1
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Werra UEM, Dorweiler B. [Cold plasma in wound healing]. UROLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00120-024-02376-6. [PMID: 38985295 DOI: 10.1007/s00120-024-02376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 07/11/2024]
Abstract
Even today, not all wounds can be healed. Treatment, which often takes many years, is a burden for patients and is very cost-intensive. Therefore, additional procedures such as cold plasma are becoming increasingly popular. Active components of cold plasma include electromagnetic radiation and free radicals. The active principle is based on, among other things, damage to bacterial cells and positive interaction with epithelial and endothelial cells. Angiogenesis and cellular oxygen metabolism are stimulated. The evidence base is still limited and heterogeneous, as some results are contradictory and comparability is difficult. However, new, well-designed studies have confirmed previous findings. In order to create a solid database, further studies are needed.
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Affiliation(s)
- Ursula Elisabeth Maria Werra
- Klinik und Poliklinik für Gefäßchirurgie, Vaskuläre und endovaskuläre Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Bernhard Dorweiler
- Klinik und Poliklinik für Gefäßchirurgie, Vaskuläre und endovaskuläre Chirurgie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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2
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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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3
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Ma Y, Sun T, Ren K, Min T, Xie X, Wang H, Xu G, Dang C, Zhang H. Applications of cold atmospheric plasma in immune-mediated inflammatory diseases via redox homeostasis: evidence and prospects. Heliyon 2023; 9:e22568. [PMID: 38107323 PMCID: PMC10724573 DOI: 10.1016/j.heliyon.2023.e22568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/28/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
As a representative technology in plasma medicine, cold atmospheric plasma (CAP) has beneficial outcomes in surface disinfection, wound repair, tissue regeneration, solid tumor therapy. Impact on immune response and inflammatory conditions was also observed in the process of CAP treatment. Relevant literatures were collected to assess efficacy and summarize possible mechanisms of the innovation. CAP mediates alteration in local immune microenvironment mainly through two ways. One is to down-regulate the expression level of several cytokines, impeding further conduction of immune or inflammatory signals. Intervening the functional phenotype of cells through different degree of oxidative stress is the other approach to manage the immune-mediated inflammatory disorders. A series of preclinical and clinical studies confirmed the therapeutic effect and side effects free of CAP. Moreover, several suggestions proposed in this manuscript might help to find directions for future investigation.
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Affiliation(s)
- Yuyi Ma
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Tuanhe Sun
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Kaijie Ren
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Tianhao Min
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xin Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Haonan Wang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Guimin Xu
- State Key Laboratory of Electrical Insulation and Power Equipment, School of Electrical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Chengxue Dang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
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4
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Carr MA, Marquart ME, Sanchez M, Saleem W, Wellington OI, Lovell KM, McCallister A, Lightfoot V, Ost EB, Wise HZ, Huang B, Sharma AC. Innovative cold atmospheric plasma (iCAP) decreases corneal ulcer formation and bacterial loads and improves anterior chamber health in methicillin resistant Staphylococcus aureus keratitis. Exp Eye Res 2023; 237:109692. [PMID: 37884203 PMCID: PMC10841653 DOI: 10.1016/j.exer.2023.109692] [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: 08/16/2023] [Revised: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Bacterial keratitis is a vision-threatening infection of the cornea that is typically treated with antibiotics. However, antibiotics sometimes fail to eradicate the infection and do not prevent or repair the damage caused directly by the bacteria or the host immune response to the infection. Our group previously demonstrated that treatment of Pseudomonas aeruginosa keratitis in rabbits with innovative cold atmospheric plasma (iCAP) resulted in reduced edema, ulcer formation, and bacterial load. In this study, we investigated the efficacy of iCAP treatment in methicillin-resistant Staphylococcus aureus (MRSA). New Zealand white rabbits were infected intrastromally with MRSA then treated with iCAP, moxifloxacin, vancomycin, or combination of iCAP with each antibiotic to assess the safety and efficacy of iCAP treatment compared to untreated controls and antibiotics. iCAP treatment significantly reduced bacterial loads and inflammation, improved anterior chamber clarity, and prevented corneal ulceration compared to untreated controls and antibiotic treatment. Safety assessments of grimace test scores and tear production showed that iCAP was not significantly different from either antibiotic treatment in terms of distress or tear production. Combination iCAP/antibiotic treatment did not appear to provide significant added benefit over iCAP alone. Our findings suggest that the addition of iCAP may be a viable tool in reducing damage to the cornea and anterior chamber of the eye following S. aureus keratitis.
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Affiliation(s)
- Mary A Carr
- Center for Immunology and Microbial Research and the Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Mary E Marquart
- Center for Immunology and Microbial Research and the Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Miguel Sanchez
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
| | - Waqar Saleem
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
| | - Ocean I Wellington
- Center for Immunology and Microbial Research and the Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - K Michael Lovell
- Center for Immunology and Microbial Research and the Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Aaliyah McCallister
- Center for Immunology and Microbial Research and the Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Victoria Lightfoot
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
| | - Evan B Ost
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
| | - Hua Z Wise
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
| | - Bo Huang
- Department of Ophthalmology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Anjal C Sharma
- Experimental Therapeutics and Diagnostics Group, Lynntech Inc., 2501 Earl Rudder Fwy South, College Station, TX, 77845, USA.
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Barjasteh A, Kaushik N, Choi EH, Kaushik NK. Cold Atmospheric Pressure Plasma: A Growing Paradigm in Diabetic Wound Healing-Mechanism and Clinical Significance. Int J Mol Sci 2023; 24:16657. [PMID: 38068979 PMCID: PMC10706109 DOI: 10.3390/ijms242316657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Diabetes is one of the most significant causes of death all over the world. This illness, due to abnormal blood glucose levels, leads to impaired wound healing and, as a result, foot ulcers. These ulcers cannot heal quickly in diabetic patients and may finally result in amputation. In recent years, different research has been conducted to heal diabetic foot ulcers: one of them is using cold atmospheric pressure plasma. Nowadays, cold atmospheric pressure plasma is highly regarded in medicine because of its positive effects and lack of side effects. These conditions have caused plasma to be considered a promising technology in medicine and especially diabetic wound healing because studies show that it can heal chronic wounds that are resistant to standard treatments. The positive effects of plasma are due to different reactive species, UV radiation, and electromagnetic fields. This work reviews ongoing cold atmospheric pressure plasma improvements in diabetic wound healing. It shows that plasma can be a promising tool in treating chronic wounds, including ones resulting from diabetes.
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Affiliation(s)
- Azadeh Barjasteh
- Department of Physics, Lorestan University, Khorramabad 68151-44316, Iran;
| | - Neha Kaushik
- Department of Biotechnology, College of Engineering, The University of Suwon, Hwaseong 18323, Republic of Korea;
| | - Eun Ha Choi
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
| | - Nagendra Kumar Kaushik
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
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Eggers B, Stope MB, Marciniak J, Mustea A, Eick S, Deschner J, Nokhbehsaim M, Kramer FJ. Non-Invasive Physical Plasma Reduces the Inflammatory Response in Microbially Prestimulated Human Gingival Fibroblasts. Int J Mol Sci 2023; 24:16156. [PMID: 38003346 PMCID: PMC10671174 DOI: 10.3390/ijms242216156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Non-invasive physical plasma (NIPP), an electrically conductive gas, is playing an increasingly important role in medicine due to its antimicrobial and regenerative properties. However, NIPP is not yet well established in dentistry, although it has promising potential, especially for periodontological applications. The aim of the present study was to investigate the effect of NIPP on a commercially available human gingival fibroblast (HGF) cell line and primary HGFs in the presence of periodontitis-associated bacteria. First, primary HGFs from eight patients were characterised by immunofluorescence, and cell numbers were examined by an automatic cell counter over 5 days. Then, HGFs that were preincubated with Fusobacterium nucleatum (F.n.) were treated with NIPP. Afterwards, the IL-6 and IL-8 levels in the cell supernatants were determined by ELISA. In HGFs, F.n. caused a significant increase in IL-6 and IL-8, and this F.n.-induced upregulation of both cytokines was counteracted by NIPP, suggesting a beneficial effect of physical plasma on periodontal cells in a microbial environment. The application of NIPP in periodontal therapy could therefore represent a novel and promising strategy and deserves further investigation.
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Affiliation(s)
- Benedikt Eggers
- Department of Oral, Maxillofacial and Plastic Surgery, University Hospital Bonn, 53111 Bonn, Germany;
| | - Matthias Bernhard Stope
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.B.S.); (A.M.)
| | - Jana Marciniak
- Department of Orthodontics, University Hospital Bonn, 53111 Bonn, Germany;
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.B.S.); (A.M.)
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, University Hospital Bonn, 53111 Bonn, Germany;
| | - Franz-Josef Kramer
- Department of Oral, Maxillofacial and Plastic Surgery, University Hospital Bonn, 53111 Bonn, Germany;
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Clemen R, Minkus L, Singer D, Schulan P, von Woedtke T, Wende K, Bekeschus S. Multi-Oxidant Environment as a Suicidal Inhibitor of Myeloperoxidase. Antioxidants (Basel) 2023; 12:1936. [PMID: 38001789 PMCID: PMC10668958 DOI: 10.3390/antiox12111936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
Tissue inflammation drives the infiltration of innate immune cells that generate reactive species to kill bacteria and recruit adaptive immune cells. Neutrophil activation fosters the release of myeloperoxidase (MPO) enzyme, a heme-containing protein generating hypochlorous acid (HOCl) from hydrogen peroxide (H2O2) and chloride ions. MPO-dependent oxidant formation initiates bioactive oxidation and chlorination products and induces oxidative post-translational modifications (oxPTMs) on proteins and lipid oxidation. Besides HOCl and H2O2, further reactive species such as singlet oxygen and nitric oxide are generated in inflammation, leading to modified proteins, potentially resulting in their altered bioactivity. So far, knowledge about multiple free radical-induced modifications of MPO and its effects on HOCl generation is lacking. To mimic this multi-oxidant microenvironment, human MPO was exposed to several reactive species produced simultaneously via argon plasma operated at body temperature. Several molecular gas admixes were used to modify the reactive species type profiles generated. MPO was investigated by studying its oxPTMs, changes in protein structure, and enzymatic activity. MPO activity was significantly reduced after treatment with all five tested plasma gas conditions. Dynamic light scattering and CD-spectroscopy revealed altered MPO protein morphology indicative of oligomerization. Using mass spectrometry, various oxPTMs, such as +1O, +2O, and +3O, were determined on methionine and cysteine (Cys), and -1H-1N+1O was detected in asparagine (Asp). The modification types identified differed between argon-oxygen and argon-nitrogen plasmas. However, all plasma gas conditions led to the deamidation of Asp and oxidation of Cys residues, suggesting an inactivation of MPO due to oxPTM-mediated conformational changes.
