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Zhao H, Meng W, Lv X, Li J, Cai Z, Guo X, Wang Z, Guo L, Rong M, Shen C, Liu D, Song L. Nebulized inhalation of plasma-activated water in the treatment of progressive moderate COVID-19 patients with antiviral treatment failure: a randomized controlled pilot trial. BMC Infect Dis 2024; 24:960. [PMID: 39266946 PMCID: PMC11391605 DOI: 10.1186/s12879-024-09886-w] [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: 04/12/2024] [Accepted: 09/05/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Antiviral drugs show significant efficacy in non-severe COVID-19 cases, yet there remains a subset of moderate COVID-19 patients whose pneumonia continues to progress post a complete course of treatment. Plasma-activated water (PAW) possesses anti-SARS-CoV-2 properties. To explore the potential of PAW in improving pneumonia in COVID-19 patients following antiviral treatment failure, we conducted this study. METHODS This was a randomized, controlled trial. Moderate COVID-19 patients with antiviral treatment failure were randomly assigned to the experimental group or the control group. They inhaled nebulized PAW or saline respectively. This was done twice daily for four consecutive days. We assessed improvement in chest CT on day 5, the rate of symptom resolution within 10 days, and safety. RESULTS A total of 23 participants were included, with 11 receiving PAW and 12 receiving saline. The baseline characteristics of both groups were comparable. The experimental group showed a higher improvement rate in chest CT on day 5 (81.8% vs. 33.3%, p = 0.036). The cumulative disappearance rate of cough within 10 days was higher in the experimental group. Within 28 days, 4 patients in each group progressed to severe illness, and no patients died. No adverse reactions were reported from inhaling nebulized PAW. CONCLUSION This pilot trial preliminarily confirmed that nebulized inhalation of PAW can alleviate pneumonia in moderate COVID-19 patients with antiviral treatment failure, with no adverse reactions observed. This still needs to be verified by large-scale studies. TRIAL REGISTRATION Chinese Clinical Trial Registry; No.: ChiCTR2300078706 (retrospectively registered, 12/15/2023); URL: www.chictr.org.cn .
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Affiliation(s)
- Heng Zhao
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Wanting Meng
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Xing Lv
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Jing Li
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Zhigui Cai
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Xingxing Guo
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Zifeng Wang
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Li Guo
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Mingzhe Rong
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Cong Shen
- Department of PET-CT, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Dingxin Liu
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Liqiang Song
- Department of Respiratory and Critical Care Medicine, Xijing Hospital of Air Force Medical University, Xi'an, 710032, China.
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2
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Werra UEM, Dorweiler B. [Cold plasma in wound healing]. UROLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00120-024-02376-6. [PMID: 38985295 DOI: 10.1007/s00120-024-02376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 07/11/2024]
Abstract
Even today, not all wounds can be healed. Treatment, which often takes many years, is a burden for patients and is very cost-intensive. Therefore, additional procedures such as cold plasma are becoming increasingly popular. Active components of cold plasma include electromagnetic radiation and free radicals. The active principle is based on, among other things, damage to bacterial cells and positive interaction with epithelial and endothelial cells. Angiogenesis and cellular oxygen metabolism are stimulated. The evidence base is still limited and heterogeneous, as some results are contradictory and comparability is difficult. However, new, well-designed studies have confirmed previous findings. In order to create a solid database, further studies are needed.
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Affiliation(s)
- Ursula Elisabeth Maria Werra
- Klinik und Poliklinik für Gefäßchirurgie, Vaskuläre und endovaskuläre Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Bernhard Dorweiler
- Klinik und Poliklinik für Gefäßchirurgie, Vaskuläre und endovaskuläre Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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3
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Abdo AI, Kopecki Z. Comparing Redox and Intracellular Signalling Responses to Cold Plasma in Wound Healing and Cancer. Curr Issues Mol Biol 2024; 46:4885-4923. [PMID: 38785562 PMCID: PMC11120013 DOI: 10.3390/cimb46050294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Cold plasma (CP) is an ionised gas containing excited molecules and ions, radicals, and free electrons, and which emits electric fields and UV radiation. CP is potently antimicrobial, and can be applied safely to biological tissue, birthing the field of plasma medicine. Reactive oxygen and nitrogen species (RONS) produced by CP affect biological processes directly or indirectly via the modification of cellular lipids, proteins, DNA, and intracellular signalling pathways. CP can be applied at lower levels for oxidative eustress to activate cell proliferation, motility, migration, and antioxidant production in normal cells, mainly potentiated by the unfolded protein response, the nuclear factor-erythroid factor 2-related factor 2 (Nrf2)-activated antioxidant response element, and the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway, which also activates nuclear factor-kappa B (NFκB). At higher CP exposures, inactivation, apoptosis, and autophagy of malignant cells can occur via the degradation of the PI3K/Akt and mitogen-activated protein kinase (MAPK)-dependent and -independent activation of the master tumour suppressor p53, leading to caspase-mediated cell death. These opposing responses validate a hormesis approach to plasma medicine. Clinical applications of CP are becoming increasingly realised in wound healing, while clinical effectiveness in tumours is currently coming to light. This review will outline advances in plasma medicine and compare the main redox and intracellular signalling responses to CP in wound healing and cancer.
