Human health risk evaluation of a microwave-driven atmospheric plasma jet as medical device

Transcriptome analysis of Candida albicans planktonic cells in response to plasma medicine

Introduction. Cold plasma is frequently utilized for the purpose of eliminating microbial contaminants. Under optimal conditions, it can function as plasma medicine for treating various diseases, including infections caused by Candida albicans, an opportunistic pathogen that can overgrow in individuals with weakened immune system.Gap Statement. To date, there has been less molecular study on cold plasma-treated C. albicans.Research Aim. The study aims to fill the gap in understanding the molecular response of C. albicans to cold plasma treatment.Methodology. This project involved testing a cold plasma generator to determine its antimicrobial effectiveness on C. albicans' planktonic cells. Additionally, the cells' transcriptomics responses were investigated using RNA sequencing at various treatment durations (1, 3 and 5 min).Results. The results show that our cold plasma effectively eliminates C. albicans. Cold plasma treatment resulted in substantial downregulation of important pathways, such as 'nucleotide metabolism', 'DNA replication and repair', 'cell growth', 'carbohydrate metabolism' and 'amino acid metabolism'. This was an indication of cell cycle arrest of C. albicans to preserve energy consumption under unfavourable conditions. Nevertheless, C. albicans adapted its GSH antioxidant system to cope with the oxidative stress induced by reactive oxygen species, reactive nitrogen species and other free radicals. The treatment likely led to a decrease in cell pathogenicity as many virulence factors were downregulated.Conclusion. The study demonstrated the major affected pathways in cold plasma-treated C. albicans, providing valuable insights into the molecular response of C. albicans to cold plasma treatment. The findings contribute to the understanding of the antimicrobial efficiency of cold plasma and its potential applications in the field of microbiology.

Non-Thermal Plasma Application in Medicine-Focus on Reactive Species Involvement

Non-thermal plasma (NTP) application in medicine is a dynamically developing interdisciplinary field. Despite the fact that basics of the plasma phenomenon have been known since the 19th century, growing scientific attention has been paid in recent years to the use of plasma in medicine. Three most important plasma-based effects are pivotal for medical applications: (i) inactivation of a broad spectrum of microorganisms, (ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and (iii) inactivation of cells by initialization of cell death with higher plasma intensity. In this review, we explain the underlying chemical processes and reactive species involvement during NTP in human (or animal) tissues, as well as in bacteria inactivation, which leads to sterilization and indirectly supports wound healing. In addition, plasma-mediated modifications of medical surfaces, such as surgical instruments or implants, are described. This review focuses on the existing knowledge on NTP-based in vitro and in vivo studies and highlights potential opportunities for the development of novel therapeutic methods. A full understanding of the NTP mechanisms of action is urgently needed for the further development of modern plasma-based medicine.

Effects of Cold Atmospheric Plasma Pre-Treatment of Titanium on the Biological Activity of Primary Human Gingival Fibroblasts

Cold atmospheric plasma treatment (CAP) enables the contactless modification of titanium. This study aimed to investigate the attachment of primary human gingival fibroblasts on titanium. Machined and microstructured titanium discs were exposed to cold atmospheric plasma, followed by the application of primary human gingival fibroblasts onto the disc. The fibroblast cultures were analyzed by fluorescence, scanning electron microscopy and cell-biological tests. The treated titanium displayed a more homogeneous and denser fibroblast coverage, while its biological behavior was not altered. This study demonstrated for the first time the beneficial effect of CAP treatment on the initial attachment of primary human gingival fibroblasts on titanium. The results support the application of CAP in the context of pre-implantation conditioning, as well as of peri-implant disease treatment.