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Affiliation(s)
- Ramona Clemen
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Lara Minkus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Debora Singer
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
| | - Paul Schulan
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Thomas von Woedtke
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475 Greifswald, Germany
| | - Kristian Wende
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany
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Ermakov AM, Afanasyeva VA, Lazukin AV, Shlyapnikov YM, Zhdanova ES, Kolotova AA, Blagodatski AS, Ermakova ON, Chukavin NN, Ivanov VK, Popov AL. Synergistic Antimicrobial Effect of Cold Atmospheric Plasma and Redox-Active Nanoparticles. Biomedicines 2023; 11:2780. [PMID: 37893152 PMCID: PMC10604215 DOI: 10.3390/biomedicines11102780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
Cold argon plasma (CAP) and metal oxide nanoparticles are well known antimicrobial agents. In the current study, on an example of Escherichia coli, a series of analyses was performed to assess the antibacterial action of the combination of these agents and to evaluate the possibility of using cerium oxide and cerium fluoride nanoparticles for a combined treatment of bacterial diseases. The joint effect of the combination of cold argon plasma and several metal oxide and fluoride nanoparticles (CeO2, CeF3, WO3) was investigated on a model of E. coli colony growth on agar plates. The mutagenic effect of different CAP and nanoparticle combinations on bacterial DNA was investigated, by means of a blue-white colony assay and RAPD-PCR. The effect on cell wall damage, using atomic force microscopy, was also studied. The results obtained demonstrate that the combination of CAP and redox-active metal oxide nanoparticles (RAMON) effectively inhibits bacterial growth, providing a synergistic antimicrobial effect exceeding that of any of the agents alone. The combination of CAP and CeF3 was shown to be the most effective mutagen against plasmid DNA, and the combination of CAP and WO3 was the most effective against bacterial genomic DNA. The analysis of direct cell wall damage by atomic force microscopy showed the combination of CAP and CeF3 to be the most effective antimicrobial agent. The combination of CAP and redox-active metal oxide or metal fluoride nanoparticles has a strong synergistic antimicrobial effect on bacterial growth, resulting in plasmid and genomic DNA damage and cell wall damage. For the first time, a strong antimicrobial and DNA-damaging effect of CeF3 nanoparticles has been demonstrated.
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Affiliation(s)
- Artem M. Ermakov
- Hospital of the Pushchino Scientific Center of the Russian Academy of Sciences, 142290 Pushchino, Russia (V.A.A.); (E.S.Z.)
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
- ANO Engineering Physics Institute, 142210 Serpukhov, Russia
| | - Vera A. Afanasyeva
- Hospital of the Pushchino Scientific Center of the Russian Academy of Sciences, 142290 Pushchino, Russia (V.A.A.); (E.S.Z.)
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Alexander V. Lazukin
- Troitsk Institute of Innovative and Thermonuclear Research (JSC “SSC RF TRINITY”), 108840 Moscow, Russia;
| | - Yuri M. Shlyapnikov
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Elizaveta S. Zhdanova
- Hospital of the Pushchino Scientific Center of the Russian Academy of Sciences, 142290 Pushchino, Russia (V.A.A.); (E.S.Z.)
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Anastasia A. Kolotova
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Artem S. Blagodatski
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Olga N. Ermakova
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
| | - Nikita N. Chukavin
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
- Scientific and Educational Center, State University of Education, 105005 Moscow, Russia
| | - Vladimir K. Ivanov
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, 119991 Moscow, Russia;
| | - Anton L. Popov
- Institute of Theoretical and Experimental Biophysics of the Russian Academy of Sciences, 142290 Pushchino, Russia; (Y.M.S.); (A.A.K.); (A.S.B.); (O.N.E.); (N.N.C.)
- Scientific and Educational Center, State University of Education, 105005 Moscow, Russia
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9
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Hämmerle G, Ascher S, Gebhardt L. Positive effects of cold atmospheric plasma on pH in wounds: a pilot study. J Wound Care 2023; 32:530-536. [PMID: 37682787 DOI: 10.12968/jowc.2023.32.9.530] [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] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Cold atmospheric plasma (CAP) is a promising new option for the treatment of hard-to-heal (chronic) wounds. The aim of this study was to observe the effect of CAP on wound pH, as a correlation between the pH of a wound and its healing tendency has been established in the literature. METHOD Patients with hard-to-heal wounds were treated with CAP in addition to standard treatment. Treatment was performed with the aid of a small, mobile plasma device, which was used for one minute at a time during dressing changes. The pH value, wound size, and other parameters, such as exudate and signs of infection, were recorded for each treatment. RESULTS A total of 10 patients took part in the study. During the observation period, there was a significant reduction in pH from a markedly alkaline pH of 9.6 to a neutral pH of 7. This was accompanied by a marked reduction in wound size by an average of 76% with seven applications of CAP within 28 days. The evaluation of tissue granulation, exudate and signs of infection showed a positive trend. CONCLUSION The number of patients in the present study is not sufficient to prove the relationship between the pH value of the wound and the treatment with CAP. However, there are clear indications that the positive effects of CAP on wound healing, which are recognised in several publications, are also due to its influence on wound pH value.
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Li M, Gao J, Wang L, Liu J, Fu C, Yang X, Zhang S, Li X, Luo S, Yang C. Basic research and clinical exploration of cold atmospheric plasma for skin wounds. Bioeng Transl Med 2023; 8:e10550. [PMID: 37693064 PMCID: PMC10487309 DOI: 10.1002/btm2.10550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/18/2023] [Accepted: 04/30/2023] [Indexed: 09/12/2023] Open
Abstract
Skin wounds, such as burns, diabetic foot ulcers, pressure sores, and wounds formed after laser or surgical treatment, comprise a very high proportion of dermatological disorders. Wounds are treated in a variety of ways; however, some wounds are greatly resistant, resulting in delayed healing and an urgent need to introduce new alternatives. Our previous studies have shown that cold atmospheric plasma (CAP) has antibacterial activity and promotes cell proliferation, differentiation, and migration in vitro. To further advance the role of CAP in wound healing, we evaluated the safety and efficacy of CAP in vitro by irradiation of common refractory bacteria on the skin, irradiation of normal skin of rats and observing reactions, treatment of scald wounds in rats, and treating clinically common acute wounds. Our findings revealed that CAP can eliminate refractory skin bacteria in vitro; CAP positively affected wound healing in a rat scalding wound model; and direct CAP irradiation of low intensity and short duration did not lead to skin erythema or edema. CAP promises to be a new, economical, and safe means of wound treatment.
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Affiliation(s)
- Miaomiao Li
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Jing Gao
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
- Anhui Provincial Institute of Translational MedicineHefeiAnhuiChina
| | - Liyun Wang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Jia Liu
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Chuyu Fu
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Xingyu Yang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Shengquan Zhang
- Anhui Provincial Institute of Translational MedicineHefeiAnhuiChina
- Department of Biochemistry and Molecular Biology, School of Basic Medical SciencesAnhui Medical UniversityHefeiAnhuiChina
| | - Xinwei Li
- Anhui Academy of Medical SciencesHefeiAnhuiChina
| | | | - Chunjun Yang
- Department of Dermatology and Venereologythe Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
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11
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Ghadirian F, Abbasi H, Bavi O, Naeimabadi A. How living cells are affected during the cold atmospheric pressure plasma treatment. Free Radic Biol Med 2023; 205:141-150. [PMID: 37295538 DOI: 10.1016/j.freeradbiomed.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/12/2023]
Abstract
When the electric discharge process is limited by high voltage electrodes shielding, the ionization measure would be controlled to less than one percent and the temperature to less than 37 °C even at atmospheric pressure, so-called cold atmospheric pressure plasma (CAP). CAP has been found to have profound medical applications in association with its reactive oxygen and nitrogen species (ROS/RNS). In this way that during plasma exposure, the subjected medium (e.g. cell cytoplasmic membrane in plasma therapy) interacts with ROS/RNS. Accordingly, a precise study of the mentioned interactions and their consequences on the cells' behavior changes, is necessary. The results lead to the reduction of possible risks and provide the opportunity of optimizing the efficacy of CAP before the development of CAP applications in the field of plasma medicine. In this report molecular dynamic (MD) simulation is used to investigate the mentioned interactions and a proper and compatible comparison with the experimental results is presented. Based on this, the effects of H2O2, NO and O2 on the living cell's membrane are investigated in biological conditions. Our results show that: i) The hydration of phospholipid polar heads would be enhanced associated with the H2O2 presence. ii) A new definition of the surface area assigned to each phospholipid (APL), more reliable and compatible with the physical expectations, is introduced. iii) The long-term behavior of NO and O2 is their penetration into the lipid bilayer and sometimes passing through the membrane into the cell. The latter would be an indication of internal cells' pathways activation leading to modification of cells' function.
