Inactivation of a foodborne norovirus outbreak strain with nonthermal atmospheric pressure plasma

In Vitro Antiviral and Virucidal Activity of Ozone against Feline Calicivirus

The Caliciviridae family includes several viral pathogens of humans and animals, including norovirus (NoV), genus Norovirus, and feline calicivirus (FCV), genus Vesivirus. Due to their resistance in the environment, NoV and FCV may give rise to nosocomial infections, and indirect transmission plays a major role in their diffusion in susceptible populations. A pillar of the control of viruses resistant to an environment is the adoption of prophylaR1.6ctic measures, including disinfection. Since NoVs are not cultivatable in common cell cultures, FCV has been largely used as a surrogate of NoV for the assessment of effective disinfectants. Ozone (O3), a molecule with strong oxidizing properties, has shown strong microbicidal activity on bacteria, fungi, protozoa, and viruses. In this study, the virucidal and antiviral activities of an O3/O2 gas mixture containing O3 were tested at different concentrations (20, 35, and 50 μg/mL) for distinct contact times against FCV. The O3/O2 gas mixture showed virucidal and antiviral activities against FCV in a dose- and contact time-dependent fashion. Ozonation could be considered as a valid strategy for the disinfection of environments at risk of contamination by FCV and NoV.

Inactivation of Human Norovirus GII.4's Infectivity in Fresh Oysters (Crassostrea gigas) through Thermal Treatment in Association with Propidium Monoazide

The current study investigated the effects of heat treatment (85 °C or 100 °C for 5-20 min) on human norovirus (HuNoV) GII.4's capsid stability in fresh oysters. In addition, propidium monoazide (PMA) was used in viral samples to distinguish infectious viruses and evaluated using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR). Further, we explored the effect of the heat treatment on oyster quality (Hunter color and hardness). The titer of HuNoV for oysters significantly (p < 0.05) decreased to 0.39-1.32 and 0.93-2.27 log10 copy number/μL in the non-PMA and PMA-treated groups, respectively, after heat treatment. HuNoV in oysters not treated with PMA showed a decrease of <1.5 - log10, whereas in PMA-treated oysters, a decrease of >1 - log10 was observed after treatment at 85 °C for 10 min. Treatments for both 15 min and 20 min at 100 °C showed a >99% log10 reduction using PMA/RT-qPCR. In the Hunter color, an increase in heat temperature and duration was associated with a significant decrease in 'L' (brightness+, darkness-) and an increase in 'a' (redness+, greenness-) and 'b' (yellowness+, blueness-) (p < 0.05). Our findings confirmed that the hardness of oyster meat significantly increased with increasing temperature and time (p < 0.05). This study demonstrated that PMA/RT-qPCR was effective in distinguishing HuNoV viability in heat-treated oysters. The optimal heat treatment for oysters was 10 min at 85 °C and 5 min at 100 °C.

Plasma disinfection procedures for surfaces in emergency service vehicles: a field trial at the German Red Cross

The demand for thorough disinfection within ambulances is essential, given the in-vehicle medical procedures and the potential high risk of infections due to patients' open wounds. One solution that can address this hygiene challenge involves the application of reactive products generated from atmospheric (air) oxygen and water vapor, activated through the use of cold plasma. Cold plasma's charged particles perforate the cell membranes of microorganisms. This process does not work in human cells, as proteins in the form of enzymes within the body break down the cold plasma and protect the cells. The study was done on an ambulance that was contaminated in eight places. Samples were taken from each site, and two surfaces measuring approximately 8 × 8 cm were carefully sealed and marked. These surfaces were deliberately contaminated by applying an Enterococcus faecium suspension of 8.5 × 107 CFU/mL using a sterile cotton swab. It was followed by the disinfection procedure, that was initiated with the PLASMOCAR device. It was positioned on the front workspace and operated for a duration of 30 min, utilizing the vehicle's onboard voltage. Throughout the operation, all doors and windows were closed and the vehicle's air conditioning system remained active. After the completion of the disinfection process, samples were collected from the surfaces for bacterial counts. A reduction of 3.73 log levels in initial bacteria was accomplished within the rescue vehicle for Enterococcus faecium, equivalent to a 10-fourfold reduction in bacteria, eliminating up to 99.99% of the initial microorganisms. This success makes the process well-suited and convenient as an ongoing "background" procedure to enhance the established disinfection procedures. The established disinfection procedures outlined in the hygiene plan must be promptly implemented whenever mechanical surface cleaning is required. The use of PLASMOCAR offers an extra layer of protection and security, significantly decreasing the risk of microorganism transmission through cross-contamination and aerosols. This is a significant benefit for the well-being of both staff and patients.

Manipulation of Oxidative Stress Responses by Non-Thermal Plasma to Treat Herpes Simplex Virus Type 1 Infection and Disease

Herpes simplex virus type 1 (HSV-1) is a contagious pathogen with a large global footprint, due to its ability to cause lifelong infection in patients. Current antiviral therapies are effective in limiting viral replication in the epithelial cells to alleviate clinical symptoms, but ineffective in eliminating latent viral reservoirs in neurons. Much of HSV-1 pathogenesis is dependent on its ability to manipulate oxidative stress responses to craft a cellular environment that favors HSV-1 replication. However, to maintain redox homeostasis and to promote antiviral immune responses, the infected cell can upregulate reactive oxygen and nitrogen species (RONS) while having a tight control on antioxidant concentrations to prevent cellular damage. Non-thermal plasma (NTP), which we propose as a potential therapy alternative directed against HSV-1 infection, is a means to deliver RONS that affect redox homeostasis in the infected cell. This review emphasizes how NTP can be an effective therapy for HSV-1 infections through the direct antiviral activity of RONS and via immunomodulatory changes in the infected cells that will stimulate anti-HSV-1 adaptive immune responses. Overall, NTP application can control HSV-1 replication and address the challenges of latency by decreasing the size of the viral reservoir in the nervous system.