Recent trends and technological development in plasma as an emerging and promising technology for food biosystems

The rising need for wholesome, fresh, safe and “minimally-processed” foods has led to pioneering research activities in the emerging non-thermal technology of food processing. Cold plasma is such an innovative and promising technology that offers several potential applications in the food industry. It uses the highly reactive, energetic and charged gas molecules and species to decontaminate the food and package surfaces and preserve the foods without causing thermal damage to the nutritional and quality attributes of food. Cold plasma technology showed promising results about the inactivation of pathogens in the food industry without affecting the food quality. It is highly effective for surface decontamination of fruits and vegetables, but extensive research is required before its commercial utilization. Recent patents are focused on the applications of cold plasma in food processing and preservation. However, further studies are strongly needed to scale up this technology for future commercialization and understand plasma physics for getting better results and expand the applications and benefits. This review summarizes the emerging trends of cold plasma along with its recent applications in the food industry to extend shelf life and improve the quality of food. It also gives an overview of plasma generation and principles including mechanism of action. Further, the patents based on cold plasma technology have also been highlighted comprehensively for the first time.

Cold Atmospheric Pressure Plasma Jet Operated in Ar and He: From Basic Plasma Properties to Vacuum Ultraviolet, Electric Field and Safety Thresholds Measurements in Plasma Medicine

Application desired functionality as well as operation expenses of cold atmospheric pressure plasma (CAP) devices scale with properties like gas selection. The present contribution provides a comparative investigation for a CAP system operated in argon or helium at different operation voltages and distance to the surface. Comparison of power dissipation, electrical field strength and optical emission spectroscopy from vacuum ultraviolet over visible up to near infrared ((V)UV-VIS-NIR) spectral range is carried out. This study is extended to safety relevant investigation of patient leakage current, induced surface temperature and species density for ozone (O3) and nitrogen oxides (NOx). It is found that in identical operation conditions (applied voltage, distance to surface and gas flow rate) the dissipated plasma power is about equal (up to 10 W), but the electrical field strength differs, having peak values of 320 kV/m for Ar and up to 300 kV/m for He. However, only for Ar CAP could we measure O3 up to 2 ppm and NOx up to 7 ppm. The surface temperature and leakage values of both systems showed different slopes, with the biggest surprise being a constant leakage current over distance for argon. These findings may open a new direction in the plasma source development for Plasma Medicine.

Cold Physical Plasma in Cancer Therapy: Mechanisms, Signaling, and Immunity

Despite recent advances in therapy, cancer still is a devastating and life-threatening disease, motivating novel research lines in oncology. Cold physical plasma, a partially ionized gas, is a new modality in cancer research. Physical plasma produces various physicochemical factors, primarily reactive oxygen and nitrogen species (ROS/RNS), causing cancer cell death when supplied at supraphysiological concentrations. This review outlines the biomedical consequences of plasma treatment in experimental cancer therapy, including cell death modalities. It also summarizes current knowledge on intracellular signaling pathways triggered by plasma treatment to induce cancer cell death. Besides the inactivation of tumor cells, an equally important aspect is the inflammatory context in which cell death occurs to suppress or promote the responses of immune cells. This is mainly governed by the release of damage-associated molecular patterns (DAMPs) to provoke immunogenic cancer cell death (ICD) that, in turn, activates cells of the innate immune system to promote adaptive antitumor immunity. The pivotal role of the immune system in cancer treatment, in general, is highlighted by many clinical trials and success stories on using checkpoint immunotherapy. Hence, the potential of plasma treatment to induce ICD in tumor cells to promote immunity targeting cancer lesions systemically is also discussed.

Repeated exposure of the oral mucosa over 12 months with cold plasma is not carcinogenic in mice

Peri-implantitis may result in the loss of dental implants. Cold atmospheric pressure plasma (CAP) was suggested to promote re-osseointegration, decrease antimicrobial burden, and support wound healing. However, the long-term risk assessment of CAP treatment in the oral cavity has not been addressed. Treatment with two different CAP devices was compared against UV radiation, carcinogen administration, and untreated conditions over 12 months. Histological analysis of 406 animals revealed that repeated CAP exposure did not foster non-invasive lesions or squamous cell carcinoma (SCCs). Carcinogen administration promoted non-invasive lesions and SCCs. Molecular analysis by a qPCR screening of 144 transcripts revealed distinct inflammatory profiles associated with each treatment regimen. Interestingly, CAP treatment of carcinogen-challenged mucosa did not promote but instead left unchanged or reduced the proportion of non-invasive lesions and SCC formation. In conclusion, repeated CAP exposure of murine oral mucosa was well tolerated, and carcinogenic effects did not occur, motivating CAP applications in patients for dental and implant treatments in the future.