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Affiliation(s)
- Fatemeh Ghadirian
- Faculty of Physics and Energy Engineering, Amirkabir University of Technology, P. O. Box, 15875-4413, Tehran, Iran
| | - Hossein Abbasi
- Faculty of Physics and Energy Engineering, Amirkabir University of Technology, P. O. Box, 15875-4413, Tehran, Iran.
| | - Omid Bavi
- Department of Mechanical Engineering, Shiraz University of Technology, Shiraz, Iran
| | - Aboutorab Naeimabadi
- Faculty of Physics and Energy Engineering, Amirkabir University of Technology, P. O. Box, 15875-4413, Tehran, Iran
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12
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Abu Rached N, Kley S, Storck M, Meyer T, Stücker M. Cold Plasma Therapy in Chronic Wounds-A Multicenter, Randomized Controlled Clinical Trial (Plasma on Chronic Wounds for Epidermal Regeneration Study): Preliminary Results. J Clin Med 2023; 12:5121. [PMID: 37568525 PMCID: PMC10419810 DOI: 10.3390/jcm12155121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic wounds (CWs) pose a significant health challenge in clinical practice. Standard wound therapy (SWT) is currently considered the gold standard. However, recent evidence suggests that cold plasma therapy (CPT) holds promise for improving CWs. In light of this, the POWER study was conducted as a multicenter, randomized clinical trial to investigate the effect of large-area plasma application compared with SWT in patients with chronic, non-healing arterial or venous wounds on the lower leg. To analyze the interim results, we employed a comprehensive range of statistical tests, including both parametric and non-parametric methods, as well as GLS model regression and an ordinal mixed model. Our findings clearly demonstrate that CPT therapy significantly accelerates wound closure compared with SWT. In fact, complete wound closure was exclusively observed in the CPT group during the intervention period. Additionally, the CPT group required significantly less antibiotic therapy (4%) compared with the SWT group (23%). Furthermore, CPT led to a significant reduction in wound pain and improved quality of life compared with SWT. In conclusion, the study highlights that the combination of CPT and SWT surpasses monotherapy with SWT alone.
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Affiliation(s)
- Nessr Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Susanne Kley
- Scientific Institute for Health Economics and Health Research, Markt 9, 04109 Leipzig, Germany;
| | - Martin Storck
- Municipal Hospital Karlsruhe gGmbH, Moltkestraße 90, 76133 Karlsruhe, Germany;
| | - Thomas Meyer
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Markus Stücker
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
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13
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Hong Q, Dong X, Jones JE, Hong L, Yu Q, Sun H, Chen M. A novel approach to expedite wound healing with plasma brush of cold flame. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2023; 94:084102. [PMID: 38065141 PMCID: PMC10431944 DOI: 10.1063/5.0096969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/18/2023] [Indexed: 12/18/2023]
Abstract
Excessive or persistent infection is a major contributing factor in impeding chronic wound healing. Wound bed preparations using antiseptics do not necessarily target the entire bacterial spectrum, and the highly proliferating granulation tissue may be sensitive to the cytotoxic effects, impairing tissue repair. Non-thermal gas atmospheric pressure plasmas are partially ionized gases that contain highly reactive particles while the gas phase remains near room temperature, thus having the capability of accessing small irregular cavities and fissures and killing bacteria because of the diffusive nature of gas phase plasma species that are chemically reactive, providing an ideal approach to topical wound disinfection. A non-thermal plasma brush device of novel design has been developed that is suitable for clinical application in the disinfection of oral and wound bacteria. In vivo studies have indicated that the plasma brush treatment rendered no harmful effect on healthy skin or tissues, while it could improve wound healing in Pseudomonas aeruginosa biofilm infected wounds exposed to an optimized treatment with argon plus 1% nitrogen (Ar + N2) plasma.
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Affiliation(s)
- Qing Hong
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, Missouri 65211, USA
| | | | | | - Liang Hong
- Department of Pediatric Dentistry and Community Oral Health, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA
| | - Qingsong Yu
- Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, Missouri 65211, USA
| | - Hongmin Sun
- Division of Cardiovascular Medicine, Department of Medicine, University of Missouri, Columbia, Missouri 65212, USA
| | - Meng Chen
- Nanova, Inc., Columbia, Missouri 65202, USA
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14
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Yang H, Liu B, Park J, Blaise O, Duchesne C, Honnorat B, Vizet J, Rousseau A, Pierangelo A. Mueller polarimetric imaging as a tool for detecting the effect of non-thermal plasma treatment on the skin. BIOMEDICAL OPTICS EXPRESS 2023; 14:2736-2755. [PMID: 37342717 PMCID: PMC10278602 DOI: 10.1364/boe.482753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/23/2023]
Abstract
Non-thermal plasma (NTP) is a promising technique studied for several medical applications such as wound healing or tumor reduction. The detection of microstructural variations in the skin is currently performed by histological methods, which are time-consuming and invasive. This study aims to show that full-field Mueller polarimetric imaging is suitable for fast and without-contact detection of skin microstructure modifications induced by plasma treatment. Defrosted pig skin is treated by NTP and analyzed by MPI within 30 minutes. NTP is shown to modify the linear phase retardance and the total depolarization. The tissue modifications are inhomogeneous and present distinct features at the center and the fringes of the plasma-treated area. According to control groups, tissue alterations are primarily caused by the local heating concomitant to plasma-skin interaction.
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Affiliation(s)
- Hang Yang
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Bo Liu
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Junha Park
- LPICM, Ecole Polytechnique, CNRS, IP Paris, Palaiseau, 91128, France
| | - Océane Blaise
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Constance Duchesne
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Bruno Honnorat
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Jérémy Vizet
- LPICM, Ecole Polytechnique, CNRS, IP Paris, Palaiseau, 91128, France
| | - Antoine Rousseau
- LPP, Ecole Polytechnique, CNRS, IP Paris,
Sorbonne Université, Palaiseau,
91128, France
| | - Angelo Pierangelo
- LPICM, Ecole Polytechnique, CNRS, IP Paris, Palaiseau, 91128, France
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15
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Bolgeo T, Maconi A, Gardalini M, Gatti D, Di Matteo R, Lapidari M, Longhitano Y, Savioli G, Piccioni A, Zanza C. The Role of Cold Atmospheric Plasma in Wound Healing Processes in Critically Ill Patients. J Pers Med 2023; 13:jpm13050736. [PMID: 37240907 DOI: 10.3390/jpm13050736] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Critically ill patients are at risk of skin wounds, which reduce their quality of life, complicate their pharmacological regimens, and prolong their hospital stays in intensive care units (ICUs), while also increasing overall mortality and morbidity rates. Cold atmospheric plasma (CAP) has been proposed as a viable option for many biological and medical applications, given its capacity to reduce wound bacterial contamination and promote wound healing. The aim of this narrative review is to describe how CAP works and its operating mechanisms, as well as reporting its possible applications in critical care settings. The success of CAP in the treatment of wounds, in particular, bedsores or pressure sores, presents an innovative path in the prevention of nosocomial infections and an opportunity of reducing the negative implications of these diseases for the NHS. This narrative review of the literature was conducted following the 'Scale for the Assessment of Narrative Review Articles' (SANRA) methodology. Previous literature highlights three biological effects of plasma: inactivation of a wide range of microorganisms, including those that are multi-drug-resistant; increased cell proliferation and angiogenesis with a shorter period of plasma treatment; and apoptosis stimulation with a longer and more intensive treatment. CAP is effective in many areas of the medical field, with no significant adverse effects on healthy cells. However, its use can produce potentially serious side effects and should, therefore, be used under expert supervision and in appropriate doses.
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Affiliation(s)
- Tatiana Bolgeo
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonio Maconi
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Menada Gardalini
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Denise Gatti
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Roberta Di Matteo
- Department of Integrated Research and Innovation Activities, AON SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Marco Lapidari
- Department of Vascular Surgery, St. Antonio and Biagio and Cesare Arrigo Hospital, 15121 Alessandria, Italy
| | - Yaroslava Longhitano
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Gabriele Savioli
- Department of Emergency Medicine and Surgery, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy
| | - Andrea Piccioni
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Christian Zanza
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
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16
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Bagheri M, von Kohout M, Zoric A, Fuchs PC, Schiefer JL, Opländer C. Can Cold Atmospheric Plasma Be Used for Infection Control in Burns? A Preclinical Evaluation. Biomedicines 2023; 11:biomedicines11051239. [PMID: 37238910 DOI: 10.3390/biomedicines11051239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
Wound infection with Pseudomonas aeruginosa (PA) is a serious complication and is responsible for higher rates of mortality in burn patients. Because of the resistance of PA to many antibiotics and antiseptics, an effective treatment is difficult. As a possible alternative, cold atmospheric plasma (CAP) can be considered for treatment, as antibacterial effects are known from some types of CAP. Hence, we preclinically tested the CAP device PlasmaOne and found that CAP was effective against PA in various test systems. CAP induced an accumulation of nitrite, nitrate, and hydrogen peroxide, combined with a decrease in pH in agar and solutions, which could be responsible for the antibacterial effects. In an ex vivo contamination wound model using human skin, a reduction in microbial load of about 1 log10 level was observed after 5 min of CAP treatment as well as an inhibition of biofilm formation. However, the efficacy of CAP was significantly lower when compared with commonly used antibacterial wound irrigation solutions. Nevertheless, a clinical use of CAP in the treatment of burn wounds is conceivable on account of the potential resistance of PA to common wound irrigation solutions and the possible wound healing-promoting effects of CAP.