Viral disinfection using nonthermal plasma: A critical review and perspectives on the plasma-catalysis system

The transmission of viral infections via aerosol has become a serious threat to public health. This has produced an ever-increasing demand for effective forms of viral inactivation technology/processes. Plasma technology is rising in popularity and gaining interest for viral disinfection use. Due to its highly effectively disinfection and flexible operation, non-thermal plasma (NTP) is a promising technology in decontaminating bacteria or virus from air or surfaces. This review discusses the fundamentals of non-thermal plasma and the disinfection mechanisms of the biocidal agents produced in plasma, including ultraviolet (UV) photons, reactive oxygen species, and reactive nitrogen species. Perspectives on the role of catalysts and its potential applications in cold plasma disinfection are discussed.

Nitrogen Accumulation in Oyster (Crassostrea gigas) Slurry Exposed to Virucidal Cold Atmospheric Plasma Treatment

Viral contamination of edible bivalves is a major food safety issue. We studied the virucidal effect of a cold atmospheric plasma (CAP) source on two virologically different surrogate viruses [a double-stranded DNA virus (Equid alphaherpesvirus 1, EHV-1), and a single-stranded RNA virus (Bovine coronavirus, BCoV)] suspended in Dulbecco’s Modified Eagle’s Medium (DMEM). A 15 min exposure effectuated a statistically significant immediate reduction in intact BCoV viruses by 2.8 (ozone-dominated plasma, “low power”) or 2.3 log cycles (nitrate-dominated, “high power”) of the initial viral load. The immediate effect of CAP on EHV-1 was less pronounced, with “low power” CAP yielding a 1.4 and “high power” a 1.0 log reduction. We observed a decline in glucose contents in DMEM, which was most probably caused by a Maillard reaction with the amino acids in DMEM. With respect to the application of the virucidal CAP treatment in oyster production, we investigated whether salt water could be sanitized. CAP treatment entailed a significant decline in pH, below the limits acceptable for holding oysters. In oyster slurry (a surrogate for live oysters), CAP exposure resulted in an increase in total nitrogen, and, to a lower extent, in nitrate and nitrite; this was most probably caused by absorption of nitrate from the plasma gas cloud. We could not observe a change in colour, indicative for binding of NO_x to haemocyanin, although this would be a reasonable assumption. Further studies are necessary to explore in which form this additional nitrogen is deposited in oyster flesh.

Effect on healing rates of wounds treated with direct cold atmospheric plasma: a case series

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.

The evaluation of efficacy of atmospheric pressure plasma in diabetic ulcers healing: A randomized clinical trial

The aim of this study is to evaluate the efficacy and safety of cold atmospheric plasma (CAP) as a novel therapy for diabetic foot ulcers. This was an investigator-blinded, randomized controlled trial of 14 weeks (6 weeks of treatment and 8 weeks of follow-up). Twenty patients with diabetic foot ulcers were divided into two groups: the control group receiving standard wound care and the plasma group, which received CAP twice a week for six consecutive weeks in addition to standard wound care. The ulcer size, amount of exudate, and wound grading were determined weekly. Cold plasma was produced by applying a high voltage (4.5 kV) and a high frequency (22 kHz) to helium gas. Exudate from wounds treated with CAP showed a significant reduction in the third week after complete treatment (p = 0.039). The wound grading of the ulcers improved by the sixth week (p = 0.019), and the sizes of ulcers significantly decreased in the plasma group at the end of the treatment period (p = 0.007). In this randomized clinical trial, CAP was an effective treatment option for diabetic foot ulcers in terms of wound surface reduction and antibacterial effects.

Microbial Inactivation and Quality Preservation of Chicken Breast Salad Using Atmospheric Dielectric Barrier Discharge Cold Plasma Treatment

Microbiological safety of ready-to-eat foods is paramount for consumer acceptability. The effects of in-package atmospheric dielectric barrier discharge cold plasma (ADCP) treatment on the microbiological safety and quality of model chicken salad (CS) were investigated in this study. CS, packaged in a commercial polyethylene terephthalate container, was treated with ADCP at 24 kV for 2 min. The inactivation of indigenous mesophilic bacteria, Salmonella, and Tulane virus in CS; growth of indigenous mesophilic bacteria and Salmonella in CS; and quality of CS during storage at 4 °C were then investigated. ADCP inactivated indigenous mesophilic bacteria, Salmonella, and Tulane virus by 1.2 ± 0.3 log CFU/g, 1.0-1.5 ± 0.2 log CFU/g, and 1.0 ± 0.1 log PFU/g, respectively. Furthermore, it effectively retarded the growth of the microorganisms, while not significantly affecting the color of chicken, romaine lettuce, and carrot, and the antioxidant capacity of all vegetables throughout storage at the tested temperatures (p > 0.05). The color, smell, and appearance of all vegetables evaluated on day 0 were not significantly different in the sensory test, regardless of the treatment (p > 0.05). Collectively, ADCP treatment effectively decontaminates packaged CS without altering its quality-related properties.