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Affiliation(s)
- Adrian I. Abdo
- Richter Lab, Surgical Specialties, Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia
- Department of Surgery, The Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia
| | - Zlatko Kopecki
- Future Industries Institute, STEM Academic Unit, University of South Australia, Mawson Lakes, SA 5095, Australia
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4
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Schmidt A, Singer D, Aden H, von Woedtke T, Bekeschus S. Gas Plasma Exposure Alters Microcirculation and Inflammation during Wound Healing in a Diabetic Mouse Model. Antioxidants (Basel) 2024; 13:68. [PMID: 38247492 PMCID: PMC10812527 DOI: 10.3390/antiox13010068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Diabetes can disrupt physiological wound healing, caused by decreased levels or impaired activity of angiogenic factors. This can contribute to chronic inflammation, poor formation of new blood vessels, and delayed re-epithelialization. The present study describes the preclinical application of medical gas plasma to treat a dermal, full-thickness ear wound in streptozotocin (STZ)-induced diabetic mice. Gas plasma-mediated effects occurred in both sexes but with gender-specific differences. Hyperspectral imaging demonstrated gas plasma therapy changing microcirculatory parameters, particularly oxygen saturation levels during wound healing, presumably due to the gas plasma's tissue delivery of reactive species and other bioactive components. In addition, gas plasma treatment significantly affected cell adhesion by regulating focal adhesion kinase and vinculin, which is important in maintaining skin barrier function by regulating syndecan expression and increasing re-epithelialization. An anticipated stimulation of blood vessel formation was detected via transcriptional and translational increase of angiogenic factors in gas plasma-exposed wound tissue. Moreover, gas plasma treatment significantly affected inflammation by modulating systemic growth factors and cytokine levels. The presented findings may help explain the mode of action of successful clinical plasma therapy of wounds of diabetic patients.
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Affiliation(s)
- Anke Schmidt
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Debora Singer
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
| | - Henrike Aden
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Thomas von Woedtke
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Institute of Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475 Greifswald, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
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Ma Y, Sun T, Ren K, Min T, Xie X, Wang H, Xu G, Dang C, Zhang H. Applications of cold atmospheric plasma in immune-mediated inflammatory diseases via redox homeostasis: evidence and prospects. Heliyon 2023; 9:e22568. [PMID: 38107323 PMCID: PMC10724573 DOI: 10.1016/j.heliyon.2023.e22568] [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: 07/09/2023] [Revised: 09/28/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
As a representative technology in plasma medicine, cold atmospheric plasma (CAP) has beneficial outcomes in surface disinfection, wound repair, tissue regeneration, solid tumor therapy. Impact on immune response and inflammatory conditions was also observed in the process of CAP treatment. Relevant literatures were collected to assess efficacy and summarize possible mechanisms of the innovation. CAP mediates alteration in local immune microenvironment mainly through two ways. One is to down-regulate the expression level of several cytokines, impeding further conduction of immune or inflammatory signals. Intervening the functional phenotype of cells through different degree of oxidative stress is the other approach to manage the immune-mediated inflammatory disorders. A series of preclinical and clinical studies confirmed the therapeutic effect and side effects free of CAP. Moreover, several suggestions proposed in this manuscript might help to find directions for future investigation.
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Affiliation(s)
- Yuyi Ma
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Tuanhe Sun
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Kaijie Ren
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Tianhao Min
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xin Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Haonan Wang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Guimin Xu
- State Key Laboratory of Electrical Insulation and Power Equipment, School of Electrical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Chengxue Dang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
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Barjasteh A, Kaushik N, Choi EH, Kaushik NK. Cold Atmospheric Pressure Plasma: A Growing Paradigm in Diabetic Wound Healing-Mechanism and Clinical Significance. Int J Mol Sci 2023; 24:16657. [PMID: 38068979 PMCID: PMC10706109 DOI: 10.3390/ijms242316657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Diabetes is one of the most significant causes of death all over the world. This illness, due to abnormal blood glucose levels, leads to impaired wound healing and, as a result, foot ulcers. These ulcers cannot heal quickly in diabetic patients and may finally result in amputation. In recent years, different research has been conducted to heal diabetic foot ulcers: one of them is using cold atmospheric pressure plasma. Nowadays, cold atmospheric pressure plasma is highly regarded in medicine because of its positive effects and lack of side effects. These conditions have caused plasma to be considered a promising technology in medicine and especially diabetic wound healing because studies show that it can heal chronic wounds that are resistant to standard treatments. The positive effects of plasma are due to different reactive species, UV radiation, and electromagnetic fields. This work reviews ongoing cold atmospheric pressure plasma improvements in diabetic wound healing. It shows that plasma can be a promising tool in treating chronic wounds, including ones resulting from diabetes.
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Affiliation(s)
- Azadeh Barjasteh
- Department of Physics, Lorestan University, Khorramabad 68151-44316, Iran;
| | - Neha Kaushik
- Department of Biotechnology, College of Engineering, The University of Suwon, Hwaseong 18323, Republic of Korea;
| | - Eun Ha Choi
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
| | - Nagendra Kumar Kaushik
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
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7
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Eggers B, Stope MB, Marciniak J, Mustea A, Eick S, Deschner J, Nokhbehsaim M, Kramer FJ. Non-Invasive Physical Plasma Reduces the Inflammatory Response in Microbially Prestimulated Human Gingival Fibroblasts. Int J Mol Sci 2023; 24:16156. [PMID: 38003346 PMCID: PMC10671174 DOI: 10.3390/ijms242216156] [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: 10/21/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Non-invasive physical plasma (NIPP), an electrically conductive gas, is playing an increasingly important role in medicine due to its antimicrobial and regenerative properties. However, NIPP is not yet well established in dentistry, although it has promising potential, especially for periodontological applications. The aim of the present study was to investigate the effect of NIPP on a commercially available human gingival fibroblast (HGF) cell line and primary HGFs in the presence of periodontitis-associated bacteria. First, primary HGFs from eight patients were characterised by immunofluorescence, and cell numbers were examined by an automatic cell counter over 5 days. Then, HGFs that were preincubated with Fusobacterium nucleatum (F.n.) were treated with NIPP. Afterwards, the IL-6 and IL-8 levels in the cell supernatants were determined by ELISA. In HGFs, F.n. caused a significant increase in IL-6 and IL-8, and this F.n.-induced upregulation of both cytokines was counteracted by NIPP, suggesting a beneficial effect of physical plasma on periodontal cells in a microbial environment. The application of NIPP in periodontal therapy could therefore represent a novel and promising strategy and deserves further investigation.
