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Schmidt A, von Woedtke T, Weltmann KD, Bekeschus S. YAP/TAZ, beta-catenin, and TGFb pathway activation in medical plasma-induced wound healing in diabetic mice. J Adv Res 2024:S2090-1232(24)00270-4. [PMID: 38986808 DOI: 10.1016/j.jare.2024.07.004] [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: 05/01/2024] [Revised: 06/15/2024] [Accepted: 07/06/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION Hippo is a signaling pathway that is evolutionarily conserved and plays critical roles in wound healing and tissue regeneration. Disruption of the transcriptional activity of both Hippo-associated factors, the yes-associated protein (YAP), and the transcriptional co-activator with PDZ binding motif (TAZ) has been associated with cardiovascular diseases, fibrosis, and cancer. This makes the Hippo pathway an appealing target for therapeutic interventions. OBJECTIVES Prior research has indicated that medical gas plasma promotes wound healing by delivering a combination of reactive species directly to the affected areas. However, the involvement of YAP/TAZ and other signaling pathways in diabetic wound healing remains unexplored. METHODS To this extent, ear wounds were generated and treated with gas plasma in streptozotocin (STZ)-induced diabetic mice. Transcriptome profiling at two wound healing stages (days 9 and 20 post-wounding) was performed in female and male mice. Additionally, we employed gene and protein expression analyses, utilizing immunohistological and -chemical staining of various targets as well as quantitative PCR and Western blot analysis. RESULTS Gas plasma treatment accelerated healing by increasing re-epithelialization and modifying extracellular matrix components. Transcriptomic profiling charting the major alterations in gene expression following plasma treatment was followed by a validation of several targets using transcriptional and translational quantification as well as localization analyses. CONCLUSION Our study evaluated the cellular regulation of essential targets of the Hippo and related pathways such as YAP/TAZ, β-catenin, tumor growth factor β, and oxidative stress signaling after plasma treatment. The activation of genes, pathways, and their regulators is an attractive therapeutic aim for a therapeutic intervention in dermal skin repair in diabetic diseases using medical gas plasmas.
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Affiliation(s)
- Anke Schmidt
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, 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 Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475 Greifswald, Germany
| | - Klaus-Dieter Weltmann
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; Department of Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany.
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Ge Y, Wang J, Gu D, Cao W, Feng Y, Wu Y, Liu H, Xu Z, Zhang Z, Xie J, Geng S, Cong J, Liu Y. Low-temperature plasma jet suppresses bacterial colonisation and affects wound healing through reactive species. Wound Repair Regen 2024; 32:407-418. [PMID: 38602090 DOI: 10.1111/wrr.13178] [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: 05/06/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
An argon-based low-temperature plasma jet (LTPJ) was used to treat chronically infected wounds in Staphylococcus aureus-laden mice. Based on physicochemical property analysis and in vitro antibacterial experiments, the effects of plasma parameters on the reactive nitrogen and oxygen species (RNOS) content and antibacterial capacity were determined, and the optimal treatment parameters were determined to be 4 standard litre per minute and 35 W. Additionally, the plasma-treated activation solution had a bactericidal effect. Although RNOS are related to the antimicrobial effect of plasma, excess RNOS may be detrimental to wound remodelling. In vivo studies demonstrated that medium-dose LTPJ promoted MMP-9 expression and inhibited bacterial growth during the early stages of healing. Moreover, LTPJ increased collagen deposition, reduced inflammation, and restored blood vessel density and TGF-β levels to normal in the later stages of wound healing. Therefore, when treating chronically infected wounds with LTPJ, selecting the medium dose of plasma is more advantageous for wound recovery. Overall, our study demonstrated that low-temperature plasma jets may be a potential tool for the treatment of chronically infected wounds.
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Affiliation(s)
- Yang Ge
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Jun Wang
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
- Nanjing Guoke Medical Enginneering Technology Development co., LTD, Nanjing, Jiangsu, China
| | - DongHua Gu
- Department of Pathology, Suzhou Science & Technology Town Hospital, Suzhou, Jiangsu, China
| | - Wei Cao
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Yongtong Feng
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Yanfan Wu
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Suzhou, Jiangsu, China
| | - Han Liu
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Zhengping Xu
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Zhe Zhang
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Jinsong Xie
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Shuang Geng
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Junrui Cong
- Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yi Liu
- The CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Suzhou, Jiangsu, China
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Lee JH, Jaiswal MS, Jang YS, Choi JH, Kim GC, Hong JW, Hwang DS. No-ozone cold plasma induces apoptosis in human neuroblastoma cell line via increased intracellular reactive oxygen species (ROS). BMC Complement Med Ther 2024; 24:46. [PMID: 38245726 PMCID: PMC10799363 DOI: 10.1186/s12906-023-04313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the effect of argon-based No-ozone Cold Plasma (NCP) on neuroblastoma cancer cell apoptosis. METHODS Experiments were performed with SK-N-SH and HS 68. Cell cultures were treated with NCP for 1, 3, and 5 min. NCP was applied using three different strategies: direct NCP application to cell cultures, to only media, and to only cells. Evaluation of cell viability and the level of the reactive oxygen species (ROS) was performed. N-acetyl-L-cysteine (NAC) was also used to antagonize intracellular ROS. Cleaved caspase 3, PARP, aquaporin (AQP) 3 and 8 were detected. RESULTS NCP induced a gradual decrease in the SK-N-SH cell viability. In contrast, the viability of HS 68 cells did not change. SK-N-SH cells viability was reduced the most when the only media-NCP application strategy was employed. Intracellular ROS levels were significantly increased with time. Cleaved caspase 3 and PARP were increased at 6 h after NCP application. SK-N-SH cells remained viable with NAC after NCP application. AQP 3 and 8 were over-expressed in SK-N-SH cells. CONCLUSION These findings demonstrate the anti-cancer effect of NCP on neuroblastoma cells. NCP enhanced the selective apoptosis of neuroblastoma cells due to the increased intracellular ROS.
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Affiliation(s)
- Jung-Han Lee
- Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute, Dental School, Pusan National University, Busan, South Korea
| | - M Shriya Jaiswal
- Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute, Dental School, Pusan National University, Busan, South Korea
| | - Yoon-Seo Jang
- Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute, Dental School, Pusan National University, Busan, South Korea
| | - Jeong-Hae Choi
- Department of Research and Development, FEAGLE Corporations, 70-6, Jeungsan-ro, Mulgeum-eup, Yangsan-si, 50614, Gyeongsangnam-do, South Korea
| | - Gyoo-Cheon Kim
- Department of Research and Development, FEAGLE Corporations, 70-6, Jeungsan-ro, Mulgeum-eup, Yangsan-si, 50614, Gyeongsangnam-do, South Korea
- Department of Oral Anatomy and Cell Biology, School of Dentistry, Pusan National University, Busan, South Korea
| | - Jin-Woo Hong
- Department of Internal Medicine, School of Korean Medicine, Yangsan Campus of Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan-si, 50612, Gyeongsangnam-do, South Korea.
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute, Dental School, Pusan National University, Busan, South Korea.
- Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea.
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan-si, 50612, Gyeongsangnam-do, South Korea.
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Hesham A, Abass M, Abdou H, Fahmy R, Rashad MM, Abdallah AA, Mossallem W, Rehan IF, Elnagar A, Zigo F, Ondrašovičová S, Abouelnaga AF, Rizk A. Ozonated saline intradermal injection: promising therapy for accelerated cutaneous wound healing in diabetic rats. Front Vet Sci 2023; 10:1283679. [PMID: 38026676 PMCID: PMC10657902 DOI: 10.3389/fvets.2023.1283679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The use of ozonized water is gaining importance in medicine due to its effects on hyperglycemia and wound healing mechanisms. Methods This experiment was conducted to assess the impacts of intradermal administration of ozonated water on acute skin wound healing in a diabetic rat model. Sixty-four adult male Wistar rats were randomly divided into two groups: an ozonated water group (O3W) and a control group (CG). Experimental diabetes was chemically induced in the rats by the intraperitoneal administration of 60 mg/kg streptozotocin. One week later, full-thickness skin surgical wounds (1 cm2) were created between the two shoulders of the rats under general anesthesia. The wounds were then daily irrigated with normal saline (CG) or intradermally injected with 1 mL of ozonated water at 10 mg/L O3W. Wound healing was evaluated through macroscopic analysis, measuring wound size, diameter, and percentage of contraction rate before wounding and at 3, 7, 9, 12, 14, 18, 21, 24, and 28 days post-wounding. On days 7, 14, 21, and 28 after induction of the wounds, the body weights and blood glucose levels of rats (8 per group) were measured before the rats were euthanized. Moreover, the morphological structure of the tissue, vascular endothelial and transforming growth factor (VEGF and TGF) affinity and gene expression were examined. Results The O3W group had significantly lower blood glucose levels and wound size and gained body weight. Additionally, epithelial vascularization, stromal edema, TGF, and VEGF gene expression significantly improved in the O3W group. Discussion Therefore, ozonated water has the potential to enhance and promote cutaneous wound healing in diabetic rats.
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Affiliation(s)
- Ahmed Hesham
- Undergraduate Student, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Marwa Abass
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Haanin Abdou
- Undergraduate Student, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Reham Fahmy
- Veterinary Surgery, Oncology Centre, Mansoura University, Mansoura, Egypt
| | - Maha M. Rashad
- Biochemistry and Molecular Biology Department, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Abdelnaser A. Abdallah
- Department of Internal Medicine and Infectious Disease, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Wael Mossallem
- Veterinary Clinical Supervisor, Al-Rahba Veterinary Clinic, Abu Dhabi, United Arab Emirates
| | - Ibrahim F. Rehan
- Department of Husbandry and Development of Animal Wealth, Faculty of Veterinary Medicine, Menofia University, Shibin El Kom, Egypt
- Department of Pathobiochemistry, Faculty of Pharmacy, Meijo University Yagotoyama, Nagoya, Japan
| | - Asmaa Elnagar
- Department of Pathobiochemistry, Faculty of Pharmacy, Meijo University Yagotoyama, Nagoya, Japan
| | - František Zigo
- Department of Nutrition and Animal Husbandry, University of Veterinary Medicine, and Pharmacy, Košice, Slovakia
| | - Silvia Ondrašovičová
- Department of Biology and Physiology, University of Veterinary Medicine, and Pharmacy, Košice, Slovakia
| | - Ahmed F. Abouelnaga
- Department of Animal Behaviour and Management, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Awad Rizk
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
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Ghasemitarei M, Ghorbi T, Yusupov M, Zhang Y, Zhao T, Shali P, Bogaerts A. Effects of Nitro-Oxidative Stress on Biomolecules: Part 1-Non-Reactive Molecular Dynamics Simulations. Biomolecules 2023; 13:1371. [PMID: 37759771 PMCID: PMC10527456 DOI: 10.3390/biom13091371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Plasma medicine, or the biomedical application of cold atmospheric plasma (CAP), is an expanding field within plasma research. CAP has demonstrated remarkable versatility in diverse biological applications, including cancer treatment, wound healing, microorganism inactivation, and skin disease therapy. However, the precise mechanisms underlying the effects of CAP remain incompletely understood. The therapeutic effects of CAP are largely attributed to the generation of reactive oxygen and nitrogen species (RONS), which play a crucial role in the biological responses induced by CAP. Specifically, RONS produced during CAP treatment have the ability to chemically modify cell membranes and membrane proteins, causing nitro-oxidative stress, thereby leading to changes in membrane permeability and disruption of cellular processes. To gain atomic-level insights into these interactions, non-reactive molecular dynamics (MD) simulations have emerged as a valuable tool. These simulations facilitate the examination of larger-scale system dynamics, including protein-protein and protein-membrane interactions. In this comprehensive review, we focus on the applications of non-reactive MD simulations in studying the effects of CAP on cellular components and interactions at the atomic level, providing a detailed overview of the potential of CAP in medicine. We also review the results of other MD studies that are not related to plasma medicine but explore the effects of nitro-oxidative stress on cellular components and are therefore important for a broader understanding of the underlying processes.