Assessment of potential infectivity of human norovirus in the traditional Korean salted clam product "Jogaejeotgal" by floating electrode-dielectric barrier discharge plasma

This study investigated the antiviral effects of floating electrode-dielectric barrier discharge (FE-DBD) plasma treatment (1.1 kV, 43 kHz, N₂ 1.5 m/s, 5-30 min) against human norovirus (HuNoV) GII.4 in Jogaejeotgal Infectivity was assessed using real-time quantitative-PCR (RT-qPCR) following treatment of samples with propidium monoazide (PMA) and sodium lauroyl sarcosinate (Sarkosyl). This study also investigated the effects of FE-DBD plasma treatment on Jogaejeotgal quality (assessed using pH value and Hunter colors). Following inoculation, the average titers of HuNoV GII.4 in Jogaejeotgal significantly (P < 0.05) decreased with increases in the FE-DBD plasma treatment time in both the non-PMA-treated and PMA + Sarkosyl-treated samples; in the non-PMA and PMA + Sarkosyl treated Jogaejeotgal, HuNoV GII.4 titers (log₁₀ copy number/µL) were to: 3.16 and 2.95 (5 min), 2.90 and 2.48 (10 min), 2.82 and 2.40 (15 min), 2.58 and 2.26 (20 min), 2.48 and 2.06 (25 min), and 2.23 and 1.91 (30 min), respectively. The average titers of HuNoV demonstrated significant (P < 0.05) reductions of 0.35 log₁₀ (55.3%) in PMA + Sarkosyl-treated samples compared with the non-PMA treated samples following exposure to 5-30 min of FE-DBD plasma. Reductions of >1-log for HuNoV in PMA + Sarkosyl- treated Jogaejeotgal required treatments of FE-DBD of 5-30 min. Using the first order kinetic model (R² = 0.95), GII.4 decimal reduction time (D-value) resulting from FE-DBD plasma was 23.75 min. The pH and Hunter colors ("L", "a", and "b") were not significantly different (P > 0.05) between the untreated and FE-DBD plasma-treated Jogaejeotgal. Based on these results, the PMA + Sarkosyl/RT-qPCR method could be assessing HuNoV viability following 5-30 min treatment of FE-DBD plasma. Furthermore, may be an optimal treatment for Jogaejeotgal without altering the food quality (color and pH).

Inactivation of norovirus by atmospheric pressure plasma jet on salmon sashimi

This study investigated atmospheric pressure plasma (APP) jet, an emerging novel non-thermal technology, for the inactivation of human norovirus (NoV) on salmon sashimi. The influences of the non-thermal plasma on quality attributes of sashimi were also evaluated. Air, O₂, and N₂ (15 L/min) were used to produce the plasma jets. N₂ plasma treatment for 12 min reduced NoV viral load (VL) (initial inoculums of 2.7 × 10⁴ copies/g) by 2.17 × 10⁴ copies/g, while air-based or O₂-based plasma treatment for 9-12 min could reduce the VL to undetectable levels (below 100 copies/g). Under the same operating condition, the air-based or O₂-based plasma treatment might increase slightly TBARS values in sashimi, yet the values (far below 1.0 mg MDA/kg) were within acceptable level for sashimi made with salmon fishes. The APP jets (APPJ) treatments could also retain the pH of sashimi at normal levels (6.29 ~ 6.02) to maintain the quality of salmon sashimi, the color quality of which was not affected evidently. The plasma-induced hardness and springiness changes in salmon sashimi were substantially low. These results suggested APPJ could be implemented as technology for inactivation of food-borne viruses and exhibited a high potential for application in fish sashimi processing, retaining product quality as well.

Inactivation of Pepper Mild Mottle Virus in Water by Cold Atmospheric Plasma

Water scarcity is one of the greatest threats for human survival and quality of life, and this is increasingly contributing to the risk of human, animal and plant infections due to waterborne viruses. Viruses are transmitted through polluted water, where they can survive and cause infections even at low concentrations. Plant viruses from the genus Tobamovirus are highly mechanically transmissible, and cause considerable damage to important crops, such as tomato. The release of infective tobamoviruses into environmental waters has been reported, with the consequent risk for arid regions, where these waters are used for irrigation. Virus inactivation in water is thus very important and cold atmospheric plasma (CAP) is emerging in this field as an efficient, safe, and sustainable alternative to classic waterborne virus inactivation methods. In the present study we evaluated CAP-mediated inactivation of pepper mild mottle virus (PMMoV) in water samples. PMMoV is a very resilient water-transmissible tobamovirus that can survive transit through the human digestive tract. The efficiency of PMMoV inactivation was characterized for infectivity and virion integrity, and at the genome level, using test plant infectivity assays, transmission electron microscopy, and molecular methods, respectively. Additionally, the safety of CAP treatment was determined by testing the cytotoxic and genotoxic properties of CAP-treated water on the HepG2 cell line. 5-min treatment with CAP was sufficient to inactivate PMMoV without introducing any cytotoxic or genotoxic effects in the in-vitro cell model system. These data on inactivation of such stable waterborne virus, PMMoV, will encourage further examination of CAP as an alternative for treatment of potable and irrigation waters, and even for other water sources, with emphasis on inactivation of various viruses including enteric viruses.

Virucidal Effects of Dielectric Barrier Discharge Plasma on Human Norovirus Infectivity in Fresh Oysters (Crassostrea gigas)

This study investigates the effects of dielectric barrier discharge (DBD) plasma treatment (1.1 kV, 43 kHz, N2 1.5 L/min, 10~60 min) on human norovirus (HuNoV) GII.4 infectivity in fresh oysters. HuNoV viability in oysters was assessed by using propidium monoazide (PMA) as a nucleic acid intercalating dye before performing a real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Additionally, the impact of the DBD plasma treatment on pH and Hunter colors was assessed. When DBD plasma was treated for 60 min, the HuNoV genomic titer reduction without PMA pretreatment was negligible (<1 log copy number/µL), whereas when PMA treatment was used, HuNoV titer was reduced to >1 log copy number/µL in just 30 min. D1 and D2-value of HuNoV infectivity were calculated as 36.5 and 73.0 min of the DBD plasma treatment, respectively, using the first-order kinetics model (R2 = 0.98). The pH and Hunter colors were not significantly different (p > 0.05) between the untreated and DBD-plasma-treated oysters. The results suggest that PMA/RT-qPCR could help distinguish HuNoV infectivity without negatively affecting oyster quality following >30 min treatment with DBD plasma. Moreover, the inactivation kinetics of nonthermal DBD plasma against HuNoV in fresh oysters might provide basic information for oyster processing and distribution.