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Affiliation(s)
- Benedikt Eggers
- Department of Oral, Maxillofacial and Plastic Surgery, University Hospital Bonn, 53111 Bonn, Germany;
| | - Matthias Bernhard Stope
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.B.S.); (A.M.)
| | - Jana Marciniak
- Department of Orthodontics, University Hospital Bonn, 53111 Bonn, Germany;
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.B.S.); (A.M.)
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, 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;
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8
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Mohseni P, Ghorbani A, Fariborzi N. Exploring the potential of cold plasma therapy in treating bacterial infections in veterinary medicine: opportunities and challenges. Front Vet Sci 2023; 10:1240596. [PMID: 37720476 PMCID: PMC10502341 DOI: 10.3389/fvets.2023.1240596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023] Open
Abstract
Cold plasma therapy is a novel approach that has shown significant promise in treating bacterial infections in veterinary medicine. Cold plasma possesses the potential to eliminate various bacteria, including those that are resistant to antibiotics, which renders it a desirable substitute for traditional antibiotics. Furthermore, it can enhance the immune system and facilitate the process of wound healing. However, there are some challenges associated with the use of cold plasma in veterinary medicine, such as achieving consistent and uniform exposure to the affected area, determining optimal treatment conditions, and evaluating the long-term impact on animal health. This paper explores the potential of cold plasma therapy in veterinary medicine for managing bacterial diseases, including respiratory infections, skin infections, and wound infections such as Clostridium botulinum, Clostridium perfringens, Bacillus cereus, and Bacillus subtilis. It also shows the opportunities and challenges associated with its use. In conclusion, the paper highlights the promising potential of utilizing cold plasma in veterinary medicine. However, to gain a comprehensive understanding of its benefits and limitations, further research is required. Future studies should concentrate on refining treatment protocols and assessing the long-term effects of cold plasma therapy on bacterial infections and the overall health of animals.
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Affiliation(s)
- Parvin Mohseni
- Department of Pathobiology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Abozar Ghorbani
- Nuclear Agriculture Research School, Nuclear Science and Technology Research Institute (NSTRI), Karaj, Iran
| | - Niloofar Fariborzi
- Department of Biology and Control of Diseases Vector, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Li M, Gao J, Wang L, Liu J, Fu C, Yang X, Zhang S, Li X, Luo S, Yang C. Basic research and clinical exploration of cold atmospheric plasma for skin wounds. Bioeng Transl Med 2023; 8:e10550. [PMID: 37693064 PMCID: PMC10487309 DOI: 10.1002/btm2.10550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/18/2023] [Accepted: 04/30/2023] [Indexed: 09/12/2023] Open
Abstract
Skin wounds, such as burns, diabetic foot ulcers, pressure sores, and wounds formed after laser or surgical treatment, comprise a very high proportion of dermatological disorders. Wounds are treated in a variety of ways; however, some wounds are greatly resistant, resulting in delayed healing and an urgent need to introduce new alternatives. Our previous studies have shown that cold atmospheric plasma (CAP) has antibacterial activity and promotes cell proliferation, differentiation, and migration in vitro. To further advance the role of CAP in wound healing, we evaluated the safety and efficacy of CAP in vitro by irradiation of common refractory bacteria on the skin, irradiation of normal skin of rats and observing reactions, treatment of scald wounds in rats, and treating clinically common acute wounds. Our findings revealed that CAP can eliminate refractory skin bacteria in vitro; CAP positively affected wound healing in a rat scalding wound model; and direct CAP irradiation of low intensity and short duration did not lead to skin erythema or edema. CAP promises to be a new, economical, and safe means of wound treatment.
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Affiliation(s)
- Miaomiao Li
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Jing Gao
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
- Anhui Provincial Institute of Translational MedicineHefeiAnhuiChina
| | - Liyun Wang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Jia Liu
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Chuyu Fu
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Xingyu Yang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Shengquan Zhang
- Anhui Provincial Institute of Translational MedicineHefeiAnhuiChina
- Department of Biochemistry and Molecular Biology, School of Basic Medical SciencesAnhui Medical UniversityHefeiAnhuiChina
| | - Xinwei Li
- Anhui Academy of Medical SciencesHefeiAnhuiChina
| | | | - Chunjun Yang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
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Li Z, Zhou Q, Yang J, Qiu X, Fu S, Chen Q. Effect of cold atmospheric plasma therapy on wound healing in patients with diabetic foot ulcers: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e066628. [PMID: 37105698 PMCID: PMC10151838 DOI: 10.1136/bmjopen-2022-066628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Diabetic foot ulcer (DFU), one of the most common and serious consequences of diabetes, affects many individuals and often leads to amputation, death and other disastrous outcomes. Diabetic foot ulcers have a relatively poor response to therapy, which increases the likelihood of recurrence. Cold atmospheric plasma (CAP) therapy is an emerging treatment method for DFU that can reduce bacterial loads and speed up the healing of chronic wounds. Although some studies have reported that CAP could improve the wound healing speed compared with conventional traditional therapy, the samples in these studies are small and not sufficiently representative. The purpose of the current systematic review and meta-analysis is to evaluate the effectiveness and safety of CAP in DFU treatment and provide a scientific basis for its clinical application. METHODS AND ANALYSIS The following databases will be searched: Wanfang, China Biology and Medicine CD, Embase, PubMed and The Cochrane Library. We will retrieve publications, conference documents, current trials and internal reports written in English or Chinese related to the effect of CAP therapy on wound healing in patients with diabetic foot ulcers up to 30 June 2022. The selected articles will be read independently by two reviewers, and valid information such as first author, publication date and outcome indicators will be extracted. Researchers will also assess the quality of the literature using the Cochrane risk-of-bias tool 2. RevMan 5.3.5, EndNote X7 and STATA V.13.0 will be used for data analysis. ETHICS AND DISSEMINATION No ethical review is necessary for this systematic review because it is based on previously published data and does not include patient intervention. A peer-reviewed publication will publish the findings of this investigation.