Inactivation of Staphylococcus aureus and Escherichia coli Biofilms by Air-Based Atmospheric-Pressure DBD Plasma

Air-based atmospheric-pressure plasma is an effective non-thermal method in deactivating various kinds of microbial biofilms with several advantages, including high bactericidal efficiency and low treatment costs. Bacterial biofilm formation is a major determinant in establishment of bacterial infection and also resistance to antibacterial chemotherapy. This study aims to assess the anti-biofilm potential of air-based atmospheric-pressure DBD plasma against Staphylococcus aureus and Escherichia coli biofilms. The biofilms of Staphylococcus aureus and Escherichia coli were exposed to air-based atmospheric-pressure DBD plasma for up to 4 min (control, 30 s, 90 s, 3 min, and 4 min) and their biofilm formation level, viability, and membrane integrity were determined. Based on the results, plasma exposure caused disruption up to 70% and 85% for S. aureus and E. coli biofilms, respectively. The biofilm disruption potential of air-based atmospheric-pressure DBD plasma was confirmed using the scanning electron microscopy (SEM). Besides, based on confocal laser scanning microscopy (CLSM), plasma exposure caused a significant bacterial inactivation and E. coli was found as more susceptible strain than S. aureus. In conclusion, atmospheric-pressure DBD plasma could be considered an efficient non-thermal approach against bacterial pathogenicity by biofilm disruption and thus prevention of infection establishment.

A compact pulse-modulation cold air plasma jet for the inactivation of chronic wound bacteria: development and characterization

A compact low-temperature plasma jet device was developed to use ambient air as plasma gas. The device was driven by a 2.52-kV high-voltage direct-current pulse in a burst mode, with a repetition rate of 2 kHz. The maximum plasma discharge current was 3.5 A, with an approximately 10 ns full-width half-maximum. Nitric oxide, hydroxyl radical, atomic oxygen, ozone, and hydrogen peroxide—important reactive oxygen and nitrogen species (RONS)—were mainly produced. The amount of plasma-generated RONS can be controlled by varying the pulse-modulation factors. After optimization, the plasma plume length was approximately 5 mm and the treatment temperature was less than 40 °C. The preliminary bactericidal effects were tested on Staphylococcus aureus, Pseudomonas aeruginosa, and methicillin-resistant S. aureus (MRSA), and their biofilms. The results showed that the plasma can effectively inactivate S. aureus, P. aeruginosa, and MRSA in both time- and pulse-dependent manner. Thus, this produced plasma device proved to be an efficient tool for inactivating deteriorating bacteria. Further versatile utilization of this portable plasma generator is also promising.

Effects of plasma jet, dielectric barrier discharge, photodynamic therapy and sodium hypochlorite on infected curved root canals

The aim of this investigation was to evaluate the effects of 2 different cold atmospheric plasma (CAP) sources, photodynamic therapy and sodium hypochlorite (NaOCl), on infected root canals. Therefore, 50 standardized curved human root canals were infected with Enterococcus faecalis and assigned to 5 groups-negative control (NC), plasma jet (CAP I), dielectric barrier discharge (CAP II), photodynamic therapy (PDT) and NaOCl + passive ultrasonic irrigation-for 30 s. Colony forming units (CFUs) were determined. NaOCl was significantly more effective at reducing CFUs than all test groups (P < .0001 [Mann-Whitney U test]) in both parts of the root canal. CFUs in PDT were significantly lower than those in CAP II (P = .015), and those in CAP I were lower than those in CAP II (P = .05). Among all other groups and in the apical parts, no significant differences were found (P > .05).