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Affiliation(s)
- Maryam Ghasemitarei
- Department of Physics, Sharif University of Technology, Tehran 14588-89694, Iran
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, 2610 Antwerp, Belgium
| | - Tayebeh Ghorbi
- Department of Physics, Sharif University of Technology, Tehran 14588-89694, Iran
| | - Maksudbek Yusupov
- School of Engineering, New Uzbekistan University, Tashkent 100007, Uzbekistan
- School of Engineering, Central Asian University, Tashkent 111221, Uzbekistan
- Laboratory of Thermal Physics of Multiphase Systems, Arifov Institute of Ion-Plasma and Laser Technologies, Academy of Sciences of Uzbekistan, Tashkent 100125, Uzbekistan
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, 2610 Antwerp, Belgium
| | - Yuantao Zhang
- School of Electrical Engineering, Shandong University, Jinan 250061, China
| | - Tong Zhao
- School of Electrical Engineering, Shandong University, Jinan 250061, China
| | - Parisa Shali
- Research Unit Plasma Technology, Department of Applied Physics, Faculty of Engineering and Agriculture, Ghent University, 9000 Ghent, Belgium
| | - Annemie Bogaerts
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, 2610 Antwerp, Belgium
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Lee Y, Ricky S, Lim TH, Kim H, Lee EJ, Song Y, Lee S, Jang Y. An Atmospheric Plasma Jet Induces Expression of Wound Healing Genes in Progressive Burn Wounds in a Comb Burn Rat Model: A Pilot Study. J Burn Care Res 2023; 44:685-692. [PMID: 33482000 PMCID: PMC10152990 DOI: 10.1093/jbcr/irab005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Indexed: 11/14/2022]
Abstract
Burn-related injuries are devastating injuries with a high mortality rate that affect people of all ages worldwide. We assessed the effectiveness of plasma jet treatment in altering the expression of genes involved in wound healing in a prospective longitudinal observational animal study. Six male Sprague-Dawley rats weighing 350 g were used, and burn wounds were made by applying a preheated brass comb (100°C) to the back of the rats, resulting in four full-thickness burn wounds separated by three interspaces. A total of 18 burn wounds were induced on three rats. One side of the burn, on each rat received plasma treatment (plasma group), while the other side did not (control group). The interspaces were subjected to the plasma jet for 2 minutes per day until 7 days post-wounding. Plasma treatment significantly decreased the expression of proinflammatory cytokines. Furthermore, an increase in the expression of anti-inflammatory cytokines was observed in the plasma group. We showed that plasma jet treatment could improve burn wound healing by altering the expression of genes involved in the development of wound healing.
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Affiliation(s)
- Yoonje Lee
- Department of Emergency Medicine, College of Medicine, Hallym University, Seoul, Korea
| | - Sanjaya Ricky
- Department of Translational Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Tae Ho Lim
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Convergence Technology Center for Disaster Preparedness, Hanyang University, Seoul, Korea
- Convergence Research Center for Plasma Medicine, Hanyang University, Seoul, Korea
| | - Hongjung Kim
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Eui Jung Lee
- Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Yeongtak Song
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Convergence Technology Center for Disaster Preparedness, Hanyang University, Seoul, Korea
- Convergence Research Center for Plasma Medicine, Hanyang University, Seoul, Korea
| | - Sunmi Lee
- Convergence Technology Center for Disaster Preparedness, Hanyang University, Seoul, Korea
- Convergence Research Center for Plasma Medicine, Hanyang University, Seoul, Korea
| | - Yongwoo Jang
- Center for Self-Powered Actuation, Department of Biomedical Engineering, Hanyang University, Seoul, Korea
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Cho SB, Lee S, Yoo DS, Kim SE, Kim T, Zouboulis CC, Lee SE. Cold Atmospheric Plasma Inhibits Lipogenesis and Proliferation of Human Sebocytes and Decreases Sebum Production in Human Facial Skin. Dermatol Ther 2023. [DOI: 10.1155/2023/2922191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background. Although several energy devices targeting sebaceous glands have been developed, an effective and safe therapeutic tool for hyperseborrhea is still needed. Nonthermal atmospheric-pressure plasma (NTAPP) induces microscopic tissue reactions in sebaceous glands of rat skin. Objective. The aim of the study is to investigate the effects of NTAPP on sebum production in human skin in vivo followed by an experimental study of human sebocytes. Methods. Fourteen healthy volunteers with oily facial skin underwent three sessions of argon- and nitrogen-NTAPP treatment at a 1-week interval and were followed up for 8 weeks. The casual sebum level, sebum excretion rate, and porphyrin index were evaluated. Histological analysis was performed using skin biopsy specimens taken from two subjects at the baseline and week 2. SZ95 sebocytes were stimulated with testosterone and linoleic acid (T/LA) with or without treatment with NTAPP. BODIPY and Nile red staining were used for qualitative lipids analysis. Proliferation and differentiation markers were also assessed. Results. Casual sebum levels and sebum excretion rates in facial skin decreased by 26 and 24%, respectively, at week 4 compared to those of the baseline. Porphyrin index also decreased by 38% at week 2. Histologically, NTAPP-treated human skin showed no obvious thermal injury, but the number of Ki67+ cells in the sebaceous glands decreased at week 2. Argon- and nitrogen-NTAPP attenuated T/LA-induced increases in neutral lipid accumulation, Ki67+ cells, and peroxisome proliferator-activated receptor-ɣ transcription in human sebocytes at energy settings that did not induce apoptosis. Conclusion. Argon- and nitrogen-NTAPP can be a safe and effective therapeutic tool for hyperseborrhea-associated diseases such as acne. This trial is registered with NCT04917835.
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Affiliation(s)
- Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, Republic of Korea
| | - Seungju Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae San Yoo
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Song-Ee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Taehee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Sang Eun Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Ikeda Y, Fukushima R, Tange K, Motomura H, Saito T, Jinno M. Growth acceleration of Nile tilapia at 21 to 31 weeks of age with plasma-treated air-supplied water. Free Radic Res 2023; 57:21-29. [PMID: 36939606 DOI: 10.1080/10715762.2023.2185124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
This study aimed to develop a technique to accelerate fish growth without using genetic modification or genome editing. We have prepared a reactor with four pairs of opposed electrodes and a high-voltage power supply for the discharge. An arc discharge generates a plasma-treated gas in the reactor. Plasma-treated gas containing active species such as nitric oxide (NO) was generated via an arc discharge in the atmosphere and inserted into an aquarium containing Nile tilapia. No ozone was detected in the plasma-treated gas. Plasma treatment gas was supplied to the 20 L tank at a flow rate of 10 L per minute for varying supply times. The supply duration of plasma-treated air to the water tank was 0.5, 2, 5, and 15 min. Tanks were prepared for each of these four conditions, and gas was supplied daily at the same time. We observed that on supplying plasma-treated gas to tilapia from the 16th week of age for 5 min daily, the average length of the fish at 31 weeks of age was ∼1.5 times longer than that of the control fish. All other supply time conditions were also found to grow acceleration over the control. In the 15-minute supply time condition, individual differences in body length were more significant. A sample had more growth suppression than controls. In other words, the results suggest that an excess supply of active species can cause growth inhibition. These results suggest that an optimal supply of plasma-treated gas has a growth-promoting effect on fish.Key policy highlightsThe fish growth was accelerated by supplying plasma-treated air to the tank.The amount of ozone in the plasma-treated air was below the detection limit, and a large amount of RNS, such as nitric oxide, was generated.After an experimental period of 16 to 31 weeks, the average length of fish in the most significant growth condition was 1.5 times that of the control fish.
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Affiliation(s)
- Yoshihisa Ikeda
- Department of Electrical and Electronic Engineering, Ehime University, Matsuyama, Japan
| | - Ryo Fukushima
- Department of Electrical and Electronic Engineering, Ehime University, Matsuyama, Japan
| | - Kazuki Tange
- Faculty of Engineering, Ehime University, Matsuyama, Japan
| | - Hideki Motomura
- Department of Electrical and Electronic Engineering, Ehime University, Matsuyama, Japan
| | - Taiju Saito
- South Ehime Fisheries Research Center, Ehime University, Ainan-cho minamiuwa-gun, Japan
| | - Masafumi Jinno
- Department of Electrical and Electronic Engineering, Ehime University, Matsuyama, Japan
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Jung JM, Yoon HK, Jung CJ, Jo SY, Hwang SG, Lee HJ, Lee WJ, Chang SE, Won CH. Cold Plasma Treatment Promotes Full-thickness Healing of Skin Wounds in Murine Models. THE INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS 2023; 22:77-84. [PMID: 33856260 DOI: 10.1177/15347346211002144] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cold plasma can be beneficial for promoting skin wound healing and has a high potential of being effectively used in treating various wounds. Our aim was to verify the effect of cold plasma in accelerating wound healing and investigate its underlying mechanism in vitro and in vivo. For the in vivo experiments, 2 full-thickness dermal wounds were created in each mouse (n = 30). While one wound was exposed to 2 daily plasma treatments for 3 min, the other wound served as a control. The wounds were evaluated by imaging and histological analyses at 4, 7, and 11 days post the wound infliction process. Immunohistochemical studies were also performed at the same time points. In vitro proliferation and scratch assay using HaCaT keratinocytes and fibroblasts were performed. The expression levels of wound healing-related genes were analyzed by real-time polymerase chain reaction and western blot analysis. On day 7, the wound healing rates were 53.94% and 63.58% for the control group and the plasma-treated group, respectively. On day 11, these rates were 76.05% and 93.44% for the control and plasma-treated groups, respectively, and the difference between them was significant (P = .039). Histological analysis demonstrated that plasma treatment promotes the formation of epidermal keratin and granular layers. Immunohistochemical studies also revealed that collagen 1, collagen 3, and alpha-smooth muscle actin appeared more abundantly in the plasma-treated group than in the control group. In vitro, the proliferation of keratinocytes was promoted by plasma exposure. Scratch assay showed that fibroblast exposure to plasma increased their migration. The expression levels of collagen 1, collagen 3, and alpha-smooth muscle actin were elevated upon plasma treatment. In conclusion, cold plasma can accelerate skin wound healing and is well tolerated.
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Affiliation(s)
- Joon M Jung
- University of Ulsan College of Medicine, Seoul, Korea
| | - Hae K Yoon
- University of Ulsan College of Medicine, Seoul, Korea
| | - Chang J Jung
- University of Ulsan College of Medicine, Seoul, Korea
| | - Soo Y Jo
- University of Ulsan College of Medicine, Seoul, Korea
| | - Sang G Hwang
- University of Ulsan College of Medicine, Seoul, Korea
| | - Heun J Lee
- 58920Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo J Lee
- University of Ulsan College of Medicine, Seoul, Korea
| | - Sung E Chang
- University of Ulsan College of Medicine, Seoul, Korea
| | - Chong H Won
- University of Ulsan College of Medicine, Seoul, Korea
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Ge Y, Wang J, Cao W, Niu Q, Wu Y, Feng Y, Xu Z, Liu Y. Low Temperature Plasma Jet Affects Acute Skin Wounds in Diabetic Mice Through Reactive Components. INT J LOW EXTR WOUND 2022:15347346221139519. [PMID: 36380558 DOI: 10.1177/15347346221139519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
As a common complication of diabetes, diabetic foot ulcers serious affect the life quality even lead to amputation if it's not properly treated. In this paper, we developed a Low Temperature Plasma Jet (LTPJ) system for treating diabetic foot ulcers on streptozotocin-induced diabetic mice. This system generates time-dependent reactive nitrogen and oxygen species (RNOS), which have temperature below 40°C. The wound area of normal mice was significantly reduced after LTPJ treatment. Histological and immunohistochemistry analysis showed faster deposition of collagen and more vessel formation both in plasma-treated normal and diabetic mice on Day 3. However, diabetic wounds showed poor collagen deposition and angiogenesis on Day 8, which might be the reason of slow wound healing. Reactive nitrogen species (RNS) that generated by LTPJ can promote endogenous nitric oxide (NO) production in diabetic wounds, thus promoting inflammation, stromal deposition, angiogenesis, cell proliferation and remodeling, while excess reactive oxygen species (ROS) will exacerbate oxidative stress in wound tissues of diabetic mice. In conclusion, LTPJ improved acute wound healing in normal mice, increased collagen deposition and angiogenesis in initial diabetic wound healing, but had no significant effect on diabetic wound healing rate.
