar-rats using a system that includes an electrocautery and red-LED. The groups were: No injury, Injury, Injury + ALA (topical 5-aminolevulinic acid application), Injury + LED and Injury + ALA + LED (topical ALA application followed by photoactivation with LED). After 2nd, 7th and 14th days post-injury, immuno-histomorphometric analyses (inflammatory infiltrate, blood vessels, fibroblasts, eschar/epidermal thickness, IL-10 and VEGF) and biochemical assays of MPO (neutrophil), NAG (macrophage), nitrite, DCF (H2 O2 ), carbonyl (membrane's damage), sulfhydryl (membrane's integrity), SOD, GSH, hydroxyproline and re-epithelialization area were performed. The Injury + LED and Injury + ALA + LED groups controlled inflammation and oxidative stress, favoring angiogenesis, fibroblasts proliferation and collagen formation. Therefore, the PBM or PDT was effective in tissue formation with thinner eschar and epidermis, resulting in less scarring after electrocauterization.
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Affiliation(s)
- Cecília do Amparo Manoel
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Araras, Sao Paulo, Brazil
| | - Samara de Sousa Mariano
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Araras, Sao Paulo, Brazil
| | - Ericsson da Silva Ramos
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Araras, Sao Paulo, Brazil
| | | | - Andrea Aparecida de Aro
- Graduate Program in Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Araras, Sao Paulo, Brazil
| | - Carolini Mendes
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense-UNESC, Criciuma, Santa Catarina, Brazil
| | - Ligia Milanez Venturini
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense-UNESC, Criciuma, Santa Catarina, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Experimental Physiopathology, Graduate Program in Science of Health, Universidade do Extremo Sul Catarinense-UNESC, Criciuma, Santa Catarina, Brazil
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Araujo S, Sganzella MF, Sagiorato RN, Leite MN, Caetano GF, Aparecida de Aro A, Esquisatto MAM, Frade MAC, de Andrade TAM, Santos GMT. Human adipose-derived stem cells in fibrin glue carrier modulate wound healing phases in rats. CURRENT RESEARCH IN BIOTECHNOLOGY 2022. [DOI: 10.1016/j.crbiot.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bekeschus S, von Woedtke T, Emmert S, Schmidt A. Medical gas plasma-stimulated wound healing: Evidence and mechanisms. Redox Biol 2021; 46:102116. [PMID: 34474394 PMCID: PMC8408623 DOI: 10.1016/j.redox.2021.102116] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 12/11/2022] Open
Abstract
Defective wound healing poses a significant burden on patients and healthcare systems. In recent years, a novel reactive oxygen and nitrogen species (ROS/RNS) based therapy has received considerable attention among dermatologists for targeting chronic wounds. The multifaceted ROS/RNS are generated using gas plasma technology, a partially ionized gas operated at body temperature. This review integrates preclinical and clinical evidence into a set of working hypotheses mainly based on redox processes aiding in elucidating the mechanisms of action and optimizing gas plasmas for therapeutic purposes. These hypotheses include increased wound tissue oxygenation and vascularization, amplified apoptosis of senescent cells, redox signaling, and augmented microbial inactivation. Instead of a dominant role of a single effector, it is proposed that all mechanisms act in concert in gas plasma-stimulated healing, rationalizing the use of this technology in therapy-resistant wounds. Finally, addressable current challenges and future concepts are outlined, which may further promote the clinical utilization, efficacy, and safety of gas plasma technology in wound care in the future.
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Affiliation(s)
- Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), A Member of the Leibniz Research Alliance Leibniz Health Technology, Felix-Hausdorff-Str. 2, 17489, Greifswald, Germany.
| | - Thomas von Woedtke
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), A Member of the Leibniz Research Alliance Leibniz Health Technology, Felix-Hausdorff-Str. 2, 17489, Greifswald, Germany; Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475, Greifswald, Germany
| | - Steffen Emmert
- Clinic for Dermatology and Venereology, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany
| | - Anke Schmidt
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), A Member of the Leibniz Research Alliance Leibniz Health Technology, Felix-Hausdorff-Str. 2, 17489, Greifswald, Germany
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Bekeschus S, Kramer A, Schmidt A. Gas Plasma-Augmented Wound Healing in Animal Models and Veterinary Medicine. Molecules 2021; 26:molecules26185682. [PMID: 34577153 PMCID: PMC8469854 DOI: 10.3390/molecules26185682] [Citation(s) in RCA: 13] [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: 08/12/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
The loss of skin integrity is inevitable in life. Wound healing is a necessary sequence of events to reconstitute the body’s integrity against potentially harmful environmental agents and restore homeostasis. Attempts to improve cutaneous wound healing are therefore as old as humanity itself. Furthermore, nowadays, targeting defective wound healing is of utmost importance in an aging society with underlying diseases such as diabetes and vascular insufficiencies being on the rise. Because chronic wounds’ etiology and specific traits differ, there is widespread polypragmasia in targeting non-healing conditions. Reactive oxygen and nitrogen species (ROS/RNS) are an overarching theme accompanying wound healing and its biological stages. ROS are signaling agents generated by phagocytes to inactivate pathogens. Although ROS/RNS’s central role in the biology of wound healing has long been appreciated, it was only until the recent decade that these agents were explicitly used to target defective wound healing using gas plasma technology. Gas plasma is a physical state of matter and is a partially ionized gas operated at body temperature which generates a plethora of ROS/RNS simultaneously in a spatiotemporally controlled manner. Animal models of wound healing have been vital in driving the development of these wound healing-promoting technologies, and this review summarizes the current knowledge and identifies open ends derived from in vivo wound models under gas plasma therapy. While gas plasma-assisted wound healing in humans has become well established in Europe, veterinary medicine is an emerging field with great potential to improve the lives of suffering animals.
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Affiliation(s)
- Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany;
- Correspondence:
| | - Axel Kramer
- Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475 Greifswald, Germany;
| | - Anke Schmidt
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany;
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