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Affiliation(s)
- Mahsa Bagheri
- Plastic Surgery, Hand Surgery, Burn Center, Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
- Institute for Research in Operative Medicine (IFOM), Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Maria von Kohout
- Plastic Surgery, Hand Surgery, Burn Center, Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
- Institute for Research in Operative Medicine (IFOM), Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Andreas Zoric
- Institute for Research in Operative Medicine (IFOM), Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Paul C Fuchs
- Plastic Surgery, Hand Surgery, Burn Center, Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Jennifer L Schiefer
- Plastic Surgery, Hand Surgery, Burn Center, Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
| | - Christian Opländer
- Institute for Research in Operative Medicine (IFOM), Cologne-Merheim Hospital, Witten/Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany
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Gesundheitsökonomische Aspekte der Kaltplasmatherapie:
exemplarische Betrachtung der Versorgung chronischer Wunden mithilfe des
Plasmajet kINPen® MED. GESUNDHEITSÖKONOMIE & QUALITÄTSMANAGEMENT 2023. [DOI: 10.1055/a-2001-1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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18
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Lertpatipanpong P, Sillapachaiyaporn C, Oh G, Kang YH, Hwang CY, Baek SJ. Effect of cold atmospheric microwave plasma (CAMP) on wound healing in canine keratinocytes. Front Cell Dev Biol 2023; 11:1105692. [PMID: 36760362 PMCID: PMC9905446 DOI: 10.3389/fcell.2023.1105692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
Cutaneous wound healing is a biological process that occurs upon skin injury and involves different mechanisms to repair tissue damage. Improper healing or prolonged curation period of wound lesions may induce unpleasant complications. Cold atmospheric microwave plasma (CAMP) is an upcoming medical therapeutic option for skin infection and wound treatment. However, the molecular mechanisms of CAMP-mediated canine wound healing are not well characterized. Wound-healing activity was examined to elucidate the biological effects and molecular mechanisms of CAMP. Canine keratinocytes (CPEKs) were treated using CAMP, and their wound-healing activities were evaluated. The molecular mechanisms of that effect were examined, based on RNA-Seq analysis data, and verified using immunoblotting and polymerase chain reaction. It was found that the CAMP-treated cells exhibited a significant increase in cell migration evaluated by scratch assay in human keratinocytes (HaCaT) and canine keratinocytes (CPEK). Additionally, CAMP-treated CPEK cells showed a significant positive effect on cell invasion. The RNA-Seq data revealed that CAMP alters different genes and pathways in CPEK cells. Gene expression involved in the cell cycle, cell proliferation, angiogenesis, cell adhesion, and wound healing was upregulated in CAMP-treated cells compared with gas-activated media used as a control. The Hippo pathway was also analyzed, and the protein and mRNA levels of YAP were significantly increased in CAMP-treated cells. CAMP-treated CPEK cells indicated the downregulation of E-cadherin and upregulation of vimentin, Snail, and Slug at transcription and translation levels, contributing to a favorable effect on cell migration. Our findings suggested that CAMP treatment provided beneficial effects on the curative wound process through the induction of genes involved in wound healing, promotion of EMT, and increase in the molecular targets in the Hippo signaling pathway.
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Affiliation(s)
- Pattawika Lertpatipanpong
- Laboratory of Signal Transduction, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Chanin Sillapachaiyaporn
- Laboratory of Signal Transduction, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea,Program in Clinical Biochemistry and Molecular Medicine, Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Garam Oh
- Laboratory of Signal Transduction, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Yeong-Hun Kang
- Laboratory of Veterinary Dermatology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Cheol-Yong Hwang
- Laboratory of Veterinary Dermatology, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Seung Joon Baek
- Laboratory of Signal Transduction, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, South Korea,*Correspondence: Seung Joon Baek,
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Argon Humidification Exacerbates Antimicrobial and Anti-MRSA kINPen Plasma Activity. Life (Basel) 2023; 13:life13020257. [PMID: 36836614 PMCID: PMC9968137 DOI: 10.3390/life13020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Gas plasma is a medical technology with antimicrobial properties. Its main mode of action is oxidative damage via reactive species production. The clinical efficacy of gas plasma-reduced bacterial burden has been shown to be hampered in some cases. Since the reactive species profile produced by gas plasma jets, such as the kINPen used in this study, are thought to determine antimicrobial efficacy, we screened an array of feed gas settings in different types of bacteria. Antimicrobial analysis was performed by single-cell analysis using flow cytometry. We identified humidified feed gas to mediate significantly greater toxicity compared to dry argon and many other gas plasma conditions. The results were confirmed by inhibition zone analysis on gas-plasma-treated microbial lawns grown on agar plates. Our results may have vital implications for clinical wound management and potentially enhance antimicrobial efficacy of medical gas plasma therapy in patient treatment.
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Werra UEM, Dorweiler B. Kaltplasmatherapie in der Wundbehandlung – Was wissen wir? GEFÄSSCHIRURGIE 2022. [DOI: 10.1007/s00772-022-00960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Suwanchinda A, Nararatwanchai T. The efficacy and safety of the innovative cold atmospheric-pressure plasma technology in the treatment of striae distensae: A randomized controlled trial. J Cosmet Dermatol 2022; 21:6805-6814. [PMID: 36217555 DOI: 10.1111/jocd.15458] [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: 07/26/2022] [Revised: 08/25/2022] [Accepted: 10/03/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Available current therapeutics modalities for striae distensae (SD) provide inconsistently effective outcomes. There is ongoing research on innovative treatment modalities to find better treatment solutions. OBJECTIVES To evaluate the efficacy and safety of innovative cold atmospheric plasma (CAP) technology in the treatment of striae distensae. METHODS This study includes twenty-three patients with striae distensae. The body was divided into two halves. One side was randomly treated with CAP biweekly on the same treated side for five sessions with 30 days follow-up after the last session. Another half was left untreated. Efficacy assessment was done using patient and observer scar assessment scale (POSAS), patient satisfaction scales, and Antera 3D® skin imaging system. Safety assessment was evaluated using the visual analog scale (VAS) and adverse effects monitoring. RESULTS Patient and observer scar assessment scale, patient and observer overall opinion score, and patient and observer total score in a summary of all rated characteristics, comparing treated and untreated areas, showed a statistically significant reduction in all parameters after one treatment (*p-value <0.05). Patients rated satisfaction as a great improvement in 52.3%, moderate improvement in 39.1%, extreme improvement in 4.3%, and slight improvement in 4.3%. Adverse effects included small scabs, shallow wounds, and rash. CONCLUSION Cold atmospheric plasma is a safe and effective, innovative treatment modality for striae distensae with minimal side effects.
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Affiliation(s)
- Atchima Suwanchinda
- Department of Dermatology, School of Anti-aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Thamthiwat Nararatwanchai
- Department of Dermatology, School of Anti-aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
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22
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Suwanchinda A, Nararatwanchai T. Efficacy and safety of the innovative cold atmospheric-pressure plasma technology in the treatment of keloid: A randomized controlled trial. J Cosmet Dermatol 2022; 21:6788-6797. [PMID: 36120805 DOI: 10.1111/jocd.15397] [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: 07/26/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Keloid (KD) treatment is challenging for both physicians and patients. It can be functional debilitating and psychologically distressing. Available current therapeutics modalities give inconsistently effective results. OBJECTIVES To evaluate the efficacy and safety of innovative cold atmospheric plasma (CAP) technology in the treatment of keloid. METHODS This prospective, randomized control trial, the assessor-blinded trial, includes 18 patients with keloids. The keloid lesion was divided into two halves. One side was randomly treated with CAP technology biweekly on the same treated side for five sessions with a follow-up 30 days after finishing the final treatment. Another half was left untreated as a control. Efficacy assessment using POSAS, VSS, Patients' satisfaction scale, Antera 3D® skin imaging system. The safety assessment using VAS and adverse effects monitoring was completed. RESULTS Objective assessment using Antera 3D® skin imaging system (Miravex, Dublin, Ireland) showed statistically significant improvement (p-value <0.05) on the treated side compared with the untreated side in all parameters, color, melanin, hemoglobin, texture, except for volume. POSAS, patient, and observer overall opinion score, and patient and observer total score in the summary of all rated characteristics, comparing the treated and untreated areas, showed a statistically significant reduction in all parameters after two treatments (*p-value <0.05). VSS showed statistically significant improvement after the second treatment and continued to the last follow-up. Most patients rated satisfaction scales up to 72.2% as moderate improvement, 11.1% as great improvement, 11.1% as slight improvement, and 5.6% as no change. The adverse effect was only a small scab in one patient. CONCLUSION CAP technology could be considered an alternative treatment for keloid offering mild-to-moderate improvement with minimal side effects.
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Affiliation(s)
- Atchima Suwanchinda
- Department of Dermatology, School of Anti-aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Thamthiwat Nararatwanchai
- Department of Dermatology, School of Anti-aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
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The Effect of Plasma on Bacteria and Normal Cells in Infected Wound. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1838202. [PMID: 36506937 PMCID: PMC9729034 DOI: 10.1155/2022/1838202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 12/05/2022]
Abstract
Infected wound is one of the most common and serious problem in wound management. Cold atmospheric plasma (CAP) is considered to have a good effect in wound healing as a new type medicine. However, there is a key issue that has not been addressed in the treatment of infected wounds by plasma. Bacteria are always found in the deep region of the wound. When plasma is used to treat wounds, it also acts on normal tissue cells while decontaminating. What is the difference between the same dose of plasma acting on bacteria and normal cells? In this study, the most common bacteria (S. aureus, P. aeruginosa, and E. coli) in infected wound and two kinds of normal skin cells (human keratinocyte and human skin fibroblasts (HSF)) were selected to study the difference of the effects of the same dose of plasma on bacteria and cells. The results reveal that three kinds of 106 CFU mL bacteria could be effectively inactivated by 5 order after plasma treatment 3 min, and P. aeruginosa was more sensitive to plasma (could be inactivated 5 order after 2 min treatment). The 104 mL keratinocyte and HSF were treated with the same dose of plasma; keratinocyte can maintain over 90% of the activity and HSF cells can maintain over 70% of the activity. Moreover, the level of collagen I secreted by HSF increased. Therefore, cells can remain a high activity when a plasma dose capable of inactivating bacteria is applied to them.
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Combined In Vitro Toxicity and Immunogenicity of Cold Plasma and Pulsed Electric Fields. Biomedicines 2022; 10:biomedicines10123084. [PMID: 36551840 PMCID: PMC9775231 DOI: 10.3390/biomedicines10123084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/11/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
In modern oncology, therapies are based on combining monotherapies to overcome treatment resistance and increase therapy precision. The application of microsecond-pulsed electric fields (PEF) is approved to enhance local chemotherapeutic drug uptake within combination electrochemotherapy regimens. Reactive oxygen species (ROS) have been implicated in anticancer effects, and cold physical plasma produces vast amounts of ROS, which have recently been shown to benefit head and neck cancer patients. PEF and cold plasma technology have been linked to immunogenic cell death (ICD) induction, a regulated cell death accompanied by sterile inflammation that promotes antitumor immunity. To this end, we investigated the combined effect of both treatments regarding their intracellular ROS accumulation, toxicity, ICD-related marker expression, and optimal exposure sequence in a leukemia model cell line. The combination treatment substantially increased ROS and intracellular glutathione levels, leading to additive cytotoxic effects accompanied by a significantly increased expression of ICD markers, such as the eat-me signal calreticulin (CRT). Preconditioned treatment with cold plasma followed by PEF exposure was the most potent treatment sequence. The results indicate additive effects of cold plasma and PEF, motivating further studies in skin and breast tumor models for the future improvement of ECT in such patients.