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Affiliation(s)
- Yang Ge
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Jun Wang
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
- Nanjing Guoke Medical Enginneering Technology Development co., LTD, Nanjing, Jiangsu, China
| | - Wei Cao
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Qun Niu
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Yanfan Wu
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Yongtong Feng
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Zhengping Xu
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Yi Liu
- The CAS Key Laboratory of Bio-Medical Diagnostics, 165085Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
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11
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Neupane YR, Handral HK, Alkaff SA, Chng WH, Venkatesan G, Huang C, Lee CK, Wang JW, Sriram G, Dienzo RA, Lu WF, Ali Y, Czarny B, Pastorin G. Cell-derived nanovesicles from mesenchymal stem cells as extracellular vesicle-mimetics in wound healing. Acta Pharm Sin B 2022; 13:1887-1902. [DOI: 10.1016/j.apsb.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
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12
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Chandika P, Khan F, Heo SY, Kim TH, Kim YM, Yi M, Jung WK. Multifunctional dual cross-linked poly (vinyl alcohol)/methacrylate hyaluronic acid/chitooligosaccharide-sinapic acid wound dressing hydrogel. Int J Biol Macromol 2022; 222:1137-1150. [PMID: 36162531 DOI: 10.1016/j.ijbiomac.2022.09.174] [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: 07/02/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022]
Abstract
Wound dressing hydrogel with multifunctional properties, including antioxidant and antimicrobial properties and appropriate mechanical, biological, and physical properties is of great interest in wound healing application and it is still a challenge. In the present study, chitooligosaccharides (COS)/ sinapic acid (SA) conjugate (COS-SA) was synthesized using H2O2-induced grafting polymerization, and photo cross-linkable hyaluronic acid was synthesized using methacrilation (HAMA). The synthesis of COS-SA and HAMA was confirmed by Fourier-transform infrared spectroscopy, proton nuclear magnetic resonance spectroscopy, ultraviolet spectroscopy, and polyphenol assay. Subsequently, we developed duel cross-linked polyvinyl alcohol (PVA)/HAMA composite hydrogel encapsulated with COS-SA as an antioxidant and antimicrobial dressing for full-thickness wound healing application. The chemical, physical, mechanical, antioxidant, antimicrobial, in vitro biocompatibility, and in vivo wound healing properties of hydrogels were subsequently investigated. The results showed that the fabricated composite hydrogel had a uniform porous architecture, excellent fluid absorbability, and appropriate mechanical stability. The introduction of COSs-SA conjugate remarkably enhanced the in vitro biocompatibility, antioxidant, and antimicrobial properties of the hydrogel, leading to the significant promotion of in vivo full-thickness wound closure, re-epithelization, granulation tissue formation, and collagen deposition indicating that COSs-SA incorporated PVA/HAMA hydrogel wound dressing has significant potential for chronic wound healing application.
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Affiliation(s)
- Pathum Chandika
- Major of Biomedical Engineering, Division of Smart Healthcare and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan 48513, Republic of Korea; Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan 48513, Republic of Korea
| | - Fazlurrahman Khan
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan 48513, Republic of Korea; Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, Republic of Korea
| | - Seong-Yong Heo
- Jeju Marine Research Center, Korea Institute of Ocean Science & Technology, Jeju 63349, Republic of Korea
| | - Tae-Hee Kim
- Major of Biomedical Engineering, Division of Smart Healthcare and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan 48513, Republic of Korea; Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan 48513, Republic of Korea
| | - Young-Mog Kim
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan 48513, Republic of Korea; Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, Republic of Korea; Major of Food Science and Technology, Pukyong National University, Busan 48513, Republic of Korea
| | - Myunggi Yi
- Major of Biomedical Engineering, Division of Smart Healthcare and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan 48513, Republic of Korea; Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, Republic of Korea
| | - Won-Kyo Jung
- Major of Biomedical Engineering, Division of Smart Healthcare and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan 48513, Republic of Korea; Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan 48513, Republic of Korea; Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan 48513, Republic of Korea.
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13
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Martusevich AK, Surovegina AV, Bocharin IV, Nazarov VV, Minenko IA, Artamonov MY. Cold Argon Athmospheric Plasma for Biomedicine: Biological Effects, Applications and Possibilities. Antioxidants (Basel) 2022; 11:antiox11071262. [PMID: 35883753 PMCID: PMC9311881 DOI: 10.3390/antiox11071262] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 01/21/2023] Open
Abstract
Currently, plasma medicine is a synthetic direction that unites the efforts of specialists of various profiles. For the successful formation of plasma medicine, it is necessary to solve a large complex of problems, including creating equipment for generating cold plasma, revealing the biological effects of this effect, as well as identifying and justifying the most promising areas of its application. It is known that these biological effects include antibacterial and antiviral activity, the ability to stimulate hemocoagulation, pro-regenerative properties, etc. The possibility of using the factor in tissue engineering and implantology is also shown. Based on this, the purpose of this review was to form a unified understanding of the biological effects and biomedical applications of argon cold plasma. The review shows that cold plasma, like any other physical and chemical factors, has dose dependence, and the variable parameter in this case is the exposure of its application. One of the significant characteristics determining the specificity of the cold plasma effect is the carrier gas selection. This gas carrier is not just an ionized medium but modulates the response of biosystems to it. Finally, the perception of cold plasma by cellular structures can be carried out by activating a special molecular biosensor, the functioning of which significantly depends on the parameters of the medium (in the field of plasma generation and the cell itself). Further research in this area can open up new prospects for the effective use of cold plasma.
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Affiliation(s)
- Andrew K. Martusevich
- Laboratory of Translational Free Radical Biomedicine, Sechenov University, 119991 Moscow, Russia; (A.V.S.); (V.V.N.); (I.A.M.); (M.Y.A.)
- MJA Research and Development, Inc., East Stroudsburg, PA 18301, USA
- Laboratory of Medical Biophysics, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia;
- Nizhny Novgorod State Agricultural Academy, 603117 Nizhny Novgorod, Russia
- Correspondence: ; Tel.: +7-909-144-9182
| | - Alexandra V. Surovegina
- Laboratory of Translational Free Radical Biomedicine, Sechenov University, 119991 Moscow, Russia; (A.V.S.); (V.V.N.); (I.A.M.); (M.Y.A.)
| | - Ivan V. Bocharin
- Laboratory of Medical Biophysics, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia;
- Nizhny Novgorod State Agricultural Academy, 603117 Nizhny Novgorod, Russia
| | - Vladimir V. Nazarov
- Laboratory of Translational Free Radical Biomedicine, Sechenov University, 119991 Moscow, Russia; (A.V.S.); (V.V.N.); (I.A.M.); (M.Y.A.)
- Laboratory of Medical Biophysics, Privolzhsky Research Medical University, 603005 Nizhny Novgorod, Russia;
- Institute of Applied Physics, 603950 Nizhny Novgorod, Russia
| | - Inessa A. Minenko
- Laboratory of Translational Free Radical Biomedicine, Sechenov University, 119991 Moscow, Russia; (A.V.S.); (V.V.N.); (I.A.M.); (M.Y.A.)
- MJA Research and Development, Inc., East Stroudsburg, PA 18301, USA
| | - Mikhail Yu. Artamonov
- Laboratory of Translational Free Radical Biomedicine, Sechenov University, 119991 Moscow, Russia; (A.V.S.); (V.V.N.); (I.A.M.); (M.Y.A.)
- MJA Research and Development, Inc., East Stroudsburg, PA 18301, USA
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14
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Urciuolo F, Passariello R, Imparato G, Casale C, Netti PA. Bioengineered Wound Healing Skin Models: The Role of Immune Response and Endogenous ECM to Fully Replicate the Dynamic of Scar Tissue Formation In Vitro. Bioengineering (Basel) 2022; 9:233. [PMID: 35735476 PMCID: PMC9219817 DOI: 10.3390/bioengineering9060233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/27/2022] Open
Abstract
The healing of deep skin wounds is a complex phenomenon evolving according with a fine spatiotemporal regulation of different biological events (hemostasis, inflammation, proliferation, remodeling). Due to the spontaneous evolution of damaged human dermis toward a fibrotic scar, the treatment of deep wounds still represents a clinical concern. Bioengineered full-thickness skin models may play a crucial role in this direction by providing a deep understanding of the process that leads to the formation of fibrotic scars. This will allow (i) to identify new drugs and targets/biomarkers, (ii) to test new therapeutic approaches, and (iii) to develop more accurate in silico models, with the final aim to guide the closure process toward a scar-free closure and, in a more general sense, (iv) to understand the mechanisms involved in the intrinsic and extrinsic aging of the skin. In this work, the complex dynamic of events underlaying the closure of deep skin wound is presented and the engineered models that aim at replicating such complex phenomenon are reviewed. Despite the complexity of the cellular and extracellular events occurring during the skin wound healing the gold standard assay used to replicate such a process is still represented by planar in vitro models that have been largely used to identify the key factors regulating the involved cellular processes. However, the lack of the main constituents of the extracellular matrix (ECM) makes these over-simplistic 2D models unable to predict the complexity of the closure process. Three-dimensional bioengineered models, which aim at recreating the closure dynamics of the human dermis by using exogenous biomaterials, have been developed to fill such a gap. Although interesting mechanistic effects have been figured out, the effect of the inflammatory response on the ECM remodelling is not replicated yet. We discuss how more faithful wound healing models can be obtained by creating immunocompetent 3D dermis models featuring an endogenous ECM.
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Affiliation(s)
- Francesco Urciuolo
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
| | - Roberta Passariello
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
| | - Giorgia Imparato
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
| | - Costantino Casale
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
| | - Paolo Antonio Netti
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy; (C.C.); (P.A.N.)
- Department of Chemical, Materials and Industrial Production Engineering (DICMAPI), University of Naples Federico II, P.le Tecchio 80, 80125 Naples, Italy;
- Center for Advanced Biomaterials for HealthCare@CRIB Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, 80125 Naples, Italy;
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15
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Shibuya Y, Hokugo A, Okawa H, Kondo T, Khalil D, Wang L, Roca Y, Clements A, Sasaki H, Berry E, Nishimura I, Jarrahy R. Therapeutic downregulation of neuronal PAS domain 2 ( Npas2) promotes surgical skin wound healing. eLife 2022; 11:e71074. [PMID: 35040776 PMCID: PMC8789286 DOI: 10.7554/elife.71074] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Attempts to minimize scarring remain among the most difficult challenges facing surgeons, despite the use of optimal wound closure techniques. Previously, we reported improved healing of dermal excisional wounds in circadian clock neuronal PAS domain 2 (Npas2)-null mice. In this study, we performed high-throughput drug screening to identify a compound that downregulates Npas2 activity. The hit compound (Dwn1) suppressed circadian Npas2 expression, increased murine dermal fibroblast cell migration, and decreased collagen synthesis in vitro. Based on the in vitro results, Dwn1 was topically applied to iatrogenic full-thickness dorsal cutaneous wounds in a murine model. The Dwn1-treated dermal wounds healed faster with favorable mechanical strength and developed less granulation tissue than the controls. The expression of type I collagen, Tgfβ1, and α-smooth muscle actin was significantly decreased in Dwn1-treated wounds, suggesting that hypertrophic scarring and myofibroblast differentiation are attenuated by Dwn1 treatment. NPAS2 may represent an important target for therapeutic approaches to optimal surgical wound management.
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Affiliation(s)
- Yoichiro Shibuya
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of TsukubaTsukubaJapan
| | - Akishige Hokugo
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
| | - Hiroko Okawa
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of DentistryMiyagiJapan
| | - Takeru Kondo
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of DentistryMiyagiJapan
| | - Daniel Khalil
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
| | - Lixin Wang
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
| | - Yvonne Roca
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
| | - Adam Clements
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
| | - Hodaka Sasaki
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
| | - Ella Berry
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
| | - Ichiro Nishimura
- Weintraub Center for Reconstructive BiotechnologyLos AngelesUnited States
| | - Reza Jarrahy
- Regenerative Bioengineering and Repair Laboratory, Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of MedicineLos AngelesUnited States
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16
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Kim CK, Kim H, Kim HJ, Cho SB. Antibacterial and anticandidal effects of atmospheric-pressure, non-thermal, nitrogen- and argon-plasma pulses. Dermatol Ther 2021; 35:e15222. [PMID: 34820982 DOI: 10.1111/dth.15222] [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: 10/18/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 11/28/2022]
Abstract
Atmospheric-pressure, non-thermal plasma destroys microorganisms by directly reacting with hydrocarbon molecules in the cell wall and/or by damaging the cytoplasmic membrane, proteins, and DNA with charged particles and reactive species. The aim of our study was to evaluate the antibacterial and anticandidal effects of atmospheric-pressure, non-thermal, nitrogen- and argon-plasma pulses on various pathogen preparations. The resultant antibacterial and anticandidal effects were assessed by evaluating percent and log reduction values for pathogen colonies. Nitrogen-plasma pulses emitted at an energy of 1.5 J and argon-plasma pulses generated at 0.5 J elicited remarkable antibacterial effects on Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus (MRSA) and anticandidal effects on Candida albicans. Nitrogen-plasma pulses at a pulse count of five elicited remarkable antibacterial effects on Cutibacterium acnes at the energy settings of 1.75, 2.5, and 3 J, but not at 1 J. Meanwhile, argon-plasma pulses showed antibacterial effects on C. acnes at an energy of 0.5 and 0.65 J. Nitrogen- or argon-plasma pulses exert antibacterial and anticandidal effects on bacterial and fungal pathogens.