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Affiliation(s)
- Zinan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qian Zhou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jiao Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xianliang Qiu
- West China Second Hospital,Sichuan University/West China Women's and Children's Hospital, Chengdu, Sichuan, China
| | - Shunlian Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qiu Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Bolgeo T, Maconi A, Gardalini M, Gatti D, Di Matteo R, Lapidari M, Longhitano Y, Savioli G, Piccioni A, Zanza C. The Role of Cold Atmospheric Plasma in Wound Healing Processes in Critically Ill Patients. J Pers Med 2023; 13:jpm13050736. [PMID: 37240907 DOI: 10.3390/jpm13050736] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Critically ill patients are at risk of skin wounds, which reduce their quality of life, complicate their pharmacological regimens, and prolong their hospital stays in intensive care units (ICUs), while also increasing overall mortality and morbidity rates. Cold atmospheric plasma (CAP) has been proposed as a viable option for many biological and medical applications, given its capacity to reduce wound bacterial contamination and promote wound healing. The aim of this narrative review is to describe how CAP works and its operating mechanisms, as well as reporting its possible applications in critical care settings. The success of CAP in the treatment of wounds, in particular, bedsores or pressure sores, presents an innovative path in the prevention of nosocomial infections and an opportunity of reducing the negative implications of these diseases for the NHS. This narrative review of the literature was conducted following the 'Scale for the Assessment of Narrative Review Articles' (SANRA) methodology. Previous literature highlights three biological effects of plasma: inactivation of a wide range of microorganisms, including those that are multi-drug-resistant; increased cell proliferation and angiogenesis with a shorter period of plasma treatment; and apoptosis stimulation with a longer and more intensive treatment. CAP is effective in many areas of the medical field, with no significant adverse effects on healthy cells. However, its use can produce potentially serious side effects and should, therefore, be used under expert supervision and in appropriate doses.
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Affiliation(s)
- Tatiana Bolgeo
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Maconi
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Menada Gardalini
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Denise Gatti
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Roberta Di Matteo
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Marco Lapidari
- Department of Vascular Surgery, St. Antonio and Biagio and Cesare Arrigo Hospital, 15121 Alessandria, Italy
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Gabriele Savioli
- Department of Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
| | - Andrea Piccioni
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Christian Zanza
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
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12
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Exploring the Use of Cold Atmospheric Plasma to Overcome Drug Resistance in Cancer. Biomedicines 2023; 11:biomedicines11010208. [PMID: 36672716 PMCID: PMC9855365 DOI: 10.3390/biomedicines11010208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
Drug resistance is a major problem in cancer treatment, as it limits the effectiveness of pharmacological agents and can lead to disease progression. Cold atmospheric plasma (CAP) is a technology that uses ionized gas (plasma) to generate reactive oxygen and nitrogen species (RONS) that can kill cancer cells. CAP is a novel approach for overcoming drug resistance in cancer. In recent years, there has been a growing interest in using CAP to enhance the effectiveness of chemotherapy drugs. In this review, we discuss the mechanisms behind this phenomenon and explore its potential applications in cancer treatment. Going through the existing literature on CAP and drug resistance in cancer, we highlight the challenges and opportunities for further research in this field. Our review suggests that CAP could be a promising option for overcoming drug resistance in cancer and warrants further investigation.
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13
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Ibáñez-Mancera NG, López-Callejas R, Toral-Rizo VH, Rodríguez-Méndez BG, Lara-Carrillo E, Peña-Eguiluz R, do Amaral RC, Mercado-Cabrera A, Valencia-Alvarado R. Healing of Recurrent Aphthous Stomatitis by Non-Thermal Plasma: Pilot Study. Biomedicines 2023; 11:biomedicines11010167. [PMID: 36672674 PMCID: PMC9856114 DOI: 10.3390/biomedicines11010167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a common disease in the oral cavity characterized by recurrent ulcers (RU). Usually, these cause acute pain without definitive treatment. The present study determines the efficacy of non-thermal plasma (NTP) for treating RU. NTP is applied to the patient's RU using a radiofrequency generator connected to a point reactor. The power density applied to the ulcer is 0.50 W/cm2, less than 4 W/cm2, which is the maximum value without biological risk. Each patient received two treatments of three minutes each and spaced 60 min apart at a distance of 5 mm from the RU. From a sample of 30 ulcers in patients treated for RU with an average age of 37 years, they stated that the pain decreased considerably and without the need for ingestion of analgesics and antibiotics. Regeneration took place in an average of three days. The NTP proved to be an excellent therapeutic alternative for the treatment of RU since it has a rapid effect of reducing pain and inflammation, as well as adequate tissue regeneration.