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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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Efficacy of Cold Atmospheric Plasma Therapy on Chronic Wounds: An Updated Systematic Review and Meta-Analysis of RCTs. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5798857. [PMID: 36262869 PMCID: PMC9576403 DOI: 10.1155/2022/5798857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022]
Abstract
Objective A previous meta-analysis has revealed that cold atmospheric plasma (CAP) might not be clinically beneficial to chronic wounds. However, several new randomized controlled trials (RCTs) reported that CAP was an effective treatment option for accelerating wound healing in chronic wounds. The purpose of this review is to incorporate these new results and evaluate the efficacy of CAP in chronic wounds. Methods The major databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched for articles related to CAP treatment in chronic wounds until March 21, 2022. The literature retrieval and evaluation were carried out by two independent researchers. Result A total of 13 randomized clinical trials published between 2010 and 2022 were finally included. CAP therapy showed to be more effective in reducing the area of wounds (mean difference (MD): -1.74, 95%; confidence interval (CI): [-3.14, -0.33], p = 0.02), compared with non-CAP treatments. The immediate reduction of the bacterial load was higher in the CAP group than in the control group. (MD: -0.37, 95%; CI: [-0.7, -0.05], p = 0.02). Conclusion No significant changes were found in long-term antibacterial efficacy and pain perception between the two groups. However, more RCTs of excellent methodological quality are required to confirm technical details of the source of AP and the appropriate duration of the treatment with plasma.
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Modulation of Inflammatory Responses by a Non-Invasive Physical Plasma Jet during Gingival Wound Healing. Cells 2022; 11:cells11172740. [PMID: 36078148 PMCID: PMC9454534 DOI: 10.3390/cells11172740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Gingival wound healing plays an important role in the treatment of a variety of inflammatory diseases. In some cases, however, wound healing is delayed by various endogenous or exogenous factors. In recent years, non-invasive physical plasma (NIPP), a highly reactive gas, has become the focus of research, because of its anti-inflammatory and wound healing-promoting efficacy. So far, since NIPP application has been poorly elucidated in dentistry, the aim of this study was to further investigate the effect of NIPP on various molecules associated with inflammation and wound healing in gingival cells. Human gingival fibroblasts (HGF) and human gingival keratinocytes (HGK) were treated with NIPP at different application times. Cell viability and cell morphology were assessed using DAPI/phalloidin staining. Cyclooxygenase (COX)2; tumour necrosis factor (TNF); CC Motif Chemokine Ligand (CCL)2; and interleukin (IL)1B, IL6 and IL8 were analysed at the mRNA and protein level by a real-time PCR and ELISA. NIPP did not cause any damage to the cells. Furthermore, NIPP led to a downregulation of proinflammatory molecules. Our study shows that NIPP application does not damage the gingival tissue and that the promotion of wound healing is also due to an anti-inflammatory component.
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Innovative Treatment Strategies to Accelerate Wound Healing: Trajectory and Recent Advancements. Cells 2022; 11:cells11152439. [PMID: 35954282 PMCID: PMC9367945 DOI: 10.3390/cells11152439] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022] Open
Abstract
Wound healing is highly specialized dynamic multiple phase process for the repair of damaged/injured tissues through an intricate mechanism. Any failure in the normal wound healing process results in abnormal scar formation, and chronic state which is more susceptible to infections. Chronic wounds affect patients’ quality of life along with increased morbidity and mortality and are huge financial burden to healthcare systems worldwide, and thus requires specialized biomedical intensive treatment for its management. The clinical assessment and management of chronic wounds remains challenging despite the development of various therapeutic regimens owing to its painstakingly long-term treatment requirement and complex wound healing mechanism. Various conventional approaches such as cell therapy, gene therapy, growth factor delivery, wound dressings, and skin grafts etc., are being utilized for promoting wound healing in different types of wounds. However, all these abovementioned therapies are not satisfactory for all wound types, therefore, there is an urgent demand for the development of competitive therapies. Therefore, there is a pertinent requirement to develop newer and innovative treatment modalities for multipart therapeutic regimens for chronic wounds. Recent developments in advanced wound care technology includes nanotherapeutics, stem cells therapy, bioengineered skin grafts, and 3D bioprinting-based strategies for improving therapeutic outcomes with a focus on skin regeneration with minimal side effects. The main objective of this review is to provide an updated overview of progress in therapeutic options in chronic wounds healing and management over the years using next generation innovative approaches. Herein, we have discussed the skin function and anatomy, wounds and wound healing processes, followed by conventional treatment modalities for wound healing and skin regeneration. Furthermore, various emerging and innovative strategies for promoting quality wound healing such as nanotherapeutics, stem cells therapy, 3D bioprinted skin, extracellular matrix-based approaches, platelet-rich plasma-based approaches, and cold plasma treatment therapy have been discussed with their benefits and shortcomings. Finally, challenges of these innovative strategies are reviewed with a note on future prospects.
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Tan F, Wang Y, Zhang S, Shui R, Chen J. Plasma Dermatology: Skin Therapy Using Cold Atmospheric Plasma. Front Oncol 2022; 12:918484. [PMID: 35903680 PMCID: PMC9314643 DOI: 10.3389/fonc.2022.918484] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Cold atmospheric plasma-based plasma medicine has been expanding the diversity of its specialties. As an emerging branch, plasma dermatology takes advantage of the beneficial complexity of plasma constituents (e.g., reactive oxygen and nitrogen species, UV photons, and electromagnetic emission), technical versatility (e.g., direct irradiation and indirect aqueous treatment), and practical feasibility (e.g., hand-held compact device and clinician-friendly operation). The objective of this comprehensive review is to summarize recent advances in the CAP-dominated skin therapy by broadly covering three aspects. We start with plasma optimisation of intact skin, detailing the effect of CAP on skin lipids, cells, histology, and blood circulation. We then conduct a clinically oriented and thorough dissection of CAP treatment of various skin diseases, focusing on the wound healing, inflammatory disorders, infectious conditions, parasitic infestations, cutaneous malignancies, and alopecia. Finally, we conclude with a brief analysis on the safety aspect of CAP treatment and a proposal on how to mitigate the potential risks. This comprehensive review endeavors to serve as a mini textbook for clinical dermatologists and a practical manual for plasma biotechnologists. Our collective goal is to consolidate plasma dermatology’s lead in modern personalized medicine.
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Affiliation(s)
- Fei Tan
- Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS), Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- The Royal College of Surgeons of England, London, United Kingdom
- *Correspondence: Fei Tan,
| | - Yang Wang
- Department of Pathology, Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
| | - Shiqun Zhang
- Department of Pharmacology, Shanghai Tenth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
| | - Runying Shui
- Department of Surgery, Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Jianghan Chen
- Department of Surgery, Department of Dermatology, Shanghai Fourth People’s Hospital, and School of Medicine, Tongji University, Shanghai, China
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Milhan NVM, Chiappim W, Sampaio ADG, Vegian MRDC, Pessoa RS, Koga-Ito CY. Applications of Plasma-Activated Water in Dentistry: A Review. Int J Mol Sci 2022; 23:ijms23084131. [PMID: 35456947 PMCID: PMC9029124 DOI: 10.3390/ijms23084131] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/12/2022] Open
Abstract
The activation of water by non-thermal plasma creates a liquid with active constituents referred to as plasma-activated water (PAW). Due to its active constituents, PAW may play an important role in different fields, such as agriculture, the food industry and healthcare. Plasma liquid technology has received attention in recent years due to its versatility and good potential, mainly focused on different health care purposes. This interest has extended to dentistry, since the use of a plasma–liquid technology could bring clinical advantages, compared to direct application of non-thermal atmospheric pressure plasmas (NTAPPs). The aim of this paper is to discuss the applicability of PAW in different areas of dentistry, according to the published literature about NTAPPs and plasma–liquid technology. The direct and indirect application of NTAPPs are presented in the introduction. Posteriorly, the main reactors for generating PAW and its active constituents with a role in biomedical applications are specified, followed by a section that discusses, in detail, the use of PAW as a tool for different oral diseases.
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Affiliation(s)
- Noala Vicensoto Moreira Milhan
- Oral Biopathology Graduate Program, São José dos Campos Institute of Science & Technology, São Paulo State University, UNESP, São Paulo 12245-000, Brazil; (A.d.G.S.); (M.R.d.C.V.); (C.Y.K.-I.)
- Correspondence: ; Tel.: +55-12-991851206
| | - William Chiappim
- Plasma and Processes Laboratory, Department of Physics, Aeronautics Institute of Technology, Praça Marechal Eduardo Gomes 50, São José dos Campos 12228-900, Brazil; (W.C.); (R.S.P.)
| | - Aline da Graça Sampaio
- Oral Biopathology Graduate Program, São José dos Campos Institute of Science & Technology, São Paulo State University, UNESP, São Paulo 12245-000, Brazil; (A.d.G.S.); (M.R.d.C.V.); (C.Y.K.-I.)
| | - Mariana Raquel da Cruz Vegian
- Oral Biopathology Graduate Program, São José dos Campos Institute of Science & Technology, São Paulo State University, UNESP, São Paulo 12245-000, Brazil; (A.d.G.S.); (M.R.d.C.V.); (C.Y.K.-I.)
| | - Rodrigo Sávio Pessoa
- Plasma and Processes Laboratory, Department of Physics, Aeronautics Institute of Technology, Praça Marechal Eduardo Gomes 50, São José dos Campos 12228-900, Brazil; (W.C.); (R.S.P.)
| | - Cristiane Yumi Koga-Ito
- Oral Biopathology Graduate Program, São José dos Campos Institute of Science & Technology, São Paulo State University, UNESP, São Paulo 12245-000, Brazil; (A.d.G.S.); (M.R.d.C.V.); (C.Y.K.-I.)