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Affiliation(s)
- Chang Ki Kim
- Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.,Seoul Clinical Laboratories, Yongin, South Korea
| | - Heesu Kim
- Yonsei New Dermatology and Laser Clinic, Incheon, South Korea
| | | | - Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, South Korea
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17
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Enhancement of Osteoblast Differentiation Using No-Ozone Cold Plasma on Human Periodontal Ligament Cells. Biomedicines 2021; 9:biomedicines9111542. [PMID: 34829771 PMCID: PMC8615272 DOI: 10.3390/biomedicines9111542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022] Open
Abstract
Periodontitis is an inflammatory disease that leads to periodontal tissue destruction and bone resorption. Proliferation and differentiation of cells capable of differentiating into osteoblasts is important for reconstructing periodontal tissues destroyed by periodontitis. In this study, the effects of the nozone (no-ozone) cold plasma (NCP) treatment on osteoblastic differentiation in periodontal ligament (PDL) cells were investigated. To test the toxicity of NCP on PDL cells, various NCP treatment methods and durations were tested, and time-dependent cell proliferation was analyzed using a water-soluble tetrazolium salts-1 assay. To determine the effect of NCP on PDL cell differentiation, the cells were provided with osteogenic media immediately after an NCP treatment to induce differentiation; the cells were then analyzed using alkaline phosphatase (ALP) staining, an ALP activity assay, real time PCR, and Alizarin Red S staining. The NCP treatment without toxicity on PDL cells was the condition of 1-min NCP treatment immediately followed by the replacement with fresh media. NCP increased ALP, osteocalcin, osteonectin, and osteopontin expression, as well as mineralization nodule formation. NCP treatment promotes osteoblastic differentiation of PDL cells; therefore, it may be beneficial for treating periodontitis.
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18
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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: 47] [Impact Index Per Article: 15.7] [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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19
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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: 4.3] [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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20
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Bafoil M, Yousfi M, Dunand C, Merbahi N. Effects of Dielectric Barrier Ambient Air Plasma on Two Brassicaceae Seeds: Arabidopsis thaliana and Camelina sativa. Int J Mol Sci 2021; 22:9923. [PMID: 34576106 PMCID: PMC8465651 DOI: 10.3390/ijms22189923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
We investigated low-temperature plasma effects on two Brassicaceae seeds (A. thaliana and C. sativa) using dielectric barrier discharge in air. Comparisons of plasma treatments on seeds showed distinct responses on germination rate and speed. Optimal treatment time giving optimal germination is 15 min for A. thaliana with 85% increase compared to control after 48 h of germination and 1 min for C. sativa with 75% increase compared to control after 32 h of germination. Such germination increases are associated with morphological changes shown by SEM of seed surface. For better understanding at the biochemical level, seed surfaces were analyzed using gas chromatography-mass spectrometry which underlined changes of lipidic composition. For both treated seeds, there is a decrease of saturated (palmitic and stearic) fatty acids while treated C. sativa showed a decrease of unsaturated (oleic and linoleic) acids and treated A. thaliana an increase of unsaturated ones. Such lipid changes, specifically a decrease of hydrophobic saturated fatty acids, are coherent with the other analyses (SEM, water uptake and contact angle). Moreover, an increase in A. thaliana of unsaturated acids (very reactive) probably neutralizes plasma RONS effects thus needing longer plasma exposure time (15 min) to reach optimal germination. For C. sativa, 1 min is enough because unsaturated linoleic acid becomes lower in treated C. sativa (1.2 × 107) compared to treated A. thaliana (3.7 × 107).
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Affiliation(s)
- Maxime Bafoil
- Laboratoire Plasma et Conversion d’Energie (LAPLACE), Université Toulouse III Paul Sabatier, UMR CNRS 5213, 31062 Toulouse, France; (M.B.); (N.M.)
- Laboratoire de Recherche en Sciences Végétales, Université de Toulouse, CNRS, UPS, Toulouse INP, 31326 Auzeville-Tolosane, France
| | - Mohammed Yousfi
- Laboratoire Plasma et Conversion d’Energie (LAPLACE), Université Toulouse III Paul Sabatier, UMR CNRS 5213, 31062 Toulouse, France; (M.B.); (N.M.)
| | - Christophe Dunand
- Laboratoire de Recherche en Sciences Végétales, Université de Toulouse, CNRS, UPS, Toulouse INP, 31326 Auzeville-Tolosane, France
| | - Nofel Merbahi
- Laboratoire Plasma et Conversion d’Energie (LAPLACE), Université Toulouse III Paul Sabatier, UMR CNRS 5213, 31062 Toulouse, France; (M.B.); (N.M.)
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21
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van Welzen A, Hoch M, Wahl P, Weber F, Rode S, Tietze JK, Boeckmann L, Emmert S, Thiem A. The Response and Tolerability of a Novel Cold Atmospheric Plasma Wound Dressing for the Healing of Split Skin Graft Donor Sites: A Controlled Pilot Study. Skin Pharmacol Physiol 2021; 34:328-336. [PMID: 34365456 PMCID: PMC8619757 DOI: 10.1159/000517524] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cold atmospheric plasma (CAP) has positive effects on wound healing and antimicrobial properties. However, an ongoing challenge is the development of specific modes of application for different clinical indications. OBJECTIVES We investigated in a prospective pilot study the response and tolerability of a newly developed CAP wound dressing for the acute healing of split skin graft donor sites compared to conventional therapy. METHODS We applied both treatments to each patient (n = 10) for 7 days and measured 4 parameters of wound healing every other day (i.e., 1,440 measurements) using a hyperspectral imaging camera. Additionally, we evaluated the clinical appearance and pain levels reported by the patients. RESULTS The CAP wound dressing was superior to the control (p < 0.001) in the improvement of 3 wound parameters, that is, deep tissue oxygen saturation, hemoglobin distribution, and tissue water distribution. CAP was well tolerated, and pain levels were lower in CAP-treated wound areas. CONCLUSION CAP wound dressing is a promising new tool for acute wound healing.
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Affiliation(s)
- Annika van Welzen
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Matti Hoch
- Department of Systems Biology and Bioinformatics, University of Rostock, Rostock, Germany
| | | | - Frank Weber
- Department for Biostatistics and Informatics in Medicine, University Medical Center, Rostock, Germany
| | - Susen Rode
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Julia Katharina Tietze
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Lars Boeckmann
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Alexander Thiem
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
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Non-Thermal Atmospheric Pressure Argon-Sourced Plasma Flux Promotes Wound Healing of Burn Wounds and Burn Wounds with Infection in Mice through the Anti-Inflammatory Macrophages. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Plasma medicine is the utilization of gas ionization that might be beneficial for the treatment of burn wounds, a healthcare problem with a significant mortality rate. Due to a lack of information on the impact of plasma flux in immune cells and a high prevalence of bacterial infection in burn wounds, non-thermal argon-based plasma flux was tested on macrophages (RAW246.7) and in mouse models of burn wounds with or without Staphylococcus aureus infection. Accordingly, plasma flux enhanced reactive oxygen species (ROS), using dihydroethidium assay, and decreased abundance of NF-κB-p65 (Western blot analysis) in non-stimulating macrophages. In parallel, plasma flux upregulated IL-10 gene expression (an anti-inflammatory cytokine) in lipopolysaccharide (LPS)-induced inflammatory macrophages, while downregulating the pro-inflammatory cytokines (IL-1β and IL-6). Additionally, plasma flux improved the migratory function of fibroblasts (L929) (fibroblast scratch assay) but not fibroblast proliferation. Moreover, once daily plasma flux administration for 7 days promoted the healing process in burn wounds with or without infection (wound area and wound rank score). Additionally, plasma flux reduced tissue cytokines (TNF-α and IL-6) in burn wounds with infection and promoted collagen in burn wounds without infection. In conclusion, plasma flux induced anti-inflammatory macrophages and promoted the burn-wound healing process partly through the decrease in macrophage NF-κB. Hence, plasma flux treatment should be tested in patients with burn wounds.
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Lee ST, Jang YS, Kim UK, Kim HJ, Ryu MH, Kim GC, Hwang DS. Non-thermal plasma application enhances the recovery of transected sciatic nerves in rats. Exp Biol Med (Maywood) 2021; 246:1287-1296. [PMID: 33653158 PMCID: PMC8371309 DOI: 10.1177/1535370221996655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/28/2021] [Indexed: 01/17/2023] Open
Abstract
This experimental research aimed to investigate the effects of non-thermal plasma on nerve regeneration after transected nerve damage using the sciatic nerve in Wistar albino (A) rats. The experiments were performed on 27 Wistar A rats. The rats underwent surgery for right sciatic nerve exposure and were divided into three groups (each group, n = 9) according to sciatic nerve transected injury (SNTI) and non-thermal plasma application: a non-nerve damage (non-ND) group, a only nerve damage without non-thermal plasma application (ND) group, and a nerve damage with non-thermal plasma application (ND + NTP) group. Subsequent to SNTI and immediate suture, non-thermal plasma was administered three times per week for eight weeks. Evaluation for functional recovery was performed using the static sciatic index measured over the full treatment period of eight weeks. The sciatic nerve specimens were obtained after euthanasia and third day from the last non-thermal plasma application. The sciatic nerve tissues were subjected to histological analysis. Behavior analysis presented that the ND + NTP group showed improved static sciatic index compared with the nerve damage group. Histopathological findings demonstrated that the ND + NTP group had more dense Schwann cells and well-established continuity of nerve fibers, greater than the nerve damage group. Immunohistochemistry showed that the ND + NTP group had increased levels of markers for microtubule-associated protein 2 (MAP2), tau, S100 calcium-binding protein B, and neurofilament-200 and regulated the overexpression of CD68 and MAP2. These results indicated that non-thermal plasma enhanced the motor function and restored the neuronal structure by accelerating myelination and axonal regeneration. Additionally, non-thermal plasma was confirmed to have a positive effect on the recovery of SNTI in rats.
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Affiliation(s)
- Sung-Tak Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Yoon-Seo Jang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
| | - Hyung-Joon Kim
- Department of Oral Physiology, BK21 Plus Project and Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
| | - Mi-Heon Ryu
- Department of Oral Pathology, BK21 Plus Project, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
| | - Gyoo-Cheon Kim
- Department of Dental Anatomy, BK21 Plus Project, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Gyeongnam 50612, Republic of Korea
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Abstract
Nonthermal atmospheric pressure biocompatible plasma (NBP), alternatively called bio-cold plasma, is a partially ionized gas that consists of charged particles, neutral atoms and molecules, photons, an electric field, and heat. Recently, nonthermal plasma-based technology has been applied to bioscience, medicine, agriculture, food processing, and safety. Various plasma device configurations and electrode layouts has fast-tracked plasma applications in the treatment of biological and material surfaces. The NBP action mechanism may be related to the synergy of plasma constituents, such as ultraviolet radiation or a reactive species. Recently, plasma has been used in the inactivation of viruses and resistant microbes, such as fungal cells, bacteria, spores, and biofilms made by microbes. It has also been used to heal wounds, coagulate blood, degrade pollutants, functionalize material surfaces, kill cancers, and for dental applications. This review provides an outline of NBP devices and their applications in bioscience and medicine. We also discuss the role of plasma-activated liquids in biological applications, such as cancer treatments and agriculture. The individual adaptation of plasma to meet specific medical requirements necessitates real-time monitoring of both the plasma performance and the target that is treated and will provide a new paradigm of plasma-based therapeutic clinical systems.