Foodborne Viruses and Innovative Non-Thermal Food-Processing Technologies

In recent years, several foodborne viruses' outbreaks have been recorded worldwide. Μost of the foodborne viruses have a low infection dose, are stable and can persist and survive in foods for a long time without loss of infectivity. The most important foodborne viruses are: human norovirus (HuNoV), human rotavirus (HRV), hepatitis A virus (HAV), hepatitis E virus (HEV), human astrovirus (HAstV), Aichi virus (AiV), sapovirus (SaV), human adenovirus (HAdV) and enterovirus (EV). In recent years, innovative non-thermal food-processing technologies including high-pressure processing (HPP), cold plasma (CP), ultraviolet light (UV), irradiation and pulsed electric field (PEF) for improving the quality and safety of foods, including foods of animal origin, have been under research. This review presents the recent data on foodborne viruses and reviews the innovative non-thermal technologies for the control of the foodborne viruses in foods.

Nonthermal plasma as part of a novel strategy for vaccination

Vaccination has been one of the most effective health intervention mechanisms to reduce morbidity and mortality associated with infectious diseases. Vaccines stimulate the body's protective immune responses through controlled exposure to modified versions of pathogens that establish immunological memory. However, only a few diseases have effective vaccines. The biological effects of nonthermal plasma on cells suggest that plasma could play an important role in improving efficacy of existing vaccines and overcoming some of the limitations and challenges with current vaccination strategies. This review summarizes the opportunities for nonthermal plasma for immunization and therapeutic purposes.

Evaluation of In-Package Atmospheric Dielectric Barrier Discharge Cold Plasma Treatment as an Intervention Technology for Decontaminating Bulk Ready-To-Eat Chicken Breast Cubes in Plastic Containers

This article evaluates the effects of in-package atmospheric dielectric barrier discharge cold plasma (ADCP) treatment on microbial inactivation, nitrate and nitrite contents, oral toxicity, and storage quality of protein-coated boiled chicken breast cubes (CBCs). ADCP treatment at 24 kV for 3 min inactivated natural mesophilic aerobic bacteria, Salmonella, and Tulane virus in CBCs by 0.7 ± 0.2, 1.4 ± 0.1 log CFU/cube, and 1.1 ± 0.2 log PFU/cube, respectively. ADCP treatment did not affect the nitrite content of CBCs (p > 0.05). Furthermore, the hematological and blood biochemical parameters from toxicity tests indicated the toxicological safety of ADCP-treated CBCs. Microbial counts of natural bacteria and Salmonella in ADCP-treated CBCs were lower than the ADCP-untreated CBCs by 0.7–0.9 and 1.4–1.7 log CFU/cube, respectively, throughout post-treatment storage at 4 °C for 21 d. ADCP treatment did not alter the pH, color, total volatile basic nitrogen, lipid oxidation, and tenderness of CBCs during storage at 4 and 24 °C, and did not change the sensory properties of CBCs following a 3 d storage period at 4 °C (p > 0.05). Thus, ADCP treatment has the potential to be applied as a method to increase the microbiological safety of packaged ready-to-eat chicken products, leading to overall toxicological safety.

The Efficiency of Atmospheric Dielectric Barrier Discharge Plasma against Escherichia coli and Bacillus cereus on Dried Laver (Porphyra tenera)

This study investigated the effects of atmospheric dielectric barrier discharge (DBD) plasma (1.1 kV, 43 kHz, 5–30 min, N₂: 1.5 L/m) on the reduction of Escherichia coli and Bacillus cereus on dried laver. The reductions of E. coli and B. cereus by 5, 10, 20, and 30 min of DBD plasma were 0.56 and 0.24, 0.61 and 0.66, 0.76 and 1.24, and 1.02 and 1.38 log CFU/g, respectively. The D-value of E. coli and B. cereus was predicted as 29.80 and 20.53 min, respectively, using the Weibull model for E. coli (R² = 0.95) and first-order kinetics for B. cereus (R² = 0.94). After DBD plasma 5–30 min treatment, there was no change in pH (6.20–6.21) and this value was higher than the untreated dried laver (6.08). All sensory scores in DBD plasma-treated laver were determined as >6 points. The 30 min of DBD plasma is regarded as a novel intervention for the control of potential hazardous bacteria in dried laver.

Factors influencing the antimicrobial efficacy of Dielectric Barrier Discharge (DBD) Atmospheric Cold Plasma (ACP) in food processing applications

Atmospheric cold plasma (ACP) is an emerging technology in the food industry with a huge antimicrobial potential to improve safety and extend the shelf life of food products. Dielectric barrier discharge (DBD) is a popular approach for generating ACP. Thanks to the numerous advantages of DBD ACP, it is proving to be successful in a number of applications, including microbial decontamination of foods. The antimicrobial efficacy of DBD ACP is influenced by multiple factors. This review presents an overview of ACP sources, with an emphasis on DBD, and an analysis of their antimicrobial efficacy in foods in open atmosphere and in-package modes. Specifically, the influence of process, product, and microbiological factors influencing the antimicrobial efficacy of DBD ACP are critically reviewed. DBD ACP is a promising technology that can improve food safety with minimal impact on food quality under optimal conditions. Once the issues pertinent to scale-up of plasma sources are appropriately addressed, the DBD ACP technology will find wider adaptation in food industry.