- Department of Environment Engineering, São José dos Campos Institute of Science & Technology, São Paulo State University, UNESP, São Paulo 12247-016, Brazil
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Non-Invasive Physical Plasma Treatment after Tooth Extraction in a Patient on Antiresorptive Medication Promotes Tissue Regeneration. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Postoperative tissue regeneration can be negatively affected by bisphosphonate administration, especially in patients with oncologic diseases. A serious complication of bisphosphonate therapy is the medication-related osteonecrosis of the jaw (MRONJ), which can be observed mainly after dental surgery. MRONJ is a progressive destruction of the bone that requires patients to stay in hospital for extended periods of time. For this reason, primary wound closure is particularly important in surgical procedures. In the case of wound dehiscence, there is a very high risk for MRONJ. In recent years, non-invasive physical plasma (NIPP) has become known for improving wound healing on the one hand, but also for its promising efficacy in cancer therapy on the other hand. We report on a 63-year-old patient with a history of multiple myeloma and receiving zoledronate, who developed wound dehiscence after tooth extraction. NIPP treatment resulted in complete epithelialization of the entire wound dehiscence. In conclusion, the use of NIPP in patients receiving antiresorptive drugs seems to support tissue regeneration and thus could be an important tool for the prevention of MRONJ.
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Nitsch A, Napiletzki K, Stope MB. Non‐invasive physical plasma (NIPP) treatment of a hedgehog with head injury: A novel therapy in veterinary medicine. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Andreas Nitsch
- Department of Trauma Reconstructive Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany
| | | | - Matthias B. Stope
- Physical Plasma Laboratory Department of Gynecology and Gynecological Oncology University Hospital Bonn Bonn Germany
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Chronic wounds treated with cold atmospheric plasmajet versus best practice wound dressings: a multicenter, randomized, non-inferiority trial. Sci Rep 2022; 12:3645. [PMID: 35256635 PMCID: PMC8901692 DOI: 10.1038/s41598-022-07333-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/10/2022] [Indexed: 01/03/2023] Open
Abstract
The use of phase-adapted wound dressings represents best practice (BP) in chronic wound treatment. However, efficacy is often limited and associated care requirements are high. Cold atmospheric plasmajet (CAP-jet) is a promising new therapeutic tool for these wounds. In the present multicenter, randomized, open-label, prospective, clinical trial, non-inferiority of the CAP-jet versus BP was assessed in 78 patients with infected or non-infected chronic wounds of different etiology. Primary outcome measure was the sum of granulation tissue, furthermore wound area reduction, healing rate, time to complete healing, changes in wound pH value, infection score, exudate level and local tolerability were assessed. In CAP-jet treated wounds compared to control, the sum of granulation tissue was significantly higher (p < 0.0001) and wound area reduced significantly faster (p < 0.001). Furthermore, wound pH value decreased significantly faster (p = 0.0123) and local infection was overcome more rapidly by CAP-jet therapy. In 58.97% CAP-jet- vs. 5.13% BP-treated patients, complete healing of chronic ulcers was documented after 6 weeks. Treatment with CAP-jet appeared not only non-inferior, but even superior to BP in all wound entities analyzed with a favorable tolerability profile. Thus, treatment with the CAP-jet provides beneficial effects in chronic wound treatment regarding promotion of the wound healing process.
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Schleusser S, Schulz L, Song J, Deichmann H, Griesmann AC, Stang FH, Mailaender P, Kraemer R, Kleemann M, Kisch T. A Single Application of Cold Atmospheric Plasma (CAP) Improves Blood Flow Parameters in Chronic Wounds. Microcirculation 2022; 29:e12754. [PMID: 35218286 DOI: 10.1111/micc.12754] [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: 11/01/2020] [Revised: 02/09/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To find out if application of cold atmospheric plasma (CAP) affects microcirculation in chronic wounds. METHODS We treated 20 patients with chronic wounds on the lower extremity with CAP. Blood flow parameters of wounds were assessed with combined Laser-Doppler-Flowmetry and spectrophotometry in tissue depth of 2 and 6-8 millimeters. Parameters were assessed under standardized conditions before and over the course of 30 minutes after application of CAP. RESULTS Deep capillary blood flow increased significantly by up to 24.33% (percentage change) after treatment with CAP and remained significantly elevated until the end of measuring period at 30 minutes. Superficial oxygen tissue saturation was significantly elevated by 14.05% for the first 5 minutes after treatment. Postcapillary venous filling pressure was significantly elevated by 10.23% 19 minutes after CAP and stayed significantly elevated starting from minute 24 until the end of measuring. CONCLUSION CAP increases microcirculation parameters in chronic wounds significantly. Since CAP is known for its benefits in wound healing the effects observed may explain the improved healing of chronic wounds after its use. Whether CAP application can increase blood flow in chronic wounds for longer periods of time or boosts blood flow when applied more than once should be subject to further research.
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Affiliation(s)
- Sophie Schleusser
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Lysann Schulz
- Department of Interdisciplinary Intensive Care, University Hospital Leipzig, Germany
| | - Jungin Song
- Department of Plastic Surgery, Helios University Hospital Wuppertal, Germany
| | - Henriette Deichmann
- Department of Surgery, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | | | - Felix H Stang
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Peter Mailaender
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Robert Kraemer
- Department of Plastic-, Reconstructive and Aesthetic Surgery, Klinikum Westfalen, Germany
| | | | - Tobias Kisch
- Department of Plastic Surgery, Hand Surgery and Burn Care Unit, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
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Laroussi M, Bekeschus S, Keidar M, Bogaerts A, Fridman A, Lu XP, Ostrikov KK, Hori M, Stapelmann K, Miller V, Reuter S, Laux C, Mesbah A, Walsh J, Jiang C, Thagard SM, Tanaka H, Liu DW, Yan D, Yusupov M. Low Temperature Plasma for Biology, Hygiene, and Medicine: Perspective and Roadmap. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2022. [DOI: 10.1109/trpms.2021.3135118] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Dikyol C, Ercan UK. Evaluation of Penetration Depth of Antimicrobial Effect by Cold Atmospheric Plasma Treatment In vitro. PLASMA MEDICINE 2022. [DOI: 10.1615/plasmamed.2022043466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Choi KY, Sultan MT, Ajiteru O, Hong H, Lee YJ, Lee JS, Lee H, Lee OJ, Kim SH, Lee JS, Park SJ, Eden JG, Park CH. Treatment of Fungal-Infected Diabetic Wounds with Low Temperature Plasma. Biomedicines 2021; 10:27. [PMID: 35052706 PMCID: PMC8773309 DOI: 10.3390/biomedicines10010027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus renders patients susceptible to chronic wounds and various infections. Regarding the latter, fungal infections are of particular concern since, although they are the source of significant morbidity and mortality in immunocompromised patients, they are generally resistant to conventional treatment and a definite treatment strategy has not yet been established. Herein, we report the treatment of skin wounds in a diabetic rat model, infected by Candida albicans, with low temperature helium plasma generated in a hand-held atmospheric jet device. A fungal infection was induced on two dorsal skin wounds of the diabetic rats, and one wound was treated with the plasma jet whereas the other served as a control. Histological analysis revealed accelerated skin wound healing and decreased evidence of fungal infection in the plasma-treated group, as compared to the control group. Regeneration of the epidermis and dermis, collagen deposition, and neovascularization were all observed as a result of plasma treatment, but without wound contraction, scar formation or any evidence of thermal damage to the tissue. These findings demonstrate that the He plasma jet is remarkably effective in diabetic skin wounds infected by Candida albicans, thereby providing a promising medical treatment option for diabetes mellitus patients with skin wound and fungal infections.
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Affiliation(s)
- Kyu Young Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea;
| | - Md. Tipu Sultan
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Olatunji Ajiteru
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Heesun Hong
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Young Jin Lee
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Ji Seung Lee
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Hanna Lee
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Ok Joo Lee
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Soon Hee Kim
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
| | - Joong Seob Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Sung-Jin Park
- Laboratory for Optical Physics and Engineering, Department of Electrical and Computer Engineering, University of Illinois, Urbana, IL 61801, USA; (S.-J.P.); (J.G.E.)
| | - James Gary Eden
- Laboratory for Optical Physics and Engineering, Department of Electrical and Computer Engineering, University of Illinois, Urbana, IL 61801, USA; (S.-J.P.); (J.G.E.)
| | - Chan Hum Park
- Nano-Bio Regenerative Medical Institute, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea; (M.T.S.); (O.A.); (H.H.); (Y.J.L.); (J.S.L.); (H.L.); (O.J.L.); (S.H.K.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea
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38
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Fallah N, Rasouli M, Amini MR. The current and advanced therapeutic modalities for wound healing management. J Diabetes Metab Disord 2021; 20:1883-1899. [PMID: 34900831 PMCID: PMC8630293 DOI: 10.1007/s40200-021-00868-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/28/2021] [Indexed: 12/27/2022]
Abstract
Ever-increasing demands on improving efficiencies of wound healing procedures are a strong driving force for the development of replacement approaches. This review focuses on wound healing management from the point of formation to the point of healing procedures. The most important usual healing modality with key characteristic is explained and their limitations are discussed. Novel interesting approaches are presented with a concentration of the unique features and action mechanisms. Special attention is paid to gas plasma and nanotechnology impact on wound healing management from fundamental processes to beneficial outcomes. Challenges and opportunities for the future trend that combined common protocols and emerging technologies are discussed.