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Affiliation(s)
- Eun H. Choi
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul, 01897 Republic of Korea
| | - Han S. Uhm
- Canode # 702, 136-11 Tojeong-ro, Mapo-gu, Seoul, 04081 Republic of Korea
| | - Nagendra K. Kaushik
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul, 01897 Republic of Korea
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Akbiyik A, Sari D, Ercan UK, Uyanikgil Y, Taşli H, Tomruk C, Usta YH. The antimicrobial and tissue healing efficacy of the atmospheric pressure cold plasma on grade III infected pressure ulcer: randomized controlled in vivo experiment. J Appl Microbiol 2021; 131:973-987. [PMID: 33354899 DOI: 10.1111/jam.14980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/12/2022]
Abstract
AIM To evaluate the antimicrobial efficacy and wound healing effect of atmospheric pressure cold plasma (APCP) on an infected pressure ulcer (IPUs) model that was created on rats. METHODS A total of 18 rats was divided into APCP, silver sulfadiazine (AgS) and control groups to have six rats in each group. A third-grade pressure ulcer model was developed on the back of each of the rats, and pressure ulcers were infected by inoculation of multidrug resistance (MDR) Pseudomonas aeruginosa. A portable dielectric barrier discharge device was used to generate cold air plasma. APCP, AgS and saline treatments were carried out once a day for 14 days. The effectiveness of the treatment was evaluated on days 5, 10 and 15. Surface area, depth, pressure ulcer healing scale (PUSH) and microbiological examination were used for evaluation. RESULTS The results of this study showed that APCP was superior over AgS application and irrigation with saline by means of the reduction in surface area and depth of ulcers. Furthermore, PUSH score in plasma group was lower than other groups and histopathological examination showed a higher epithelization in APCP group. The average reductions of MDR P. aeruginosa for APCP, AgS and control groups were determined as 5·64 ± 1·87, 1·91 ± 0·90 and 1·22 ± 0·88 log10 CFU per gram tissue, respectively. CONCLUSION Atmospheric pressure cold plasma healed IPUs better than AgS. SIGNIFICANCE AND IMPACT OF THE STUDY Portable cold plasma devices could be a potential novel treatment modality for the patients who have IPUs.
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Affiliation(s)
- A Akbiyik
- Faculty of Health Sciences, Izmir Katip Celebi University, Çiğli İzmir, Turkey
| | - D Sari
- Department of Fundamentals of Nursing, Faculty of Nursing, Ege University, Izmir, Turkey
| | - U K Ercan
- Department of Biomedical Engineering, Faculty of Engineering, İzmir Katip Çelebi University, Çiğli/İzmir, Turkey
| | - Y Uyanikgil
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - H Taşli
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Ege University, Izmir, Turkey
| | - C Tomruk
- Department of Histology and Embryology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Y H Usta
- Department of Biomedical Engineering, Faculty of Engineering, İzmir Katip Çelebi University, Çiğli/İzmir, Turkey
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Zhou X, Wu D, Liang D, Zhang W, Shi Q, Cao Y. Evaluation of modified cold‐atmospheric pressure plasma (MCAP) for the treatment of peri‐implantitis in beagles. Oral Dis 2020; 28:495-502. [PMID: 33320400 DOI: 10.1111/odi.13757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Xincai Zhou
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Donglei Wu
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Defeng Liang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Wenhao Zhang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Qi Shi
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yingguang Cao
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
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27
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Busco G, Robert E, Chettouh-Hammas N, Pouvesle JM, Grillon C. The emerging potential of cold atmospheric plasma in skin biology. Free Radic Biol Med 2020; 161:290-304. [PMID: 33039651 DOI: 10.1016/j.freeradbiomed.2020.10.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/25/2022]
Abstract
The maintenance of skin integrity is crucial to ensure the physiological barrier against exogenous compounds, microorganisms and dehydration but also to fulfill social and aesthetic purposes. Besides the development of new actives intended to enter a formulation, innovative technologies based on physical principles have been proposed in the last years. Among them, Cold Atmospheric Plasma (CAP) technology, which already showed interesting results in dermatology, is currently being studied for its potential in skin treatments and cares. CAP bio-medical studies gather several different expertise ranging from physics to biology through chemistry and biochemistry, making this topic hard to pin. In this review we provide a broad survey of the interactions between CAP and skin. In the first section, we tried to give some fundamentals on skin structure and physiology, related to its essential functions, together with the main bases on cold plasma and its physicochemical properties. In the following parts we dissected and analyzed each CAP parameter to highlight the already known and the possible effects they can play on skin. This overview aims to get an idea of the potential of cold atmospheric plasma technology in skin biology for the future developments of dermo-cosmetic treatments, for example in aging prevention.
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Affiliation(s)
- Giovanni Busco
- Centre de Biophysique Moléculaire, UPR4301, CNRS, 45071, Orléans, France; Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France.
| | - Eric Robert
- Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France
| | | | - Jean-Michel Pouvesle
- Groupe de Recherches sur l'Énergétique des Milieux Ionisés, UMR 7344, Université d'Orléans/CNRS, 45067, Orléans, France
| | - Catherine Grillon
- Centre de Biophysique Moléculaire, UPR4301, CNRS, 45071, Orléans, France.
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28
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Zubor P, Wang Y, Liskova A, Samec M, Koklesova L, Dankova Z, Dørum A, Kajo K, Dvorska D, Lucansky V, Malicherova B, Kasubova I, Bujnak J, Mlyncek M, Dussan CA, Kubatka P, Büsselberg D, Golubnitschaja O. Cold Atmospheric Pressure Plasma (CAP) as a New Tool for the Management of Vulva Cancer and Vulvar Premalignant Lesions in Gynaecological Oncology. Int J Mol Sci 2020; 21:ijms21217988. [PMID: 33121141 PMCID: PMC7663780 DOI: 10.3390/ijms21217988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022] Open
Abstract
Vulvar cancer (VC) is a specific form of malignancy accounting for 5–6% of all gynaecologic malignancies. Although VC occurs most commonly in women after 60 years of age, disease incidence has risen progressively in premenopausal women in recent decades. VC demonstrates particular features requiring well-adapted therapeutic approaches to avoid potential treatment-related complications. Significant improvements in disease-free survival and overall survival rates for patients diagnosed with post-stage I disease have been achieved by implementing a combination therapy consisting of radical surgical resection, systemic chemotherapy and/or radiotherapy. Achieving local control remains challenging. However, mostly due to specific anatomical conditions, the need for comprehensive surgical reconstruction and frequent post-operative healing complications. Novel therapeutic tools better adapted to VC particularities are essential for improving individual outcomes. To this end, cold atmospheric plasma (CAP) treatment is a promising option for VC, and is particularly appropriate for the local treatment of dysplastic lesions, early intraepithelial cancer, and invasive tumours. In addition, CAP also helps reduce inflammatory complications and improve wound healing. The application of CAP may realise either directly or indirectly utilising nanoparticle technologies. CAP has demonstrated remarkable treatment benefits for several malignant conditions, and has created new medical fields, such as “plasma medicine” and “plasma oncology”. This article highlights the benefits of CAP for the treatment of VC, VC pre-stages, and postsurgical wound complications. There has not yet been a published report of CAP on vulvar cancer cells, and so this review summarises the progress made in gynaecological oncology and in other cancers, and promotes an important, understudied area for future research. The paradigm shift from reactive to predictive, preventive and personalised medical approaches in overall VC management is also considered.
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Affiliation(s)
- Pavol Zubor
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
- OBGY Health & Care, Ltd., 010 01 Zilina, Slovakia
- Correspondence: or
| | - Yun Wang
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
| | - Alena Liskova
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Marek Samec
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Lenka Koklesova
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Zuzana Dankova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Anne Dørum
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
| | - Karol Kajo
- Department of Pathology, St. Elizabeth Cancer Institute Hospital, 81250 Bratislava, Slovakia;
| | - Dana Dvorska
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Vincent Lucansky
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Bibiana Malicherova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Ivana Kasubova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Jan Bujnak
- Department of Obstetrics and Gynaecology, Kukuras Michalovce Hospital, 07101 Michalovce, Slovakia;
| | - Milos Mlyncek
- Department of Obstetrics and Gynaecology, Faculty Hospital Nitra, Constantine the Philosopher University, 949 01 Nitra, Slovakia;
| | - Carlos Alberto Dussan
- Department of Surgery, Orthopaedics and Oncology, University Hospital Linköping, 581 85 Linköping, Sweden;
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Dietrich Büsselberg
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, P.O. Box 24144 Doha, Qatar;
| | - Olga Golubnitschaja
- Predictive, Preventive Personalised (3P) Medicine, Department of Radiation Oncology, Rheinische Friedrich-Wilhelms-Universität Bonn, 53105 Bonn, Germany;
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Mitra S, Kaushik N, Moon IS, Choi EH, Kaushik NK. Utility of Reactive Species Generation in Plasma Medicine for Neuronal Development. Biomedicines 2020; 8:E348. [PMID: 32932745 PMCID: PMC7555638 DOI: 10.3390/biomedicines8090348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Reactive oxygen species (ROS) are critical signaling molecules for neuronal physiology that stimulate growth and development and play vital roles in several pathways when in a balanced state, but they cause neurodegeneration when unbalanced. As ROS levels above a certain threshold cause the activation of the autophagy system, moderate levels of ROS can be used as treatment strategies. Currently, such treatments are used together with low-level laser or photodynamic therapies, photo-bio modulation, or infrared treatments, in different chronic diseases but not in the treatment of neurodegeneration. Recently, non-thermal plasma has been successfully used in biomedical applications and treatments, and beneficial effects such as differentiation, cell growth, and proliferation, stimulation of ROS based pathways have been observed. Besides the activation of a wide range of biological signaling pathways by generating ROS, plasma application can be an effective treatment in neuronal regeneration, as well as in neuronal diseases. In this review, we summarize the generation and role of ROS in neurons and provide critical insights into their potential benefits on neurons. We also discuss the underlying mechanisms of ROS on neuronal development. Regarding clinical applications, we focus on ROS-based neuronal growth and regeneration strategies and in the usage of non-thermal plasma in neuronal and CNS injury treatments.
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Affiliation(s)
- Sarmistha Mitra
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea;
- Department of Anatomy, Dongguk University College of Medicine, Gyeongju 38066, Korea;
| | - Neha Kaushik
- Department of Biotechnology, University of Suwon, Hwaseong 18323, Korea;
| | - Il Soo Moon
- Department of Anatomy, Dongguk University College of Medicine, Gyeongju 38066, Korea;
| | - Eun Ha Choi
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea;
| | - Nagendra Kumar Kaushik
- Plasma Bioscience Research Center/Applied Plasma Medicine Center, Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea;
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30
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Smolková B, Frtús A, Uzhytchak M, Lunova M, Kubinová Š, Dejneka A, Lunov O. Critical Analysis of Non-Thermal Plasma-Driven Modulation of Immune Cells from Clinical Perspective. Int J Mol Sci 2020; 21:ijms21176226. [PMID: 32872159 PMCID: PMC7503900 DOI: 10.3390/ijms21176226] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/30/2020] [Accepted: 08/26/2020] [Indexed: 02/07/2023] Open
Abstract
The emerged field of non-thermal plasma (NTP) shows great potential in the alteration of cell redox status, which can be utilized as a promising therapeutic implication. In recent years, the NTP field considerably progresses in the modulation of immune cell function leading to promising in vivo results. In fact, understanding the underlying cellular mechanisms triggered by NTP remains incomplete. In order to boost the field closer to real-life clinical applications, there is a need for a critical overview of the current state-of-the-art. In this review, we conduct a critical analysis of the NTP-triggered modulation of immune cells. Importantly, we analyze pitfalls in the field and identify persisting challenges. We show that the identification of misconceptions opens a door to the development of a research strategy to overcome these limitations. Finally, we propose the idea that solving problems highlighted in this review will accelerate the clinical translation of NTP-based treatments.
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Affiliation(s)
- Barbora Smolková
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Adam Frtús
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Mariia Uzhytchak
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Mariia Lunova
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Institute for Clinical & Experimental Medicine (IKEM), 14021 Prague, Czech Republic
| | - Šárka Kubinová
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Department of Biomaterials and Biophysical Methods, Institute of Experimental Medicine of the Czech Academy of Sciences, 14220 Prague, Czech Republic
| | - Alexandr Dejneka
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
| | - Oleg Lunov
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic; (B.S.); (A.F.); (M.U.); (M.L.); (Š.K.); (A.D.)
- Correspondence: ; Tel.: +420-2660-52131
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Lou BS, Hsieh JH, Chen CM, Hou CW, Wu HY, Chou PY, Lai CH, Lee JW. Helium/Argon-Generated Cold Atmospheric Plasma Facilitates Cutaneous Wound Healing. Front Bioeng Biotechnol 2020; 8:683. [PMID: 32695763 PMCID: PMC7338308 DOI: 10.3389/fbioe.2020.00683] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
Cold atmospheric plasma jet (CAPJ) or non-thermal plasma jet has been employed in various biomedical applications based on their functions in bactericidal activity and wound healing. However, the effect of CAPJ generated by a particular composition of gases on wound closure and the underlying mechanisms that regulate wound healing signals remain elusive. In the present study, we investigated the impact of helium (He)- or a gas mixture of He and argon (He/Ar)-generated CAPJ on cell proliferation, which is a pivotal step during the wound healing process. With careful treatment duration control, He/Ar-CAPJ effectively induced keratinocyte proliferation and migration mediated through the activation of epithelial-to-mesenchymal transition (EMT) and cell cycle progression, which was evidenced by a decrease in E-cadherin levels and increases in N-cadherin, cyclin D1, Ki-67, Cdk2, and p-ERK levels. Rat wound healing studies showed that He/Ar-CAPJ treatment facilitated granulation tissue formation and mitigated inflammation in cutaneous tissue, resulting in accelerated wound closure. These findings highlight the possibility that He/Ar-CAPJ can be developed as a therapeutic agent for enhancing wound healing.