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Affiliation(s)
- Norma Guadalupe Ibáñez-Mancera
- Interdisciplinary Center for Health Sciences CICS-UST, Instituto Politécnico Nacional, Av. Luis Enrique Erro S/N, Unidad Profesional Adolfo López Mateos, Zacatenco 07738, Mexico
| | - Régulo López-Callejas
- Plasma Physics Laboratory, Instituto Nacional de Investigaciones Nucleares, Carretera México Toluca S/N, Ocoyoacac 52750, Mexico
| | - Víctor Hugo Toral-Rizo
- Orocenter Clinic, Facultad de Odontología, Universidad Autónoma del Estado de México, Av. Paseo Tollocan esq. Jesús Carranza, Colonia Universidad, Toluca de Lerdo 50130, Mexico
| | - Benjamín Gonzalo Rodríguez-Méndez
- Plasma Physics Laboratory, Instituto Nacional de Investigaciones Nucleares, Carretera México Toluca S/N, Ocoyoacac 52750, Mexico
- Correspondence:
| | - Edith Lara-Carrillo
- Orocenter Clinic, Facultad de Odontología, Universidad Autónoma del Estado de México, Av. Paseo Tollocan esq. Jesús Carranza, Colonia Universidad, Toluca de Lerdo 50130, Mexico
| | - Rosendo Peña-Eguiluz
- Plasma Physics Laboratory, Instituto Nacional de Investigaciones Nucleares, Carretera México Toluca S/N, Ocoyoacac 52750, Mexico
| | | | - Antonio Mercado-Cabrera
- Plasma Physics Laboratory, Instituto Nacional de Investigaciones Nucleares, Carretera México Toluca S/N, Ocoyoacac 52750, Mexico
| | - Raúl Valencia-Alvarado
- Plasma Physics Laboratory, Instituto Nacional de Investigaciones Nucleares, Carretera México Toluca S/N, Ocoyoacac 52750, Mexico
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14
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Werra UEM, Dorweiler B. Kaltplasmatherapie in der Wundbehandlung – Was wissen wir? GEFÄSSCHIRURGIE 2022. [DOI: 10.1007/s00772-022-00960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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15
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Wound healing in db/db mice with type 2 diabetes using non-contact exposure with an argon non-thermal atmospheric pressure plasma jet device. PLoS One 2022; 17:e0275602. [PMID: 36240146 PMCID: PMC9565687 DOI: 10.1371/journal.pone.0275602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022] Open
Abstract
A non-thermal atmospheric pressure plasma jet (APPJ) may stimulate cells and tissues or result in cell death depending on the intensity of plasma at the target; therefore, we herein investigated the effects of non-thermal plasma under non-contact conditions on the healing of full-thickness wounds in diabetic mice (DM+ group) and normal mice (DM- group). A hydrogen peroxide colorimetric method and high performance liquid chromatography showed that APPJ produced low amounts of reactive oxygen and nitrogen species. Ten-week-old male C57BL/6j mice with normal blood glucose levels (DM- group) and 10-week-old male C57BLKS/J Iar-+Leprdb/+Leprdb mice (DM+ group) received two full-thickness cutaneous wounds (4 mm in diameter) on both sides of the dorsum. Wounds were treated with or without the plasma jet or argon gas for 1 minute and were then covered with a hydrocolloid dressing (Hydrocolloid), according to which mice were divided into the following groups: DM+Plasma, DM+Argon, DM+Hydrocolloid, DM-Plasma, DM-Argon, and DM-Hydrocolloid. Exudate weights, wound areas, and wound area ratios were recorded every day. Hematoxylin and eosin staining was performed to assess re-epithelialization and α-SMA immunohistological staining to evaluate the formation of new blood vessels. Non-thermal plasma under non-contact conditions reduced the production of exudate. Exudate weights were smaller in the DM+Plasma group than in the DM+Hydrocolloid and DM+Argon groups. The wound area ratio was smaller for plasma-treated wounds, and was also smaller in the DM+Plasma group than in the DM+Hydrocolloid and DM+Argon groups on days 1-21 (p<0.01). Wound areas were smaller in the DM-Plasma group than in the DM-Argon group until day 14 and differences were significant on days 1-5 (p<0.01). The percentage of re-epithelialization was significantly higher in the DM+Plasma group than in the DM+Argon and DM+Hydrocolloid groups (p<0.01). The number of new blood vessels that had formed by day 7 was significantly higher in the DM+Plasma group than in the DM+Hydrocolloid and DM+Argon groups (p<0.05). These results indicate that treatment with the current non-thermal plasma APPJ device under non-contact conditions accelerated wound healing in diabetic mice.
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16
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Efficacy of Cold Atmospheric Plasma Therapy on Chronic Wounds: An Updated Systematic Review and Meta-Analysis of RCTs. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5798857. [PMID: 36262869 PMCID: PMC9576403 DOI: 10.1155/2022/5798857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022]
Abstract
Objective A previous meta-analysis has revealed that cold atmospheric plasma (CAP) might not be clinically beneficial to chronic wounds. However, several new randomized controlled trials (RCTs) reported that CAP was an effective treatment option for accelerating wound healing in chronic wounds. The purpose of this review is to incorporate these new results and evaluate the efficacy of CAP in chronic wounds. Methods The major databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched for articles related to CAP treatment in chronic wounds until March 21, 2022. The literature retrieval and evaluation were carried out by two independent researchers. Result A total of 13 randomized clinical trials published between 2010 and 2022 were finally included. CAP therapy showed to be more effective in reducing the area of wounds (mean difference (MD): -1.74, 95%; confidence interval (CI): [-3.14, -0.33], p = 0.02), compared with non-CAP treatments. The immediate reduction of the bacterial load was higher in the CAP group than in the control group. (MD: -0.37, 95%; CI: [-0.7, -0.05], p = 0.02). Conclusion No significant changes were found in long-term antibacterial efficacy and pain perception between the two groups. However, more RCTs of excellent methodological quality are required to confirm technical details of the source of AP and the appropriate duration of the treatment with plasma.