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Affiliation(s)
- Nadia Fallah
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Milad Rasouli
- Plasma Medicine Group, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Institute for Plasma Research and Department of Physics, Kharazmi University, Tehran, Iran
| | - Mohammad Reza Amini
- Plasma Medicine Group, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ernst J, Tanyeli M, Borchardt T, Ojugo M, Helmke A, Viöl W, Schilling AF, Felmerer G. Effect on healing rates of wounds treated with direct cold atmospheric plasma: a case series. J Wound Care 2021; 30:904-914. [PMID: 34747217 DOI: 10.12968/jowc.2021.30.11.904] [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: 11/11/2022]
Abstract
OBJECTIVE The response of different critical acute and hard-to-heal wounds to an innovative wound care modality-direct application of cold atmospheric plasma (CAP)-was investigated in this clinical case series. METHOD Over an observation period of two years, acute wounds with at least one risk factor for chronification, as well as hard-to-heal wounds were treated for 180 seconds three times per week with CAP. CAP treatment was additional to standard wound care. Photographs were taken for wound documentation. The wound sizes before the first CAP treatment, after four weeks, after 12 weeks and at wound closure/end of observation time were determined using image processing software, and analysed longitudinally for the development of wound size. RESULTS A total of 27 wounds (19 hard-to-heal and eight acute wounds) with a mean wound area of 15cm2 and a mean wound age of 49 months were treated with CAP and analysed. All (100%) of the acute wounds and 68% of the hard-to-heal wounds healed after an average treatment duration of 14.2 weeks. At the end of the observation period, 21% of hard-to-heal wounds were not yet closed but were reduced in size by >80%. In 11% of the hard-to-heal wounds (n=2) therapy failed. CONCLUSION The results suggested a beneficial effect of additional CAP therapy on wound healing. DECLARATION OF INTEREST This work was carried out within the research projects 'Plasma for Life' (funding reference no. 13FH6I04IA) with financial support from the German Federal Ministry of Education and Research (BMBF). In the past seven years AFS has provided consulting services to Evonik and has received institutional support by Heraeus, Johnson & Johnson and Evonik. There are no royalties to disclose. The Department for Trauma Surgery, Orthopaedics and Plastic Surgery received charitable donations by CINOGY GmbH. CINOGY GmbH released the di_CAP devices and electrodes for the study. WV and AH were involved in the development of the used di_CAP device (Plasmaderm, CINOGY GmbH). WV is shareholder of the outsourced start-up company CINOGY GmbH.
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Affiliation(s)
- Jennifer Ernst
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Murat Tanyeli
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Thomas Borchardt
- Department of Sciences and Technology, University of Applied Sciences and Arts, Goettingen, Germany
| | - Moses Ojugo
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Andreas Helmke
- Department of Sciences and Technology, University of Applied Sciences and Arts, Goettingen, Germany.,Application Center for Plasma and Photonic, Fraunhofer Institute for Surface Engineering and Thin Films IST, Goettingen, Germany
| | - Wolfgang Viöl
- Department of Sciences and Technology, University of Applied Sciences and Arts, Goettingen, Germany.,Application Center for Plasma and Photonic, Fraunhofer Institute for Surface Engineering and Thin Films IST, Goettingen, Germany
| | - Arndt F Schilling
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
| | - Gunther Felmerer
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen, Georg-August-University, Goettingen, Germany
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Zhai S, Xu M, Li Q, Guo K, Chen H, Kong MG, Xia Y. Successful Treatment of Vitiligo with Cold Atmospheric Plasma‒Activated Hydrogel. J Invest Dermatol 2021; 141:2710-2719.e6. [PMID: 34029575 DOI: 10.1016/j.jid.2021.04.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022]
Abstract
Vitiligo shows insufficient response to current therapies largely owing to T-lymphocyte dysfunction, abnormal inflammatory activation, and excessive oxidative stress in lesions. Cold atmospheric plasma (CAP) possesses pleiotropic antioxidant and anti-inflammatory properties and may offer an improvement to current treatment options. In this study, the efficacy and safety of CAP were investigated in a mouse model of vitiligo and a randomized and controlled trial of patients with active focal vitiligo. Skin biopsies showed that topical treatment of vitiligo-like lesions on mouse dorsal skin by CAP restored the distribution of melanin. In addition, CAP treatment reduced the infiltration of CD11c+ dendritic cells, CD3+ T cells, and CD8+ T cells; inhibited the release of CXCL10 and cytokine IFN-γ; and enhanced cellular resistance to oxidative stress and excessive immune response by enhancing the expression of the transcription factor NRF2 and attenuating the activity of inducible nitric oxide synthase. In a randomized and controlled trial, CAP treatment achieved partial and complete repigmentation in 80% and 20% of vitiligo lesions, respectively, without hyperpigmentation in surrounding areas or other adverse events during the treatment period and its follow-up period. In conclusion, CAP offers a promising option for the management of vitiligo.
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Affiliation(s)
- Siyue Zhai
- Department of Dermatology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China; Center of Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - Meifeng Xu
- Department of Dermatology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qiaosong Li
- Center of Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China; School of Electrical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Kun Guo
- Department of Dermatology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Hailan Chen
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, Virginia, USA
| | - Michael G Kong
- Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, Virginia, USA; Department of Electrical & Computer Engineering, Batten College of Engineering and Technology, Old Dominion University, Norfolk, Virginia, USA
| | - Yumin Xia
- Department of Dermatology, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
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41
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Arndt S, Unger P, Bosserhoff AK, Berneburg M, Karrer S. The Anti-Fibrotic Effect of Cold Atmospheric Plasma on Localized Scleroderma In Vitro and In Vivo. Biomedicines 2021; 9:biomedicines9111545. [PMID: 34829774 PMCID: PMC8615017 DOI: 10.3390/biomedicines9111545] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 02/06/2023] Open
Abstract
Cold Atmospheric Plasma (CAP) has shown promising results in the treatment of various skin diseases. The therapeutic effect of CAP on localized scleroderma (LS), however, has not yet been evaluated. We investigated the effects of CAP on LS by comparing human normal fibroblasts (hNF), human TGF-β-activated fibroblasts (hAF), and human localized scleroderma-derived fibroblasts (hLSF) after direct CAP treatment, co-cultured with plasma-treated human epidermal keratinocytes (hEK) and with an experimental murine model of scleroderma. In hAF and hLSF, 2 min CAP treatment with the MicroPlaSterβ® plasma torch did not affect pro-fibrotic gene expression of alpha smooth muscle actin, fibroblast activating protein, and collagen type I, however, it promoted re-expression of matrix metalloproteinase 1. Functionally, CAP treatment reduced cell migration and stress fiber formation in hAF and hLSF. The relevance of CAP treatment was confirmed in an in vivo model of bleomycin-induced dermal fibrosis. In this model, CAP-treated mice showed significantly reduced dermal thickness and collagen deposition as well as a decrease in both alpha smooth muscle actin-positive myofibroblasts and CD68-positive macrophages in the affected skin in comparison to untreated fibrotic tissue. In conclusion, this study provides the first evidence for the successful use of CAP for treating LS and may be the basis for clinical trials including patients with LS.
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Affiliation(s)
- Stephanie Arndt
- Department of Dermatology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany; (P.U.); (M.B.); (S.K.)
- Correspondence: ; Tel.: +49-941-944-9650
| | - Petra Unger
- Department of Dermatology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany; (P.U.); (M.B.); (S.K.)
| | - Anja-Katrin Bosserhoff
- Institute of Biochemistry, University of Erlangen-Nuernberg (FAU), 91054 Erlangen, Germany;
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Mark Berneburg
- Department of Dermatology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany; (P.U.); (M.B.); (S.K.)
| | - Sigrid Karrer
- Department of Dermatology, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany; (P.U.); (M.B.); (S.K.)
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Adachi T. [Molecular Mechanisms Underlying Cellular Responses to the Loading of Non-thermal Atmospheric Pressure Plasma-activated Solutions]. YAKUGAKU ZASSHI 2021; 141:1185-1194. [PMID: 34602515 DOI: 10.1248/yakushi.21-00134] [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: 11/22/2022]
Abstract
Plasma medicine is a rapidly expanding new field of interdisciplinary research that combines physics, chemistry, biology, and medicine. Non-thermal atmospheric pressure plasma (NTAPP) has recently been applied to living cells and tissues, and has emerged as a novel technology for medical applications, such as wound healing, blood coagulation, and cancer treatment. NTAPP was found to affect cells indirectly through the treatment of cells with previously prepared medium irradiated by NTAPP, termed plasma-activated medium (PAM). The treatment of culture media with NTAPP results in the generation of a large amount of reactive oxygen species and reactive nitrogen species, and their derived species. We found that PAM triggered a spiral apoptotic cascade in the mitochondrial-nuclear network in A549 cancer cells. This process induced the depletion of total cellular NAD+ and elevations in intracellular calcium ion, ultimately leading to cell death. We also detected the production of hydroxyl radical and elevations in intracellular ferrous ions in PAM-treated cells. The elevations observed in ferrous ions may have been due to their release from the intracellular iron store, ferritin. However, difficulties are associated with applying PAM to the clinical phase because culture media cannot be used for medical treatments. The anti-tumor activity of plasma-activated Ringer's solution was significantly stronger than that of PAM. At the end, we herein demonstrated the advantages of the combined application of plasma-activated acetate Ringer's solution and hyperthermia, a heat treatment at 42℃, for A549 cancer cell death and elucidated the underlying mechanisms.
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Affiliation(s)
- Tetsuo Adachi
- Laboratory of Clinical Pharmaceutics, Gifu Pharmaceutical University
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43
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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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44
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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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45
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Nam G, Kim M, Jang Y, Cho S. Cold Atmospheric Pressure Microplasma Pipette for Disinfection of Methicillin-Resistant Staphylococcus aureus. MICROMACHINES 2021; 12:1103. [PMID: 34577746 PMCID: PMC8465082 DOI: 10.3390/mi12091103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/20/2022]
Abstract
Microbial infections should be controlled and prevented for successful wound healing and tissue regeneration. Various disinfection methods exist that use antibiotics, ultraviolet (UV), heat, radiation, or chemical disinfectants; however, cold atmospheric pressure plasma has exhibited a unique and effective antibacterial ability that is not affected by antibiotic resistance or pain. This study develops a cold atmospheric pressure microplasma pipette (CAPMP) that outputs an Ar plasma plume through a tube with an inner radius of 180 μm for disinfection in a small area. The CAPMP was evaluated using Staphylococcus aureus and methicillin-resistant Staphylococcus aureus diluted in liquid media, spread on solid agar, or covered by dressing gauze. An increase in the treatment time of CAPMP resulted in a decrease in the number of colonies of the grown microorganism (colony forming unit) and an increase in the disinfected area for both bacteria. The disinfection ability of CAPMP was observed when the bacteria were covered with dressing gauze and was dependent on the number of gauze layers.