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Affiliation(s)
- Bih-Show Lou
- Chemistry Division, Center for General Education, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jang-Hsing Hsieh
- Center for Plasma and Thin Film Technologies, Ming Chi University of Technology, New Taipei, Taiwan.,Department of Materials Engineering, Ming Chi University of Technology, New Taipei, Taiwan
| | - Chun-Ming Chen
- Center for Plasma and Thin Film Technologies, Ming Chi University of Technology, New Taipei, Taiwan
| | - Chun-Wei Hou
- Chemistry Division, Center for General Education, Chang Gung University, Taoyuan, Taiwan
| | - Hui-Yu Wu
- Department of Microbiology and Immunology, College of Medicine, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Pang-Yun Chou
- Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Ho Lai
- Department of Microbiology and Immunology, College of Medicine, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan.,Department of Pediatrics, Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medical Research, School of Medicine, China Medical University and Hospital, Taichung, Taiwan.,Department of Nursing, Asia University, Taichung, Taiwan
| | - Jyh-Wei Lee
- Center for Plasma and Thin Film Technologies, Ming Chi University of Technology, New Taipei, Taiwan.,Department of Materials Engineering, Ming Chi University of Technology, New Taipei, Taiwan.,Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
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32
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Kusakci-Seker B, Demirayak-Akdemir M. The effect of non-thermal atmospheric pressure plasma application on wound healing after gingivectomy. Int Wound J 2020; 17:1376-1383. [PMID: 32462820 DOI: 10.1111/iwj.13379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 01/24/2023] Open
Abstract
Recent studies have indicated the potential benefits of Non-thermal atmospheric pressure plasma (NTAPP) as a novel therapeutic approach. The purpose of the current study was thus to assess the effect of NTAPP on gingival wound healing. Fifteen patients with bilaterally symmetrical gingival hyperplasia were included in the study. After gingivectomy and gingivoplasty, the left-hand side of the symmetrical surgical area was irradiated with NTAPP (plasma jet kINPen 11). Digital photographs of the gingival wounds were taken at baseline and days 3, 7, and 14. Wound epithelialisation was evaluated. Landry Wound Healing Index (WHI) scores and visual analogue scale (VAS) scores were also recorded. There were significant differences between the epithelialisation of the NTAPP-treated sites and the control sites after the surgical procedures. The NTAPP-treated sites had significantly smaller stained surface areas compared with the control sites on the 3rd, 7th , and 14th days (P < .05). The NTAPP-treated sites had better WHI scores than the control sites throughout the follow-up period (P < .05). It can be concluded that NTAPP enhances epithelialisation and stimulates wound healing after gingivectomy and gingivoplasty. However, further clinical studies with larger sample sizes are needed to determine the exact benefits of NTAPP for gingival wound healing.
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Affiliation(s)
- Basak Kusakci-Seker
- Department of Periodontology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Melike Demirayak-Akdemir
- Department of Periodontology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
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Abstract
Despite increasing knowledge gained based on multidisciplinary research, plasma medicine still raises various questions regarding specific effects as well as potential risks. With regard to significant statements about in vivo applicability that cannot be prognosticated exclusively based on in vitro data, there is still a deficit of clinical data. This study included a clinical follow-up of five probands who had participated five years previously in a study on the influence of cold atmospheric pressure plasma (CAP) on the wound healing of CO2 laser-induced skin lesions. The follow-up included a complex imaging diagnostic involving dermatoscopy, confocal laser scanning microscopy (CLSM) and hyperspectral imaging (HSI). Hyperspectral analysis showed no relevant microcirculatory differences between plasma-treated and non-plasma-treated areas. In summary of all the findings, no malignant changes, inflammatory reactions or pathological changes in cell architecture could be detected in the plasma-treated areas. These unique in vivo long-term data contribute to a further increase in knowledge about important safety aspects in regenerative plasma medicine. However, to confirm these findings and secure indication-specific dose recommendations, further clinical studies are required.
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Rutkowski R, Daeschlein G, von Woedtke T, Smeets R, Gosau M, Metelmann HR. Long-term Risk Assessment for Medical Application of Cold Atmospheric Pressure Plasma. Diagnostics (Basel) 2020; 10:diagnostics10040210. [PMID: 32290487 PMCID: PMC7235715 DOI: 10.3390/diagnostics10040210] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 12/31/2022] Open
Abstract
Despite increasing knowledge gained based on multidisciplinary research, plasma medicine still raises various questions regarding specific effects as well as potential risks. With regard to significant statements about in vivo applicability that cannot be prognosticated exclusively based on in vitro data, there is still a deficit of clinical data. This study included a clinical follow-up of five probands who had participated five years previously in a study on the influence of cold atmospheric pressure plasma (CAP) on the wound healing of CO2 laser-induced skin lesions. The follow-up included a complex imaging diagnostic involving dermatoscopy, confocal laser scanning microscopy (CLSM) and hyperspectral imaging (HSI). Hyperspectral analysis showed no relevant microcirculatory differences between plasma-treated and non-plasma-treated areas. In summary of all the findings, no malignant changes, inflammatory reactions or pathological changes in cell architecture could be detected in the plasma-treated areas. These unique in vivo long-term data contribute to a further increase in knowledge about important safety aspects in regenerative plasma medicine. However, to confirm these findings and secure indication-specific dose recommendations, further clinical studies are required.
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Affiliation(s)
- Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medicine Hamburg-Eppendorf, 20251 Hamburg, Germany
- Correspondence: ; Tel.: +49-1522-2887432
| | - Georg Daeschlein
- Department of Dermatology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology (INP) e.V. Greifswald, 17489 Greifswald, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medicine Hamburg-Eppendorf, 20251 Hamburg, Germany
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medicine Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hans-Robert Metelmann
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17475 Greifswald, Germany
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35
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Wang XF, Fang QQ, Jia B, Hu YY, Wang ZC, Yan KP, Yin SY, Liu Z, Tan WQ. Potential effect of non-thermal plasma for the inhibition of scar formation: a preliminary report. Sci Rep 2020; 10:1064. [PMID: 31974451 PMCID: PMC6978306 DOI: 10.1038/s41598-020-57703-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/18/2019] [Indexed: 12/19/2022] Open
Abstract
Non-thermal plasma (NTP) is a promising biomedical tool for application to wound healing. However, there is limited scientific evidence that confirms its efficacy to inhibit scar formation. This study aims to investigate the role of non-thermal plasma in scar formation. Two full-thickness dorsal cutaneous wounds of rats were treated with either a non-thermal helium plasma jet or helium. It was determined that the non-thermal plasma jet accelerated the wound healing process from 5 days after surgery (day 5: 41.27% ± 2.351 vs 54.7% ± 5.314, p < 0.05; day 7: 56.05% ± 1.881 vs 75.28% ± 3.914, p < 0.01; day 14: 89.85% ± 2.991 vs 98.07% ± 0.839, p < 0.05). The width of the scars for the NTP group was narrower than those of control group (4.607 ± 0.416 mm vs 3.260 ± 0.333 mm, p < 0.05). In addition, a lower level of TGF-β1, p-Smad2 and p-Smad3 were detected in the NTP treated wounds (p < 0.05, p < 0.01 and p < 0.01). As expected, α-SMA was also significantly decreased in the NTP treatment group (p < 0.01). Moreover, the expression of type I collagen and the proportion of type I to III collagen were lower in the NTP group (p < 0.05). The results of the study suggest that NTP may play a potential role in scar formation by inhibiting the TGF β1 signal pathway and reducing the levels of α-SMA and type I collagen, and may have clinical utility in the future.
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Affiliation(s)
- Xiao-Feng Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, P.R. China
| | - Qing-Qing Fang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, P.R. China
| | - Bing Jia
- Institute of Industrial Ecology and Environment, Collage of Chemical and Biological Engineering, Zhejiang University, Zhejiang Province, P.R. China
| | - Yan-Yan Hu
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, P.R. China
| | - Zheng-Cai Wang
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, P.R. China
| | - Ke-Ping Yan
- Institute of Industrial Ecology and Environment, Collage of Chemical and Biological Engineering, Zhejiang University, Zhejiang Province, P.R. China
| | - Sheng-Yong Yin
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China
| | - Zhen Liu
- Institute of Industrial Ecology and Environment, Collage of Chemical and Biological Engineering, Zhejiang University, Zhejiang Province, P.R. China.
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China.
- Department of Plastic Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, P.R. China.
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36
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VON Woedtke T, Schmidt A, Bekeschus S, Wende K, Weltmann KD. Plasma Medicine: A Field of Applied Redox Biology. In Vivo 2019; 33:1011-1026. [PMID: 31280189 DOI: 10.21873/invivo.11570] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/25/2022]
Abstract
Plasma medicine comprises the application of physical plasma directly on or in the human body for therapeutic purposes. Three most important basic plasma effects are relevant for medical applications: i) inactivation of a broad spectrum of microorganisms, including multidrug-resistant pathogens, ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and iii) inactivation of cells by initialization of cell death with higher plasma treatment intensity, above all in cancer cells. Based on own published results as well as on monitoring of relevant literature the aim of this topical review is to summarize the state of the art in plasma medicine and connect it to redox biology. One of the most important results of basic research in plasma medicine is the insight that biological plasma effects are mainly mediated via reactive oxygen and nitrogen species influencing cellular redox-regulated processes. Plasma medicine can be considered a field of applied redox biology.
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Affiliation(s)
- Thomas VON Woedtke
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany .,Greifswald University Medicine, Greifswald, Germany
| | - Anke Schmidt
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany
| | | | | | - Klaus-Dieter Weltmann
- Leibniz Institute for Plasma Science and Technology, INP Greifswald, Greifswald, Germany
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37
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Parameters Affecting the Antimicrobial Properties of Cold Atmospheric Plasma Jet. J Clin Med 2019; 8:jcm8111930. [PMID: 31717600 PMCID: PMC6912271 DOI: 10.3390/jcm8111930] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/17/2022] Open
Abstract
Using the Taguchi method to narrow experimental parameters, the antimicrobial efficiency of a cold atmospheric plasma jet (CAPJ) treatment was investigated. An L9 array with four parameters of CAPJ treatments, including the application voltage, CAPJ-sample distance, argon (Ar) gas flow rate, and CAPJ treatment time, were applied to examine the antimicrobial activity against Escherichia coli (E. coli). CAPJ treatment time was found to be the most influential parameter in its antimicrobial ability by evaluation of signal to noise ratios and analysis of variance. 100% bactericidal activity was achieved under the optimal bactericidal activity parameters including the application voltage of 8.5 kV, CAPJ-sample distance of 10 mm, Ar gas flow rate of 500 sccm, and CAPJ treatment time of 300 s, which confirms the efficacy of the Taguchi method in this design. In terms of the mechanism of CAPJ's antimicrobial ability, the intensity of hydroxyl radical produced by CAPJ positively correlated to its antimicrobial efficiency. The CAPJ antimicrobial efficiency was further evaluated by both DNA double-strand breaks analysis and scanning electron microscopy examination of CAPJ treated bacteria. CAPJ destroyed the cell wall of E. coli and further damaged its DNA structure, thus leading to successful killing of bacteria. This study suggests that optimal conditions of CPAJ can provide effective antimicrobial activity and may be grounds for a novel approach for eradicating bacterial infections.