Ìn situ inactivation of human norovirus GII.4 by cold plasma: Ethidium monoazide (EMA)-coupled RT-qPCR underestimates virus reduction and fecal material suppresses inactivation

Cold atmospheric-gaseous plasma (CAP) is an emerging non-thermal technology for decontamination of foodborne bacterial and viral pathogens. We obtained a >5 log10 reduction in the titer (TCID50) of feline calicivirus (FCV) on stainless steel discs and Romaine lettuce leaves after 3 min wet exposure to air plasma generated by a two-dimensional array of integrated coaxial-microhollow dielectric barrier discharge (2D-AICM-DBD). However, when human norovirus (HuNoV GII.4) was treated for 5 min under the same conditions, ~2.6 log10 (>99.5%) reduction in genome copy number was observed as measured by ethidium monoazide-coupled RT-qPCR (EMA-RT-qPCR). To assess this discrepancy, we studied CAP's effect on FCV by the cell culture method and by the EMA-coupled RT-qPCR method. It was found that the molecular titration method (EMA-RT-qPCR) underestimates the level of virus reduction by CAP. Additionally, the fecal matter present in HuNoV samples partially suppressed virucidal activity of CAP. Assuming that the lower virus reduction measured by EMA-RT-qPCR method compared to cell culture method for FCV is the same as for HuNoV, we can conclude that FCV may be used as a surrogate for HuNoV to assess the virucidal effect of CAP. CAP is able to inactivate 3.5 Log10 units of HuNoV at low titers after 2 min of exposure.

Cold atmospheric plasma as antiviral therapy - effect on human herpes simplex virus type 1

In previous studies, cold atmospheric plasma (CAP) was explored as an antibacterial and antiviral agent for the treatment of chronic wounds. The aim of the present study was to investigate whether CAP may also be suitable as an antiviral therapy against herpes simplex virus type 1 (HSV-1). HSV-1 most frequently manifests as recurrent herpes labialis, but it can also cause encephalitis, conjunctivitis or herpes neonatorum as a perinatal infection. HSV-1 encoding the reporter gene GFP was propagated. The CAP dose for HSV-1 treatment was gradually increased, ranging from 0-150 s, and aciclovir was used as a positive control. After CAP treatment, the virus suspension was applied to a standard HSV research cell line (Vero cells) and the neuroblastoma cell line SH-SY5Y as a model for neuronal infection. The results showed that plasma treatment had a negligible antiviral effect on HSV-1 in both Vero- and SH-SY5Y cells at high dose. However, when we lowered the viral load 100-fold, we observed a significantly decreased number of internalized HSV-1 genomes 3 h post-infection for CAP-treated viruses. This difference was less pronounced with respect to GFP expression levels 24 h post-infection, which was in sharp contrast to the acyclovir-treated positive control, for which the viral load was reduced from 95 to 25%. In summary, we observed a low but measurable antiviral effect of CAP on HSV-1.

Medical applications of cold atmospheric plasma: state of the science

Cold atmospheric plasmas (CAP) have been used in multiple medical fields and have become a promising medical technology. CAP-generating devices are safe and easy to operate and can now be manufactured at a low cost due to advancements in electronics and microchips. A primary application of CAP is as a broad-spectrum antimicrobial technology. With the high incidence of infections caused by drug-resistant microorganisms, a non-antibiotic based treatment modality such as CAP holds great therapeutic promise, particularly in the wound care field. In addition to its antimicrobial properties, CAP treatment enhances wound healing by increasing cutaneous microcirculation, monocyte stimulation, and keratinocyte proliferation. CAP has been used by dentists for disinfection of teeth, enhancing gingival fibroblast activity, and even teeth whitening. CAP can combat tumour growth by increasing the efficacy of antitumour therapeutic agents, reactivating apoptotic pathways, or down-regulating growth-related gene sites. Most of the health-care related research on CAP has occurred in the past 15 years; the field is relatively young and needs additional research, as well as confirmation of the existing supporting literature. The purpose of this report is to provide the reader with an overview of the therapeutic application of the cold plasma technology.

The State of Research on Antimicrobial Activity of Cold Plasma

Microbiological contamination is a big challenge to the food industry, medicine, agriculture, and environmental protection. For this reason, scientists are constantly looking for alternative methods of decontamination, which ensure the effective elimination of unwanted biological agents. Cold plasma is a new technology, which due to its unique physical and chemical properties becomes a point of interest to a growing group of researchers. The previously conducted experiments confirm its effective action, e.g. in the disinfection of skin wounds, air, and sewage treatment, as well as in food preservation and decontamination. The reactive compounds present in the plasma: high-energy electrons, ionized atoms and molecules, and UV photons are the key factors that cause an effective reduction in the number of microorganisms. The mechanism and effectiveness of the cold plasma are complex and depend on the process parameters, environmental factors and the type and properties of the microorganisms that are to be killed. This review describes the current state of knowledge regarding the effectiveness of the cold plasma and characterizes its interaction with various groups of microorganisms based on the available literature data.

Effect of cold atmospheric plasma (CAP) on human adenoviruses is adenovirus type-dependent

More than 70 human adenovirus types were identified divided into 7 different species (A-G). Diseases caused by human adenoviruses are type-dependent and can range from mild to severe respiratory infections, gastrointestinal infections or eye infections such as epidemic keratoconjunctivitis. Unfortunately there is no specific anti-adenovirus therapy available. Here we addressed the question whether treatment with cold atmospheric plasma (CAP) for anti-adenoviral therapy such as virus-mediated ulcerations may be feasible. CAP has already been explored for the treatment of dermatological diseases such as chronic wounds. To investigate whether CAP is an effective antiviral tool, purified human adenovirus types derived from different human adenovirus species (HAdV -4, -5, -20, -35, -37, -50) tagged with luciferase were treated with defined dosages of plasma. The CAP treatment was varied by incrementally increasing the time span of CAP treatment. After CAP treatment, the virus containing solution was added to eukaryotic cells and the viral load was determined by measurement of luciferase expression levels. Through the plasma treatment the adenovirus driven luciferase expression directly correlating with adenovirus transduction efficiencies could be reduced for HAdV-5 and HAdV-37. Plasma treatment had no influence on adenovirus derived luciferase expression levels for HAdV-4 and HAdV-50 and it even had a positive effect on luciferase expression levels for HAdV-20 and HAdV-35. These results suggest that CAP has a type dependent effect on adenoviruses and that infectivity can be even increased for certain adenovirus types. Further studies should address the mechanisms behind this phenomenon. In summary we demonstrate that CAP may represent an interesting option for antiviral treatment in a virus type dependent manner.