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Affiliation(s)
- Geunyoung Nam
- Department of Biomedical Engineering, Gachon Advanced Institute for Health Science & Technology, Gachon University, 191 Hambakmoe-ro, Incheon 21999, Korea;
| | - Muhwan Kim
- Femto Science Inc., 557 Dongtangiheung-ro, Hwaseong-si 18469, Gyeonggi-do, Korea; (M.K.); (Y.J.)
| | - Yeonsook Jang
- Femto Science Inc., 557 Dongtangiheung-ro, Hwaseong-si 18469, Gyeonggi-do, Korea; (M.K.); (Y.J.)
| | - Sungbo Cho
- Department of Biomedical Engineering, Gachon Advanced Institute for Health Science & Technology, Gachon University, 191 Hambakmoe-ro, Incheon 21999, Korea;
- Department of Electronic Engineering, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si 13120, Gyeonggi-do, Korea
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Emmert S, Pantermehl S, Foth A, Waletzko-Hellwig J, Hellwig G, Bader R, Illner S, Grabow N, Bekeschus S, Weltmann KD, Jung O, Boeckmann L. Combining Biocompatible and Biodegradable Scaffolds and Cold Atmospheric Plasma for Chronic Wound Regeneration. Int J Mol Sci 2021; 22:9199. [PMID: 34502107 PMCID: PMC8430875 DOI: 10.3390/ijms22179199] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/04/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022] Open
Abstract
Skin regeneration is a quite complex process. Epidermal differentiation alone takes about 30 days and is highly regulated. Wounds, especially chronic wounds, affect 2% to 3% of the elderly population and comprise a heterogeneous group of diseases. The prevailing reasons to develop skin wounds include venous and/or arterial circulatory disorders, diabetes, or constant pressure to the skin (decubitus). The hallmarks of modern wound treatment include debridement of dead tissue, disinfection, wound dressings that keep the wound moist but still allow air exchange, and compression bandages. Despite all these efforts there is still a huge treatment resistance and wounds will not heal. This calls for new and more efficient treatment options in combination with novel biocompatible skin scaffolds. Cold atmospheric pressure plasma (CAP) is such an innovative addition to the treatment armamentarium. In one CAP application, antimicrobial effects, wound acidification, enhanced microcirculations and cell stimulation can be achieved. It is evident that CAP treatment, in combination with novel bioengineered, biocompatible and biodegradable electrospun scaffolds, has the potential of fostering wound healing by promoting remodeling and epithelialization along such temporarily applied skin replacement scaffolds.
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Affiliation(s)
- Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (S.P.); (A.F.); (O.J.)
| | - Sven Pantermehl
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (S.P.); (A.F.); (O.J.)
| | - Aenne Foth
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (S.P.); (A.F.); (O.J.)
| | - Janine Waletzko-Hellwig
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, 18057 Rostock, Germany;
| | - Georg Hellwig
- Clinic and Policlinic for Orthopedics, University Medical Center Rostock, 18057 Rostock, Germany; (G.H.); (R.B.)
| | - Rainer Bader
- Clinic and Policlinic for Orthopedics, University Medical Center Rostock, 18057 Rostock, Germany; (G.H.); (R.B.)
| | - Sabine Illner
- Institute for Biomedical Engineering, University Medical Center Rostock, 18119 Rostock, Germany; (S.I.); (N.G.)
| | - Niels Grabow
- Institute for Biomedical Engineering, University Medical Center Rostock, 18119 Rostock, Germany; (S.I.); (N.G.)
| | - Sander Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (S.B.); (K.-D.W.)
| | - Klaus-Dieter Weltmann
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), 17489 Greifswald, Germany; (S.B.); (K.-D.W.)
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (S.P.); (A.F.); (O.J.)
| | - Lars Boeckmann
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (S.P.); (A.F.); (O.J.)
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Guo L, Yang L, Qi Y, Niyazi G, Zheng J, Xu R, Chen X, Zhang J, Xi W, Liu D, Wang X, Chen H, Kong MG. Low-Temperature Gas Plasma Combined with Antibiotics for the Reduction of Methicillin-Resistant Staphylococcus aureus Biofilm Both In Vitro and In Vivo. Life (Basel) 2021; 11:life11080828. [PMID: 34440572 PMCID: PMC8400093 DOI: 10.3390/life11080828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 11/23/2022] Open
Abstract
Biofilm infections in wounds seriously delay the healing process, and methicillin-resistant Staphylococcus aureus is a major cause of wound infections. In addition to inactivating micro-organisms, low-temperature gas plasma can restore the sensitivity of pathogenic microbes to antibiotics. However, the combined treatment has not been applied to infectious diseases. In this study, low-temperature gas plasma treatment promoted the effects of different antibiotics on the reduction of S. aureus biofilms in vitro. Low-temperature gas plasma combined with rifampicin also effectively reduced the S. aureus cells in biofilms in the murine wound infection model. The blood and histochemical analysis demonstrated the biosafety of the combined treatment. Our findings demonstrated that low-temperature gas plasma combined with antibiotics is a promising therapeutic strategy for wound infections.
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Affiliation(s)
- Li Guo
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Lu Yang
- School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (L.Y.); (G.N.); (R.X.)
| | - Yu Qi
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Gulimire Niyazi
- School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (L.Y.); (G.N.); (R.X.)
| | - Jianbao Zheng
- Department of General Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
- Correspondence: author: (J.Z.); (D.L.); (M.G.K.)
| | - Ruobing Xu
- School of Life Science and Technology, Xi’an Jiaotong University, Xi’an 710049, China; (L.Y.); (G.N.); (R.X.)
| | - Xusong Chen
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Jingye Zhang
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Wang Xi
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Dingxin Liu
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
- Correspondence: author: (J.Z.); (D.L.); (M.G.K.)
| | - Xiaohua Wang
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
| | - Hailan Chen
- Frank Reidy Center for Bioelectrics, Old Dominion University, Norfolk, VA 23508, USA;
| | - Michael G. Kong
- Center for Plasma Biomedicine, State Key Laboratory of Electrical Insulation and Power Equipment, Xi’an Jiaotong University, Xi’an 710049, China; (L.G.); (Y.Q.); (X.C.); (J.Z.); (W.X.); (X.W.)
- Frank Reidy Center for Bioelectrics, Old Dominion University, Norfolk, VA 23508, USA;
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
- Correspondence: author: (J.Z.); (D.L.); (M.G.K.)
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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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Rai S, Gupta TP, Shaki O, Kale A. Hydrogen Peroxide: Its Use in an Extensive Acute Wound to Promote Wound Granulation and Infection Control - Is it Better Than Normal Saline? INT J LOW EXTR WOUND 2021:15347346211032555. [PMID: 34338578 DOI: 10.1177/15347346211032555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Hydrogen peroxide (H2O2) is used as a topical antiseptic in contaminated wounds caused by road traffic accidents. It kills bacteria by producing oxidation through local, nascent, free oxygen radicals. It also removes dirt from the wound due to its frothing action. H2O2 is synthesized by various cells as an active biochemical agent that affects cell biological behavior through complex chemical reactions. H2O2 has also been used as a wound cleaning agent, removing debris, preventing infection, and causing hemostasis due to its exothermic reaction with blood. Despite its widespread use, there is scanty literature on its use to promote granulation tissue formation. Objective: In the orthopaedics literature, studies on H2O2 use are very limited and its potential is underestimated. In the present study, we would like to report our protocol of use of H2O2 for its tremendous potential for stimulating granulation and early wound healing. Material and Methods: A total of 53 patients with large acute extensive lower limb contaminated wounds reported to the emergency department have been included with and without lower limb fracture. In group A (43 patients) wound management was done using 7% H2O2 and group B (10 patients) was treated by only saline dressing as a control group. Results: In the present study, daily dressing by 7% H2O2 solution and provide solution gives excellent results compared to the Saline group. Granulation tissue appeared much earlier with a mean SD 6.3 ± 6.8 days in the hydrogen peroxide group as compared to the Saline group where granulation tissue appeared in 9.3 ± 8.4 days. Conclusion: Spontaneous wound healing is a controlled balance between destructive and healing processes. It is mandatory to remove damaged tissue to promote healing by secondary intention and minimize infection. The dynamic effect of H2O2 promotes faster healing, stimulates granulation, and minimizes infection by oxidative stress.
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Affiliation(s)
- Sanjay Rai
- Base Hospital Guwahati, Basistha Guwahati, India
| | | | - Omna Shaki
- Base Hospital Guwahati, Basistha Guwahati, India
| | - Amit Kale
- Base Hospital Guwahati, Basistha Guwahati, India
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He Z, Xu Q, Newland B, Foley R, Lara-Sáez I, Curtin JF, Wang W. Reactive oxygen species (ROS): utilizing injectable antioxidative hydrogels and ROS-producing therapies to manage the double-edged sword. J Mater Chem B 2021; 9:6326-6346. [PMID: 34304256 DOI: 10.1039/d1tb00728a] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Reactive oxygen species (ROS) are generated in cellular metabolism and are essential for cellular signalling networks and physiological functions. However, the functions of ROS are 'double-edged swords' to living systems that have a fragile redox balance between ROS generation and elimination. A modest increase of ROS leads to enhanced cell proliferation, survival and benign immune responses, whereas ROS stress that overwhelms the cellular antioxidant capacity can damage nucleic acids, proteins and lipids, resulting in oncogenic mutations and cell death. ROS are therefore involved in many pathological conditions. On the other hand, ROS present selective toxicity and have been utilised against cancer and pathogens, thus also acting as a double-edged sword in the healthcare field. Injectable antioxidative hydrogels are gel precursors that form hydrogel constructs in situ upon delivery in vivo to maintain an antioxidative capacity. These hydrogels have been developed to counter ROS-induced pathological conditions, with significant advantages of biocompatibility, excellent moldability, and minimally invasive delivery. The intrinsic, readily controllable ROS-scavenging ability of the functionalised hydrogels overcomes many drawbacks of small molecule antioxidants. This review summarises the roles of ROS under pathological conditions and describes the state-of-the-art of injectable antioxidative hydrogels. A particular emphasis is also given to current ROS-producing therapeutic interventions, enabling potential application of injectable antioxidant hydrogels to prevent the adverse effects of many cancer and infection treatments.
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Affiliation(s)
- Zhonglei He
- Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland.
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