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38
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ROS from Physical Plasmas: Redox Chemistry for Biomedical Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9062098. [PMID: 31687089 PMCID: PMC6800937 DOI: 10.1155/2019/9062098] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/17/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022]
Abstract
Physical plasmas generate unique mixes of reactive oxygen and nitrogen species (RONS or ROS). Only a bit more than a decade ago, these plasmas, operating at body temperature, started to be considered for medical therapy with considerably little mechanistic redox chemistry or biomedical research existing on that topic at that time. Today, a vast body of evidence is available on physical plasma-derived ROS, from their spatiotemporal resolution in the plasma gas phase to sophisticated chemical and biochemical analysis of these species once dissolved in liquids. Data from in silico analysis dissected potential reaction pathways of plasma-derived reactive species with biological membranes, and in vitro and in vivo experiments in cell and animal disease models identified molecular mechanisms and potential therapeutic benefits of physical plasmas. In 2013, the first medical plasma systems entered the European market as class IIa devices and have proven to be a valuable resource in dermatology, especially for supporting the healing of chronic wounds. The first results in cancer patients treated with plasma are promising, too. Due to the many potentials of this blooming new field ahead, there is a need to highlight the main concepts distilled from plasma research in chemistry and biology that serve as a mechanistic link between plasma physics (how and which plasma-derived ROS are produced) and therapy (what is the medical benefit). This inevitably puts cellular membranes in focus, as these are the natural interphase between ROS produced by plasmas and translation of their chemical reactivity into distinct biological responses.
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Kaushik NK, Ghimire B, Li Y, Adhikari M, Veerana M, Kaushik N, Jha N, Adhikari B, Lee SJ, Masur K, von Woedtke T, Weltmann KD, Choi EH. Biological and medical applications of plasma-activated media, water and solutions. Biol Chem 2019; 400:39-62. [PMID: 30044757 DOI: 10.1515/hsz-2018-0226] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/11/2018] [Indexed: 01/28/2023]
Abstract
Non-thermal atmospheric pressure plasma has been proposed as a new tool for various biological and medical applications. Plasma in close proximity to cell culture media or water creates reactive oxygen and nitrogen species containing solutions known as plasma-activated media (PAM) or plasma-activated water (PAW) - the latter even displays acidification. These plasma-treated solutions remain stable for several days with respect to the storage temperature. Recently, PAM and PAW have been widely studied for many biomedical applications. Here, we reviewed promising reports demonstrating plasma-liquid interaction chemistry and the application of PAM or PAW as an anti-cancer, anti-metastatic, antimicrobial, regenerative medicine for blood coagulation and even as a dental treatment agent. We also discuss the role of PAM on cancer initiation cells (spheroids or cancer stem cells), on the epithelial mesenchymal transition (EMT), and when used for metastasis inhibition considering its anticancer effects. The roles of PAW in controlling plant disease, seed decontamination, seed germination and plant growth are also considered in this review. Finally, we emphasize the future prospects of PAM, PAW or plasma-activated solutions in biomedical applications with a discussion of the mechanisms and the stability and safety issues in relation to humans.
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Affiliation(s)
- Nagendra Kumar Kaushik
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Bhagirath Ghimire
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Ying Li
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Manish Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Mayura Veerana
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Neha Kaushik
- Department of Life Science, Hanyang University, Seoul 04763, Republic of Korea
| | - Nayansi Jha
- Graduate School of Clinical Dentistry, Korea University, Seoul 02841, Republic of Korea
| | - Bhawana Adhikari
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Su-Jae Lee
- Department of Life Science, Hanyang University, Seoul 04763, Republic of Korea
| | - Kai Masur
- Leibniz Institute for Plasma Science and Technology, D-17489 Greifswald, Germany
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology, D-17489 Greifswald, Germany
| | | | - Eun Ha Choi
- Plasma Bioscience Research Center, Applied Plasma Medicine Center, Department of Electrical and Biological Physics and Department of Plasma-Bio Display, Kwangwoon University, Seoul 01897, Republic of Korea
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40
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Bekeschus S, Seebauer C, Wende K, Schmidt A. Physical plasma and leukocytes - immune or reactive? Biol Chem 2019; 400:63-75. [PMID: 30030959 DOI: 10.1515/hsz-2018-0224] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/20/2018] [Indexed: 12/15/2022]
Abstract
Leukocytes are professionals in recognizing and removing pathogenic or unwanted material. They are present in virtually all tissues, and highly motile to enter or leave specific sites throughout the body. Less than a decade ago, physical plasmas entered the field of medicine to deliver their delicate mix of reactive species and other physical agents for mainly dermatological or oncological therapy. Plasma treatment thus affects leukocytes via direct or indirect means: immune cells are either present in tissues during treatment, or infiltrate or exfiltrate plasma-treated areas. The immune system is crucial for human health and resolution of many types of diseases. It is therefore vital to study the response of leukocytes after plasma treatment in vitro and in vivo. This review gathers together the major themes in the plasma treatment of innate and adaptive immune cells, and puts these into the context of wound healing and oncology, the two major topics in plasma medicine.
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Affiliation(s)
- Sander Bekeschus
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
| | - Christian Seebauer
- Greifswald University Medical Center, Department of Oral and Maxillofacial Surgery/Plastic Surgery, Ferdinand-Sauerbruch-Str. DZ 7, D-17475 Greifswald, Germany
| | - Kristian Wende
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
| | - Anke Schmidt
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
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41
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Kwon T, Chandimali N, Lee DH, Son Y, Yoon SB, Lee JR, Lee S, Kim KJ, Lee SY, Kim SY, Jo YJ, Kim M, Park BJ, Lee JK, Jeong DK, Kim JS. Potential Applications of Non-thermal Plasma in Animal Husbandry to Improve Infrastructure. In Vivo 2019; 33:999-1010. [PMID: 31280188 PMCID: PMC6689345 DOI: 10.21873/invivo.11569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 12/28/2022]
Abstract
Infrastructure in animal husbandry refers to fundamental facilities and services necessary for better living conditions of animals and its economy to function through better productivity. Mainly, infrastructure can be divided into two categories: hard infrastructure and soft infrastructure. Physical infrastructure, such as buildings, roads, and water supplying systems, belongs to hard infrastructure. Soft infrastructure includes services which are required to maintain economic, health, cultural and social standards of animal husbandry. Therefore, the proper management of infrastructure in animal husbandry is necessary for animal welfare and its economy. Among various technologies to improve the quality of infrastructure, non-thermal plasma (NTP) technology is an effectively applicable technology in different stages of animal husbandry. NTP is mainly helpful in maintaining better health conditions of animals in several ways via decontamination from microorganisms present in air, water, food, instruments and surfaces of animal farming systems. Furthermore, NTP is used in the treatment of waste water, vaccine production, wound healing in animals, odor-free ventilation, and packaging of animal food or animal products. This review summarizes the recent studies of NTP which can be related to the infrastructure in animal husbandry.
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Affiliation(s)
- Taeho Kwon
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Nisansala Chandimali
- Immunotherapy Convergence Research Center,Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea
- Laboratory of Animal Genetic Engineering and Stem Cell Biology, Advanced Convergence Technology & Science, Jeju National University, Jeju, Republic of Korea
| | - Dong-Ho Lee
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Yeonghoon Son
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Seung-Bin Yoon
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Ja-Rang Lee
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Sangil Lee
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Ki Jin Kim
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Sang-Yong Lee
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Se-Yong Kim
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Yu-Jin Jo
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Minseong Kim
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Byoung-Jin Park
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Jun-Ki Lee
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
| | - Dong Kee Jeong
- Laboratory of Animal Genetic Engineering and Stem Cell Biology, Advanced Convergence Technology & Science, Jeju National University, Jeju, Republic of Korea
| | - Ji-Su Kim
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeonbuk, Republic of Korea
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Chaichi A, Prasad A, Kootta Parambil L, Shaik S, Hemmasian Ettefagh A, Dasa V, Guo S, Osborn ML, Devireddy R, Khonsari MM, Gartia MR. Improvement of Tribological and Biocompatibility Properties of Orthopedic Materials Using Piezoelectric Direct Discharge Plasma Surface Modification. ACS Biomater Sci Eng 2019; 5:2147-2159. [PMID: 33405717 DOI: 10.1021/acsbiomaterials.9b00009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Various types of alloys and polymers are utilized in orthopedic implants. However, there are still several issues accompanied by the use of prosthetic materials, such as low wear performance and catastrophic failure. Surface enhancement of biomaterials is a promising method that can improve the success rate of prosthetic operations without negatively affecting their bulk properties while improving the biocompatibility of implants and reducing infections. Nonthermal plasma treatment has become a ubiquitous surface modification method in sterilization and healthcare applications. However, the clinical applications of such an approach have been limited due to the lack of detailed studies delineating the wear behavior and biocompatibility of implants after plasma treatment. In this study, we have employed a handheld piezoelectric direct discharge (PDD) plasma generator to modify the surface of two common metallic (Ti6Al4V) and nonmetallic (GUR1020 polymer) biomaterials used typically in joint and disc replacements. We have observed an approximately 60-fold reduction in tribological wear rate along with a 2- to 3-fold increase in the biocompatibility properties of plasma coated samples compared to noncoated (untreated) surfaces, respectively. Our study introduces a novel application of nonthermal PDD plasma technology that is capable of increasing the quality and success rate of joint and disc replacements.
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Affiliation(s)
- Ardalan Chaichi
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Alisha Prasad
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Lijesh Kootta Parambil
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Shahensha Shaik
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Ali Hemmasian Ettefagh
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Vinod Dasa
- Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans 70112, United States
| | - Shengmin Guo
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Michelle L Osborn
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, United States
| | - Ram Devireddy
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Michael M Khonsari
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
| | - Manas Ranjan Gartia
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge 70803, United States
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43
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Schmidt A, von Woedtke T, Vollmar B, Hasse S, Bekeschus S. Nrf2 signaling and inflammation are key events in physical plasma-spurred wound healing. Theranostics 2019; 9:1066-1084. [PMID: 30867816 PMCID: PMC6401410 DOI: 10.7150/thno.29754] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/02/2019] [Indexed: 12/26/2022] Open
Abstract
Wound healing is strongly associated with the presence of a balanced content of reactive species in which oxygen-dependent, redox-sensitive signaling represents an essential step in the healing cascade. Numerous studies have demonstrated that cold physical plasma supports wound healing due to its ability to deliver a beneficial mixture of reactive species directly to the cells. Methods: We described a preclinical proof-of-principle-concept of cold plasma use in a dermal, full-thickness wound model in immunocompetent SKH1 mice. Quantitative PCR, Western blot analysis, immunohistochemistry and immunofluorescence were perfomed to evaluate the expression and cellular translocation of essential targets of Nrf2 and p53 signaling as well as immunomodulatory and angiogenetic factors. Apoptosis and proliferation were detected using TUNEL assay and Ki67 staining, respectively. Cytokine levels in serum were measured using bead-based multiplex cytokine analysis. Epidermal keratinocytes and dermal fibroblasts were isolated from mouse skin to perform functional knockdown experiments. Intravital fluorescence analysis was used to illustrate and quantified microvascular features. Results: Plasma exerted significant effects on wound healing in mice, including the promotion of granulation and reepithelialization as a consequence of the migration of skin cells, the balance of antioxidant and inflammatory response, and the early induction of macrophage and neutrophil recruitment to the wound sites. Moreover, through an early and local plasma-induced p53 inhibition with a concomitant stimulation of proliferation, the upregulation of angiogenetic factors, and an increased outgrowth of new vessels, our findings explain why dermal skin repair is accelerated. The cellular redox homeostasis was maintained and cells were defended from damage by a strong modulation of the nuclear E2-related factor (Nrf2) pathway and redox-sensitive p53 signaling. Conclusions: Although acute wound healing is non-problematic, the pathways highlighted that mainly the activation of Nrf2 signaling is a promising strategy for the clinical use of cold plasma in chronic wound healing.
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Smolková B, Uzhytchak M, Lynnyk A, Kubinová Š, Dejneka A, Lunov O. A Critical Review on Selected External Physical Cues and Modulation of Cell Behavior: Magnetic Nanoparticles, Non-thermal Plasma and Lasers. J Funct Biomater 2018; 10:jfb10010002. [PMID: 30586923 PMCID: PMC6463085 DOI: 10.3390/jfb10010002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/13/2018] [Accepted: 12/21/2018] [Indexed: 12/18/2022] Open
Abstract
Physics-based biomedical approaches have proved their importance for the advancement of medical sciences and especially in medical diagnostics and treatments. Thus, the expectations regarding development of novel promising physics-based technologies and tools are very high. This review describes the latest research advances in biomedical applications of external physical cues. We overview three distinct topics: using high-gradient magnetic fields in nanoparticle-mediated cell responses; non-thermal plasma as a novel bactericidal agent; highlights in understanding of cellular mechanisms of laser irradiation. Furthermore, we summarize the progress, challenges and opportunities in those directions. We also discuss some of the fundamental physical principles involved in the application of each cue. Considerable technological success has been achieved in those fields. However, for the successful clinical translation we have to understand the limitations of technologies. Importantly, we identify the misconceptions pervasive in the discussed fields.