Norovirus: The Burden of the Unknown

Human noroviruses (HNoVs) are primarily transmitted by the fecal-oral route, either by person-to-person contact, or by ingestion of contaminated food or water as well as by aerosolization. Moreover, HNoVs significantly contribute to foodborne diseases being the causative agent of one-fifth of acute gastroenteritis worldwide. As a consequence of globalization, transnational outbreaks of foodborne infections are reported with increasing frequency. Therefore, in this review, state-of-the-art information regarding molecular procedures for human norovirus detection in food as well common food processing technologies have been summarized. Besides, the purpose of this chapter is to consolidate basic information on various aspects of HNoVs and to summarize food processing technologies that can potentially be applied in the food industry.

In vivo study of non-invasive effects of non-thermal plasma in pressure ulcer treatment

According to high incidence and prevalence of pressure ulcers worldwide, the purpose of this study is using of non-thermal atmospheric plasma as a novel therapy for pressure ulcers. Cold plasma was produced by applying a high-voltage (5 kV) and high-frequency (25 kHz), to helium gas. Under general anesthesia and sterile conditions, two circular magnets were used to create pressure ulcers on the dorsal skin of adult rats. The wounds were divided randomly into control and plasma-treated groups. Animals in the plasma-treated group received plasma radiation for 5 days, each day 3 times and every time 60 s. Mechanical assays were performed to determine plasma effects on the mechanical strength of the repaired tissue. The results showed that mechanical strength of repaired wound in the plasma-treated group was significantly higher than that in the control group (p < 0.05). In addition, evidence from histological studies indicates a significantly accelerated wound re-epithelialization in comparison with the control group; angiogenesis and fibrosis (collagen synthesis) were also significantly increased and the inflammation phase of wound healing was shorter in the plasma-treated group. The plasma treatment also resulted in significant wound contraction and acceleration of wound healing. The findings of present study indicate the effects of cold plasma on pressure ulcer treatment.

Cold argon-oxygen plasma species oxidize and disintegrate capsid protein of feline calicivirus

Possible mechanisms that lead to inactivation of feline calicivirus (FCV) by cold atmospheric-pressure plasma (CAP) generated in 99% argon-1% O₂ admixture were studied. We evaluated the impact of CAP exposure on the FCV viral capsid protein and RNA employing several cultural, molecular, proteomic and morphologic characteristics techniques. In the case of long exposure (2 min) to CAP, the reactive species of CAP strongly oxidized the major domains of the viral capsid protein (VP1) leading to disintegration of a majority of viral capsids. In the case of short exposure (15 s), some of the virus particles retained their capsid structure undamaged but failed to infect the host cells in vitro. In the latter virus particles, CAP exposure led to the oxidation of specific amino acids located in functional peptide residues in the P2 subdomain of the protrusion (P) domain, the dimeric interface region of VP1 dimers, and the movable hinge region linking the S and P domains. These regions of the capsid are known to play an essential role in the attachment and entry of the virus to the host cell. These observations suggest that the oxidative effect of CAP species inactivates the virus by hindering virus attachment and entry into the host cell. Furthermore, we found that the oxidative impact of plasma species led to oxidation and damage of viral RNA once it becomes unpacked due to capsid destruction. The latter effect most likely plays a secondary role in virus inactivation since the intact FCV genome is infectious even after damage to the capsid.

Effect of direct cold atmospheric plasma (diCAP) on microcirculation of intact skin in a controlled mechanical environment

OBJECTIVE

The microcirculatory response of intact human skin to exposure with diCAP for different durations with a focus on the effect of implied mechanical pressure during plasma treatment was investigated.

METHODS

Local relative hemoglobin, blood flow velocity, tissue oxygen saturation, and blood flow were monitored noninvasively for up to 1 hour in 1-2 mm depth by optical techniques, as well as temperature, pH values, and moisture before and after skin stimulation. The experimental protocol (N = 10) was set up to differentiate between pressure- and plasma-induced effects.

RESULTS

Significant increases in microcirculation were only observed after plasma stimulation but not after pressure stimulus alone. For a period of 1 h after stimulation, local relative hemoglobin was increased by 5.1% after 270 seconds diCAP treatment. Tissue oxygen saturation increased by up to 9.4%, whereas blood flow was doubled (+106%). Skin pH decreased by 0.3 after 180 seconds and 270 seconds diCAP treatment, whereas skin temperature and moisture were not affected.

CONCLUSIONS

diCAP treatment of intact skin notably enhances microcirculation for a therapeutically relevant period. This effect is specific to the plasma treatment and not an effect of the applied pressure. Prolonged treatment durations lead to more pronounced effects.