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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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Mateu-Sanz M, Ginebra MP, Tornín J, Canal C. Cold atmospheric plasma enhances doxorubicin selectivity in metastasic bone cancer. Free Radic Biol Med 2022; 189:32-41. [PMID: 35843475 DOI: 10.1016/j.freeradbiomed.2022.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/20/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
High-dose systemic chemotherapy constitutes a main strategy in the management of bone metastases, employing drugs like doxorubicin (DOX), related with severe side effects. To solve this issue, Cold Atmospheric Plasmas (CAP) have been proposed as potential non-invasive anti-cancer agents capable of improving the efficacy of traditional drugs. Here, we investigate the cytotoxic effects of Plasma Conditioned Medium (PCM) in combination with DOX in prostate cancer cells from bone metastases (PC-3) as well as in non-malignant bone-cells. PCM was able to enhance the cytotoxic potential of DOX both in monolayer and in a 3D bioengineered model mimicking the bone matrix. The combined treatment of PCM + DOX resulted in a profound downregulation of the redox defenses (CAT1, SOD2, GPX1) and drug resistance genes (MRP1, MDR1, BCRP1), resulting in an enhanced uptake of DOX coupled to an overload of intracellular ROS. Besides, PCM improved the cytotoxic potential of DOX interfering on the migratory and clonogenic potential of PC-3 cells. Importantly, non-malignant bone cells were unaffected by the combination of PCM + DOX. Overall, these new findings may represent a new therapeutic approach for the management of bone metastatic prostate cancer in the future.
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Affiliation(s)
- Miguel Mateu-Sanz
- Biomaterials, Biomechanics and Tissue Engineering Group, Materials Science and Engineering Department, and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya (UPC), Escola d'Enginyeria Barcelona Est (EEBE), c/Eduard Maristany 14, 08019, Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain
| | - María-Pau Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group, Materials Science and Engineering Department, and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya (UPC), Escola d'Enginyeria Barcelona Est (EEBE), c/Eduard Maristany 14, 08019, Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain
| | - Juan Tornín
- Biomaterials, Biomechanics and Tissue Engineering Group, Materials Science and Engineering Department, and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya (UPC), Escola d'Enginyeria Barcelona Est (EEBE), c/Eduard Maristany 14, 08019, Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain; Sarcomas and Experimental Therapeutics Laboratory, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, 33011, Oviedo, Spain.
| | - Cristina Canal
- Biomaterials, Biomechanics and Tissue Engineering Group, Materials Science and Engineering Department, and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya (UPC), Escola d'Enginyeria Barcelona Est (EEBE), c/Eduard Maristany 14, 08019, Barcelona, Spain; Barcelona Research Center in Multiscale Science and Engineering, UPC, 08019, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, 08034, Barcelona, Spain.
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Neamtu B, Barbu A, Negrea MO, Berghea-Neamțu CȘ, Popescu D, Zăhan M, Mireșan V. Carrageenan-Based Compounds as Wound Healing Materials. Int J Mol Sci 2022; 23:ijms23169117. [PMID: 36012381 PMCID: PMC9409225 DOI: 10.3390/ijms23169117] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
The following review is focused on carrageenan, a heteroglycan-based substance that is a very significant wound healing biomaterial. Every biomaterial has advantages and weaknesses of its own, but these drawbacks are typically outweighed by combining the material in various ways with other substances. Carrageenans' key benefits include their water solubility, which enables them to keep the wound and periwound damp and absorb the wound exudate. They have low cytotoxicity, antimicrobial and antioxidant qualities, do not stick to the wound bed, and hence do not cause pain when removed from the wounded region. When combined with other materials, they can aid in hemostasis. This review emphasizes the advantages of using carrageenan for wound healing, including the use of several mixes that improve its properties.
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Affiliation(s)
- Bogdan Neamtu
- Pediatric Research Department, Pediatric Hospital Sibiu, 550166 Sibiu, Romania
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Faculty of Engineering, “Lucian Blaga” University of Sibiu, 550025 Sibiu, Romania
- Correspondence: (B.N.); (A.B.); Tel.: +40-773-994-375 (B.N.); +40-748-063-335 (A.B.)
| | - Andreea Barbu
- Pediatric Research Department, Pediatric Hospital Sibiu, 550166 Sibiu, Romania
- Faculty of Animal Science and Biotechnologies, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
- Correspondence: (B.N.); (A.B.); Tel.: +40-773-994-375 (B.N.); +40-748-063-335 (A.B.)