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Affiliation(s)
- Barbora Smolková
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
| | - Mariia Uzhytchak
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
| | - Anna Lynnyk
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
| | - Šárka Kubinová
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
- Institute of Experimental Medicine of the Czech Academy of Sciences, 14220 Prague, Czech Republic.
| | - Alexandr Dejneka
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
| | - Oleg Lunov
- Institute of Physics of the Czech Academy of Sciences, 18221 Prague, Czech Republic.
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Dickenson A, Britun N, Nikiforov A, Leys C, Hasan MI, Walsh JL. The generation and transport of reactive nitrogen species from a low temperature atmospheric pressure air plasma source. Phys Chem Chem Phys 2018; 20:28499-28510. [PMID: 30417902 DOI: 10.1039/c8cp05762a] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The reactive chemical species generated by non-equilibrium plasma under atmospheric pressure conditions are key enablers for many emerging applications spanning the fields of biomedicine, manufacturing and agriculture. Despite showing great application potential, insight in to the underpinning reactive species generation and transport mechanisms remains scarce. This contribution focuses on the spatiotemporal behaviour of reactive nitrogen species (RNS) created and transported by an atmospheric pressure air surface barrier discharge (SBD) using both laser induced fluorescence and particle imaging velocimetry measurements combined with experimentally validated numerical modelling. It was observed that highly reactive species such as N are confined to the discharge region while less reactive species such as NO, NO2 and N2O closely followed the induced flow. The concentration of key RNS was found to be in the 10-100 ppm range at a position of 25 mm downstream of the discharge region. A close agreement between the experimental and computational results was achieved and the findings provide a valuable insight in to the role of electrohydrodynamic forces in dictating the spatiotemporal distribution of reactive chemical species beyond the plasma generation region, which is ultimately a key contributor towards downstream treatment uniformity and application efficacy.
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Affiliation(s)
- Aaron Dickenson
- Centre for Plasma Microbiology, Department of Electrical Engineering & Electronics, University of Liverpool, L69 3GJ, UK.
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46
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Prevention of bacterial colonization on non-thermal atmospheric plasma treated surgical sutures for control and prevention of surgical site infections. PLoS One 2018; 13:e0202703. [PMID: 30183745 PMCID: PMC6124751 DOI: 10.1371/journal.pone.0202703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
Surgical site infections have a remarkable impact on morbidity, extended hospitalization and mortality. Sutures strongly contribute to development of surgical site infections as they are considered foreign material in the human body. Sutures serve as excellent surfaces for microbial adherence and subsequent colonization, biofilm formation and infection on the site of a surgery. Various antimicrobial sutures have been developed to prevent suture-mediated surgical site infection. However, depending on the site of surgery, antimicrobial sutures may remain ineffective, and antimicrobial agents on them might have drawbacks. Plasma, defined as the fourth state of matter, composed of ionized gas, reactive oxygen and nitrogen species, free radical and neutrals, draws attention for the control and prevention of hospital-acquired infections due to its excellent antimicrobial activities. In the present study, the efficacy of non-thermal atmospheric plasma treatment for prevention of surgical site infections was investigated. First, contaminated poly (glycolic-co-lactic acid), polyglycolic acid, polydioxanone and poly (glycolic acid-co-caprolactone) sutures were treated with non-thermal atmospheric plasma to eradicate contaminating bacteria like Staphylococcus aureus and Escherichia coli. Moreover, sutures were pre-treated with non-thermal atmospheric plasma and then exposed to S. aureus and E. coli. Our results revealed that non-thermal atmospheric plasma treatment effectively eradicates contaminating bacteria on sutures, and non-thermal atmospheric plasma pre-treatment effectively prevents bacterial colonization on sutures without altering their mechanical properties. Chemical characterization of sutures was performed with FT-IR and XPS and results showed that non-thermal atmospheric plasma treatment substantially increased the hydrophilicity of sutures which might be the primary mechanism for the prevention of bacterial colonization. In conclusion, plasma-treated sutures could be considered as novel alternative materials for the control and prevention of surgical site infections.
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47
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Kondeti VSSK, Phan CQ, Wende K, Jablonowski H, Gangal U, Granick JL, Hunter RC, Bruggeman PJ. Long-lived and short-lived reactive species produced by a cold atmospheric pressure plasma jet for the inactivation of Pseudomonas aeruginosa and Staphylococcus aureus. Free Radic Biol Med 2018; 124:275-287. [PMID: 29864482 DOI: 10.1016/j.freeradbiomed.2018.05.083] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/11/2018] [Accepted: 05/28/2018] [Indexed: 12/29/2022]
Abstract
Different chemical pathways leading to the inactivation of Pseudomonas aeruginosa and Staphylococcus aureus by a cold atmospheric pressure plasma jet (APPJ) in buffered and non-buffered solutions are reported. As APPJs produce a complex mixture of reactive species in solution, a comprehensive set of diagnostics were used to assess the liquid phase chemistry. This includes absorption and electron paramagnetic resonance spectroscopy in addition to a scavenger study to assess the relative importance of the various plasma produced species involved in the inactivation of bacteria. Different modes of inactivation of bacteria were found for the same plasma source depending on the solution and the plasma feed gas. The inactivation of bacteria in saline is due to the production of short-lived species in the case of argon plasma when the plasma touches the liquid. Long-lived species (ClO-) formed by the abundant amount of O. radicals produced by the plasmas played a dominant role in the case of Ar + 1% O2 and Ar + 1% air plasmas when the plasma is not in direct contact with the liquid. Inactivation of bacteria in distilled water was found to be due to the generation of short-lived species: O. &O2.- for Ar + 1% O2 plasma and O2.- (and .OH in absence of saline) for Ar plasma.
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Affiliation(s)
- V S Santosh K Kondeti
- Department of Mechanical Engineering, University of Minnesota, 111, Church Street, SE, Minneapolis, MN 55455, USA.
| | - Chi Q Phan
- Department of Microbiology and Immunology, University of Minnesota, Microbiology Research Facility, 689, SE, 23rd Ave, Minneapolis, MN 55455, USA.
| | - Kristian Wende
- ZIK Plasmatis at Leibniz Institute for Plasma Science and Technology e.V. (INP Greifswald e.V.), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.
| | - Helena Jablonowski
- ZIK Plasmatis at Leibniz Institute for Plasma Science and Technology e.V. (INP Greifswald e.V.), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.
| | - Urvashi Gangal
- Department of Mechanical Engineering, University of Minnesota, 111, Church Street, SE, Minneapolis, MN 55455, USA.
| | - Jennifer L Granick
- Department of Veterinary Clinical Sciences, University of Minnesota, 339 Veterinary Medical Center, 1352 Boyd Ave, Saint Paul, MN 55108, USA.
| | - Ryan C Hunter
- Department of Microbiology and Immunology, University of Minnesota, Microbiology Research Facility, 689, SE, 23rd Ave, Minneapolis, MN 55455, USA.
| | - Peter J Bruggeman
- Department of Mechanical Engineering, University of Minnesota, 111, Church Street, SE, Minneapolis, MN 55455, USA.
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De Backer J, Razzokov J, Hammerschmid D, Mensch C, Hafideddine Z, Kumar N, van Raemdonck G, Yusupov M, Van Doorslaer S, Johannessen C, Sobott F, Bogaerts A, Dewilde S. The effect of reactive oxygen and nitrogen species on the structure of cytoglobin: A potential tumor suppressor. Redox Biol 2018; 19:1-10. [PMID: 30081385 PMCID: PMC6084017 DOI: 10.1016/j.redox.2018.07.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/15/2018] [Accepted: 07/22/2018] [Indexed: 12/12/2022] Open
Abstract
Many current anti-cancer therapies rely on increasing the intracellular reactive oxygen and nitrogen species (RONS) contents with the aim to induce irreparable damage, which subsequently results in tumor cell death. A novel tool in cancer therapy is the use of cold atmospheric plasma (CAP), which has been found to be very effective in the treatment of many different cancer cell types in vitro as well as in vivo, mainly through the vast generation of RONS. One of the key determinants of the cell's fate will be the interaction of RONS, generated by CAP, with important proteins, i.e. redox-regulatory proteins. One such protein is cytoglobin (CYGB), a recently discovered globin proposed to be involved in the protection of the cell against oxidative stress. In this study, the effect of plasma-produced RONS on CYGB was investigated through the treatment of CYGB with CAP for different treatment times. Spectroscopic analysis of CYGB showed that although chemical modifications occur, its secondary structure remains intact. Mass spectrometry experiments identified these modifications as oxidations of mainly sulfur-containing and aromatic amino acids. With longer treatment time, the treatment was also found to induce nitration of the heme. Furthermore, the two surface-exposed cysteine residues of CYGB were oxidized upon treatment, leading to the formation of intermolecular disulfide bridges, and potentially also intramolecular disulfide bridges. In addition, molecular dynamics and docking simulations confirmed, and further show, that the formation of an intramolecular disulfide bond, due to oxidative conditions, affects the CYGB 3D structure, thereby opening the access to the heme group, through gate functioning of His117. Altogether, the results obtained in this study (1) show that plasma-produced RONS can extensively oxidize proteins and (2) that the oxidation status of two redox-active cysteines lead to different conformations of CYGB.
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Affiliation(s)
- Joey De Backer
- Research Group PPES, Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium.
| | - Jamoliddin Razzokov
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Dietmar Hammerschmid
- Research Group PPES, Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium; Biomolecular & Analytical Mass Spectrometry, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Carl Mensch
- Research Group Molecular Spectroscopy, Department of Chemistry, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Zainab Hafideddine
- Research Group PPES, Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium; The Laboratory of Biophysics and Biomedical Physics, Department of Physics, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Naresh Kumar
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Geert van Raemdonck
- Center for Proteomics, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Maksudbek Yusupov
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Sabine Van Doorslaer
- The Laboratory of Biophysics and Biomedical Physics, Department of Physics, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Christian Johannessen
- Research Group Molecular Spectroscopy, Department of Chemistry, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Frank Sobott
- Biomolecular & Analytical Mass Spectrometry, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium; Astbury Centre for Structural Molecular Biology, University of Leeds, Leeds, UK; School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Annemie Bogaerts
- Research Group PLASMANT, Department of Chemistry, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium
| | - Sylvia Dewilde
- Research Group PPES, Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 1610 Antwerp, Belgium.
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Non-thermal atmospheric pressure plasma-induced IL-8 expression is regulated via intracellular K + loss and subsequent ERK activation in human keratinocyte HaCaT cells. Arch Biochem Biophys 2018. [PMID: 29518371 DOI: 10.1016/j.abb.2018.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Non-thermal atmospheric pressure plasma (NTAPP) has recently emerged as a novel medical therapy for skin wounds. Interleukin-8 (IL-8) is thought to play a critical role in wound healing. NTAPP irradiation has been reported to promote production of IL-8; however, the mechanism is not fully understood. The aim of this study was to elucidate the underlying mechanism of NTAPP-induced IL-8 expression in human keratinocyte HaCaT cells. NTAPP irradiation of HaCaT cells increased IL-8 mRNA expression in an irradiation time-dependent manner. Although hydrogen peroxide (H2O2) was generated in culture medium irradiated with NTAPP, treatment of HaCaT cells with H2O2 itself failed to induce the expression. In addition, we found that NTAPP irradiation of HaCaT cells decreased intracellular K+ levels. High intracellular K+ concentrations suppressed NTAPP-induced IL-8 mRNA expression, and the K+ ionophore valinomycin (Val) enhanced the induction of IL-8 mRNA. Moreover, NTAPP stimulated activation of ERK MAP kinase and the ERK inhibitor prevented NTAPP-induced IL-8 mRNA expression. NTAPP-induced ERK activation was inhibited in the presence of high concentrations of extracellular K+ and enhanced in the presence of Val. Taken together, these findings suggest that NTAPP irradiation stimulates intracellular K+ loss and subsequent ERK activation, leading to the induction of IL-8 expression.
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50
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López-Callejas R, Peña-Eguiluz R, Valencia-Alvarado R, Mercado-Cabrera A, Rodríguez-Méndez BG, Serment-Guerrero JH, Cabral-Prieto A, González-Garduño AC, Domínguez-Cadena NA, Muñoz-Infante J, Betancourt-Ángeles M. Alternative method for healing the diabetic foot by means of a plasma needle. CLINICAL PLASMA MEDICINE 2018. [DOI: 10.1016/j.cpme.2018.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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