Microbiological interactions with cold plasma

There is a diverse range of microbiological challenges facing the food, healthcare and clinical sectors. The increasing and pervasive resistance to broad-spectrum antibiotics and health-related concerns with many biocidal agents drives research for novel and complementary antimicrobial approaches. Biofilms display increased mechanical and antimicrobial stability and are the subject of extensive research. Cold plasmas (CP) have rapidly evolved as a technology for microbial decontamination, wound healing and cancer treatment, owing to the chemical and bio-active radicals generated known collectively as reactive oxygen and nitrogen species. This review outlines the basics of CP technology and discusses the interactions with a range of microbiological targets. Advances in mechanistic insights are presented and applications to food and clinical issues are discussed. The possibility of tailoring CP to control specific microbiological challenges is apparent. This review focuses on microbiological issues in relation to food- and healthcare-associated human infections, the role of CP in their elimination and the current status of plasma mechanisms of action.

A review on microbiological decontamination of fresh produce with nonthermal plasma

Food safety is a critical public health issue for consumers and the food industry because microbiological contamination of food causes considerable social and economic burdens on health care. Most foodborne illness comes from animal production, but as of the mid-1990s in the United States and more recently in the European Union, the contribution of fresh produce to foodborne outbreaks has rapidly increased. Recent studies have suggested that sterilization with nonthermal plasma could be a viable alternative to the traditional methods for the decontamination of heat-sensitive materials or food because this technique proves capable of eliminating micro-organisms on surfaces without altering the substrate. In the last 10 years, researchers have used nonthermal plasma in a variety of food inoculated with many bacterial species. All of these experiments were conducted exclusively in a laboratory and, to our knowledge, this technique has not been used in an industrial setting. Thus, the purpose of this review is to understand whether this technology could be used at the industrial level. The latest researches using nonthermal plasma on fresh produce were analysed. These evaluations have focused on the log reduction of micro-organisms and the treatment time.

Liver Hemostasis by Using Cold Plasma

Surgical resection is associated with blood loss and bacterial infections. The aim of this study was to evaluate the effectiveness of cold plasma treatment during liver resection. Thirty adult male Wistar rats were divided randomly into 2 groups. Group I was the control group—intact animals (5 in total). The second group (25 in total)—experimental animals—had atypical resection of the left lobe of the liver with subsequent coagulation by “nonequilibrium” plasma. Histological tissue samples, biochemical blood indices, and hemocoagulation parameters were investigated on 3, 5, 7, 14, and 30 days after plasma treatment. The sterilization test was made to investigate the plasma bactericidal effects. Cessation of bleeding took less than 1 minute. Blood loss was negligible. Morphometric analysis of the liver revealed increased number of hepatocytes with signs of dystrophy after surgical intervention, which returned to the baseline values after 30 days. Biochemical blood parameters revealed significant differences in the groups only in terms of glucose ( P < .05); other parameters remained unchanged. High sterilization efficiency of cold plasma is confirmed. These results demonstrate the high efficiency of cold plasma treatment during surgical interventions.

An Atmospheric Pressure Plasma Setup to Investigate the Reactive Species Formation

Non-thermal atmospheric pressure ('cold') plasmas have received increased attention in recent years due to their significant biomedical potential. The reactions of cold plasma with the surrounding atmosphere yield a variety of reactive species, which can define its effectiveness. While efficient development of cold plasma therapy requires kinetic models, model benchmarking needs empirical data. Experimental studies of the source of reactive species detected in aqueous solutions exposed to plasma are still scarce. Biomedical plasma is often operated with He or Ar feed gas, and a specific interest lies in investigation of the reactive species generated by plasma with various gas admixtures (O₂, N₂, air, H₂O vapor, etc.) Such investigations are very complex due to difficulties in controlling the ambient atmosphere in contact with the plasma effluent. In this work, we addressed common issues of 'high' voltage kHz frequency driven plasma jet experimental studies. A reactor was developed allowing the exclusion of ambient atmosphere from the plasma-liquid system. The system thus comprised the feed gas with admixtures and the components of the liquid sample. This controlled atmosphere allowed the investigation of the source of the reactive oxygen species induced in aqueous solutions by He-water vapor plasma. The use of isotopically labelled water allowed distinguishing between the species originating in the gas phase and those formed in the liquid. The plasma equipment was contained inside a Faraday cage to eliminate possible influence of any external field. The setup is versatile and can aid in further understanding the cold plasma-liquid interactions chemistry.

Cold Atmospheric Plasma Inhibits HIV-1 Replication in Macrophages by Targeting Both the Virus and the Cells

Cold atmospheric plasma (CAP) is a specific type of partially ionized gas that is less than 104°F at the point of application. It was recently shown that CAP can be used for decontamination and sterilization, as well as anti-cancer treatment. Here, we investigated the effects of CAP on HIV-1 replication in monocyte-derived macrophages (MDM). We demonstrate that pre-treatment of MDM with CAP reduced levels of CD4 and CCR5, inhibiting virus-cell fusion, viral reverse transcription and integration. In addition, CAP pre-treatment affected cellular factors required for post-entry events, as replication of VSV-G-pseudotyped HIV-1, which by-passes HIV receptor-mediated fusion at the plasma membrane during entry, was also inhibited. Interestingly, virus particles produced by CAP-treated cells had reduced infectivity, suggesting that the inhibitory effect of CAP extended to the second cycle of infection. These results demonstrate that anti-HIV activity of CAP involves the effects on target cells and the virus, and suggest that CAP may be considered for potential application as an anti-HIV treatment.

[Plasma medicine in dermatology: Mechanisms of action and clinical applications]

Plasma medicine has developed into an innovative field of research showing high potential. Since the establishment of cold atmospheric plasma, new, multifaceted medical treatment opportunities have become available. Within a short time a multidisciplinary special interest group of medical scientists, physicists, and biologists was created, aiming to understand plasma medicine and answer clinical as well as scientific questions. In dermatology, new horizons are being opened for wound healing, tissue regeneration, treatment of skin infections, and tumor therapy. A major task will be the introduction of plasma into clinical medicine and, simultaneously, the further investigation of the mechanisms of action of plasma at the cellular level. Only then can the safety of plasma treatment in patients be assured.