| | | | - Cristian Ștefan Berghea-Neamțu
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Department of Pediatric Surgery, Pediatric Hospital Sibiu, 550166 Sibiu, Romania
| | - Dragoș Popescu
- Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Obstetrics and Gynecology Clinic, County Clinical Emergency Hospital, 550245 Sibiu, Romania
| | - Marius Zăhan
- Faculty of Animal Science and Biotechnologies, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
| | - Vioara Mireșan
- Faculty of Animal Science and Biotechnologies, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
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20
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Tan F, Wang Y, Zhang S, Shui R, Chen J. Plasma Dermatology: Skin Therapy Using Cold Atmospheric Plasma. Front Oncol 2022; 12:918484. [PMID: 35903680 PMCID: PMC9314643 DOI: 10.3389/fonc.2022.918484] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Cold atmospheric plasma-based plasma medicine has been expanding the diversity of its specialties. As an emerging branch, plasma dermatology takes advantage of the beneficial complexity of plasma constituents (e.g., reactive oxygen and nitrogen species, UV photons, and electromagnetic emission), technical versatility (e.g., direct irradiation and indirect aqueous treatment), and practical feasibility (e.g., hand-held compact device and clinician-friendly operation). The objective of this comprehensive review is to summarize recent advances in the CAP-dominated skin therapy by broadly covering three aspects. We start with plasma optimisation of intact skin, detailing the effect of CAP on skin lipids, cells, histology, and blood circulation. We then conduct a clinically oriented and thorough dissection of CAP treatment of various skin diseases, focusing on the wound healing, inflammatory disorders, infectious conditions, parasitic infestations, cutaneous malignancies, and alopecia. Finally, we conclude with a brief analysis on the safety aspect of CAP treatment and a proposal on how to mitigate the potential risks. This comprehensive review endeavors to serve as a mini textbook for clinical dermatologists and a practical manual for plasma biotechnologists. Our collective goal is to consolidate plasma dermatology’s lead in modern personalized medicine.
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Affiliation(s)
- Fei Tan
- Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- The Royal College of Surgeons of England, London, United Kingdom
- *Correspondence: Fei Tan,
| | - Yang Wang
- Department of Pathology, Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
| | - Shiqun Zhang
- Department of Pharmacology, Shanghai Tenth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
| | - Runying Shui
- Department of Surgery, Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Jianghan Chen
- Department of Surgery, Department of Dermatology, Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
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Mirhaj M, Labbaf S, Tavakoli M, Seifalian AM. Emerging treatment strategies in wound care. Int Wound J 2022; 19:1934-1954. [PMID: 35297170 DOI: 10.1111/iwj.13786] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 12/20/2022] Open
Abstract
Wound healing is a complex process in tissue regeneration through which the body responds to the dissipated cells as a result of any kind of severe injury. Diabetic and non-healing wounds are considered an unmet clinical need. Currently, different strategic approaches are widely used in the treatment of acute and chronic wounds which include, but are not limited to, tissue transplantation, cell therapy and wound dressings, and the use of an instrument. A large number of literatures have been published on this topic; however, the most effective clinical treatment remains a challenge. The wound dressing involves the use of a scaffold, usually using biomaterials for the delivery of medication, autologous stem cells, or growth factors from the blood. Antibacterial and anti-inflammatory drugs are also used to stop the infection as well as accelerate wound healing. With an increase in the ageing population leading to diabetes and associated cutaneous wounds, there is a great need to improve the current treatment strategies. This research critically reviews the current advancement in the therapeutic and clinical approaches for wound healing and tissue regeneration. The results of recent clinical trials suggest that the use of modern dressings and skin substitutes is the easiest, most accessible, and most cost-effective way to treat chronic wounds with advances in materials science such as graphene as 3D scaffold and biomolecules hold significant promise. The annual market value for successful wound treatment exceeds over $50 billion US dollars, and this will encourage industries as well as academics to investigate the application of emerging smart materials for modern dressings and skin substitutes for wound therapy.
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Affiliation(s)
- Marjan Mirhaj
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran.,Nanotechnology & Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), London BioScience Innovation Centre, London, UK
| | - Sheyda Labbaf
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Mohamadreza Tavakoli
- Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Alexander Marcus Seifalian
- Nanotechnology & Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), London BioScience Innovation Centre, London, UK
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22
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Kusakcı-Seker B, Ozdemir H, Karadeniz-Saygili S. Evaluation of the protective effects of non-thermal atmospheric plasma on alveolar bone loss in experimental periodontitis. Clin Oral Investig 2021; 25:6949-6959. [PMID: 34585260 DOI: 10.1007/s00784-021-04203-0] [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: 06/01/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The inhibition of bone destruction is one of the main goals of periodontitis treatment. The aim of this study was to investigate the protective effects of non-thermal atmospheric plasma (NTAP) on alveolar bone loss radiographically, histomorphometrically, and histologically in experimental periodontitis in rats. MATERIALS AND METHODS A total of twenty-eight rats were randomly divided into three groups: control group (CG) (n = 8), periodontitis group (PG) (n = 10), and NTAP group (NTAPG) (n = 10). In PG and NTAPG, experimental periodontitis was created with ligating. The kINPen 11 plasma jet was applied around the ligatured teeth in NTAPG. The samples from each group were radiographically assessed with microcomputed tomography (micro-CT); then, histological (presence of osteoclasts and inflammatory cells) and immunohistochemical (immunoreactive of OCN and ALP) findings were compared. RESULTS The results revealed a significant increase in alveolar bone loss in the PG compared with CG and NTAPG (p < 0.05). Inflammation, alveolar resorption, and cement damage were reduced significantly in the group treated with NTAP compared to the PG (p < 0.05). Significantly higher levels of osteoclasts were detected in the PG in comparison with both CG and NTAPG (p < 0.05). The lowest osteocalcin and ALP values were determined in PG, and the differences between PG and both groups were also significant (p < 0.05). CONCLUSION Within the limitations of the present study, we can say that NTAP may enhance the bone remodeling process by inhibiting inflammation and preventing alveolar bone destruction. CLINICAL RELEVANCE NTAP has clinical potential for accelerating and treating periodontitis with the inflammatory response modulation, osteoblast differentiation, and alveolar bone loss reduction.
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Affiliation(s)
- Basak Kusakcı-Seker
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, Turkey.
| | - Hakan Ozdemir
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Suna Karadeniz-Saygili
- Faculty of Medicine, Department of Histology and Embryology, Kütahya Health Science University, Kütahya, Turkey
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Fallah N, Rasouli M, Amini MR. The current and advanced therapeutic modalities for wound healing management. J Diabetes Metab Disord 2021; 20:1883-1899. [PMID: 34900831 PMCID: PMC8630293 DOI: 10.1007/s40200-021-00868-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/28/2021] [Indexed: 12/27/2022]
Abstract
Ever-increasing demands on improving efficiencies of wound healing procedures are a strong driving force for the development of replacement approaches. This review focuses on wound healing management from the point of formation to the point of healing procedures. The most important usual healing modality with key characteristic is explained and their limitations are discussed. Novel interesting approaches are presented with a concentration of the unique features and action mechanisms. Special attention is paid to gas plasma and nanotechnology impact on wound healing management from fundamental processes to beneficial outcomes. Challenges and opportunities for the future trend that combined common protocols and emerging technologies are discussed.
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Affiliation(s)
- Nadia Fallah
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Milad Rasouli
- Plasma Medicine Group, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Institute for Plasma Research and Department of Physics, Kharazmi University, Tehran, Iran
| | - Mohammad Reza Amini
- Plasma Medicine Group, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kim S, Kim CH. Applications of Plasma-Activated Liquid in the Medical Field. Biomedicines 2021; 9:biomedicines9111700. [PMID: 34829929 PMCID: PMC8615748 DOI: 10.3390/biomedicines9111700] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/01/2021] [Accepted: 11/12/2021] [Indexed: 12/18/2022] Open
Abstract
Much progress has been made since plasma was discovered in the early 1900s. The first form of plasma was thermal type, which was limited for medical use due to potential thermal damage on living cells. In the late 1900s, with the development of a nonthermal atmospheric plasma called cold plasma, profound clinical research began and ‘plasma medicine’ became a new area in the academic field. Plasma began to be used mainly for environmental problems, such as water purification and wastewater treatment, and subsequent research on plasma and liquid interaction led to the birth of ‘plasma-activated liquid’ (PAL). PAL is currently used in the fields of environment, food, agriculture, nanoparticle synthesis, analytical chemistry, and sterilization. In the medical field, PAL usage can be expanded for accessing places where direct application of plasma is difficult. In this review, recent studies with PAL will be introduced to inform researchers of the application plan and possibility of PAL in the medical field.
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Affiliation(s)
- Sungryeal Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon 16499, Korea;
| | - Chul-Ho Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon 16499, Korea;
- Department of Molecular Science and Technology, Ajou University, Suwon 16499, Korea
- Correspondence:
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25
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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: 19.3] [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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Pefani-Antimisiari K, Athanasopoulos DK, Marazioti A, Sklias K, Rodi M, de Lastic AL, Mouzaki A, Svarnas P, Antimisiaris SG. Synergistic effect of cold atmospheric pressure plasma and free or liposomal doxorubicin on melanoma cells. Sci Rep 2021; 11:14788. [PMID: 34285268 PMCID: PMC8292331 DOI: 10.1038/s41598-021-94130-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/30/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of the present study was to investigate combined effects of cold atmospheric plasma (CAP) and the chemotherapeutic drug doxorubicin (DOX) on murine and human melanoma cells, and normal cells. In addition to free drug, the combination of CAP with a liposomal drug (DOX-LIP) was also studied for the first time. Thiazolyl blue tetrazolium bromide (MTT) and Trypan Blue exclusion assays were used to evaluate cell viability; the mechanism of cell death was evaluated by flow cytometry. Combined treatment effects on the clonogenic capability of melanoma cells, was also tested with soft agar colony formation assay. Furthermore the effect of CAP on the cellular uptake of DOX or DOX-LIP was examined. Results showed a strong synergistic effect of CAP and DOX or DOX-LIP on selectively decreasing cell viability of melanoma cells. CAP accelerated the apoptotic effect of DOX (or DOX-LIP) and dramatically reduced the aggressiveness of melanoma cells, as the combination treatment significantly decreased their anchorage independent growth. Moreover, CAP did not result in increased cellular uptake of DOX under the present experimental conditions. In conclusion, CAP facilitates DOX cytotoxic effects on melanoma cells, and affects their metastatic potential by reducing their clonogenicity, as shown for the first time.
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Affiliation(s)
| | - Dimitrios K Athanasopoulos
- High Voltage Laboratory, Department of Electrical and Computer Engineering, University of Patras, 26504, Rion, Greece
| | - Antonia Marazioti
- Pharmaceutical Technology Laboratory, Department of Pharmacy, University of Patras, 26504, Rion, Greece.
- FORTH/ICE-ΗΤ, Institute of Chemical Engineering Sciences, 26504, Rion, Greece.
| | - Kyriakos Sklias
- High Voltage Laboratory, Department of Electrical and Computer Engineering, University of Patras, 26504, Rion, Greece
| | - Maria Rodi
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26500, Patras, Greece
| | - Anne-Lise de Lastic
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26500, Patras, Greece
| | - Athanasia Mouzaki
- Laboratory of Immunohematology, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, 26500, Patras, Greece
| | - Panagiotis Svarnas
- High Voltage Laboratory, Department of Electrical and Computer Engineering, University of Patras, 26504, Rion, Greece.
| | - Sophia G Antimisiaris
- Pharmaceutical Technology Laboratory, Department of Pharmacy, University of Patras, 26504, Rion, Greece
- FORTH/ICE-ΗΤ, Institute of Chemical Engineering Sciences, 26504, Rion, Greece
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