Non-thermal Plasma Exposure Rapidly Attenuates Bacterial AHL-Dependent Quorum Sensing and Virulence

The antimicrobial activity of atmospheric pressure non-thermal plasma has been exhaustively characterised, however elucidation of the interactions between biomolecules produced and utilised by bacteria and short plasma exposures are required for optimisation and clinical translation of cold plasma technology. This study characterizes the effects of non-thermal plasma exposure on acyl homoserine lactone (AHL)-dependent quorum sensing (QS). Plasma exposure of AHLs reduced the ability of such molecules to elicit a QS response in bacterial reporter strains in a dose-dependent manner. Short exposures (30-60 s) produce of a series of secondary compounds capable of eliciting a QS response, followed by the complete loss of AHL-dependent signalling following longer exposures. UPLC-MS analysis confirmed the time-dependent degradation of AHL molecules and their conversion into a series of by-products. FT-IR analysis of plasma-exposed AHLs highlighted the appearance of an OH group. In vivo assessment of the exposure of AHLs to plasma was examined using a standard in vivo model. Lettuce leaves injected with the rhlI/lasI mutant PAO-MW1 alongside plasma treated N-butyryl-homoserine lactone and n-(3-oxo-dodecanoyl)-homoserine lactone, exhibited marked attenuation of virulence. This study highlights the capacity of atmospheric pressure non-thermal plasma to modify and degrade AHL autoinducers thereby attenuating QS-dependent virulence in P. aeruginosa.

The interplay between biological and physical scenarios of bacterial death induced by non-thermal plasma

Direct interactions of plasma matter with living cells and tissues can dramatically affect their functionality, initiating many important effects from cancer elimination to bacteria deactivation. However, the physical mechanisms and biochemical pathways underlying the effects of non-thermal plasma on bacteria and cell fate have still not been fully explored. Here, we report on the molecular mechanisms of non-thermal plasma-induced bacteria inactivation in both Gram-positive and Gram-negative strains. We demonstrate that depending on the exposure time plasma induces either direct physical destruction of bacteria or triggers programmed cell death (PCD) that exhibits characteristic features of apoptosis. The interplay between physical disruption and PCD is on the one hand driven by physical plasma parameters, and on the other hand by biological and physical properties of bacteria. The explored possibilities of the tuneable bacteria deactivation provide a basis for the development of advanced plasma-based therapies. To a great extent, our study opens new possibilities for controlled non-thermal plasma interactions with living systems.

A Gnotobiotic Pig Model for Determining Human Norovirus Inactivation by High-Pressure Processing

Human norovirus (NoV) is responsible for over 90% of outbreaks of acute nonbacterial gastroenteritis worldwide and accounts for 60% of cases of foodborne illness in the United States. Currently, the infectivity of human NoVs is poorly understood due to the lack of a cell culture system. In this study, we determined the survival of a human NoV genogroup II, genotype 4 (GII.4) strain in seeded oyster homogenates after high-pressure processing (HPP) using a novel receptor binding assay and a gnotobiotic pig model. Pressure conditions of 350 MPa at 0°C for 2 min led to a 3.7-log10 reduction in the number of viral RNA copies in oysters, as measured by the porcine gastric mucin-conjugated magnetic bead (PGM-MB) binding assay and real-time RT-PCR, whereas pressure conditions of 350 MPa at 35°C for 2 min achieved only a 1-log10 reduction in the number of RNA copies. Newborn gnotobiotic piglets orally fed oyster homogenate treated at 350 MPa and 0°C for 2 min did not have viral RNA shedding in feces, histologic lesions, or viral replication in the small intestine. In contrast, gnotobiotic piglets fed oysters treated at 350 MPa and 35°C for 2 min had high levels of viral shedding in feces and exhibited significant histologic lesions and viral replication in the small intestine. Collectively, these data demonstrate that (i) human NoV survival estimated by an in vitro PGM-MB virus binding assay is consistent with the infectivity determined by an in vivo gnotobiotic piglet model and (ii) HPP is capable of inactivating a human NoV GII.4 strain at commercially acceptable pressure levels.

Inactivation of murine norovirus-1 and hepatitis A virus on fresh meats by atmospheric pressure plasma jets

In the current study, inactivation effect of atmospheric pressure plasma (APP) jets (10s-20min) was investigated against murine norovirus (MNV-1), as a norovirus (NoV) surrogate and hepatitis A virus (HAV) associated with three types of fresh meats (beef loin, pork shoulder and chicken breast). The quality characteristics of fresh meats, such as surface color, moisture content and thiobarbituric acid reactive substance (TBARS) were also examined. After 5-20min of treatment with APP jets, the reduction in MNV-1 titers (initial inoculums of 10⁷ plaque-forming units (PFU)) were >2log₁₀PFU/mL in the three types of meat. After 5-20min treatment with APP jets, the reduction in HAV titers (initial inoculums of 10⁶PFU) were >1log₁₀PFU/mL in the three types of meat. There was no significant difference (p>0.05) in the L*, a*, and b* values for APP jet treatment times below 5min. Furthermore, there was no significant difference (p>0.05) in the water content (%) value for treatment times under 5min. Although the TBARS values gradually increased with increase in APP jet treatment times, these TBA values were below 1.0mgMA/kg (an indicator of meat rancidity). The results of the current study indicate that 5min of APP jet treatment showed >99% reduction (2log₁₀PFU/mL) of MNV-1 titer and >90% reduction (1log₁₀PFU/mL) of HAV titer without concomitant changes in meat quality; thus, this procedure can be considered in fresh meat production, processing and distribution processes to enhance fresh meat safety.