1
|
Schmidt A, von Woedtke T, Weltmann KD, Bekeschus S. YAP/TAZ, beta-catenin, and TGFb pathway activation in medical plasma-induced wound healing in diabetic mice. J Adv Res 2024:S2090-1232(24)00270-4. [PMID: 38986808 DOI: 10.1016/j.jare.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/15/2024] [Accepted: 07/06/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION Hippo is a signaling pathway that is evolutionarily conserved and plays critical roles in wound healing and tissue regeneration. Disruption of the transcriptional activity of both Hippo-associated factors, the yes-associated protein (YAP), and the transcriptional co-activator with PDZ binding motif (TAZ) has been associated with cardiovascular diseases, fibrosis, and cancer. This makes the Hippo pathway an appealing target for therapeutic interventions. OBJECTIVES Prior research has indicated that medical gas plasma promotes wound healing by delivering a combination of reactive species directly to the affected areas. However, the involvement of YAP/TAZ and other signaling pathways in diabetic wound healing remains unexplored. METHODS To this extent, ear wounds were generated and treated with gas plasma in streptozotocin (STZ)-induced diabetic mice. Transcriptome profiling at two wound healing stages (days 9 and 20 post-wounding) was performed in female and male mice. Additionally, we employed gene and protein expression analyses, utilizing immunohistological and -chemical staining of various targets as well as quantitative PCR and Western blot analysis. RESULTS Gas plasma treatment accelerated healing by increasing re-epithelialization and modifying extracellular matrix components. Transcriptomic profiling charting the major alterations in gene expression following plasma treatment was followed by a validation of several targets using transcriptional and translational quantification as well as localization analyses. CONCLUSION Our study evaluated the cellular regulation of essential targets of the Hippo and related pathways such as YAP/TAZ, β-catenin, tumor growth factor β, and oxidative stress signaling after plasma treatment. The activation of genes, pathways, and their regulators is an attractive therapeutic aim for a therapeutic intervention in dermal skin repair in diabetic diseases using medical gas plasmas.
Collapse
Affiliation(s)
- Anke Schmidt
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany.
| | - Thomas von Woedtke
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; Institute for Hygiene and Environmental Medicine, Greifswald University Medical Center, Sauerbruchstr., 17475 Greifswald, Germany
| | - Klaus-Dieter Weltmann
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP), a member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; Department of Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057 Rostock, Germany.
| |
Collapse
|
2
|
Oliver MA, Hussein LK, Molina EA, Keyloun JW, McKnight SM, Jimenez LM, Moffatt LT, Shupp JW, Carney BC. Cold atmospheric plasma is bactericidal to wound-relevant pathogens and is compatible with burn wound healing. Burns 2024; 50:1192-1212. [PMID: 38262886 DOI: 10.1016/j.burns.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 12/13/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
Burn wound healing can be significantly delayed by infection leading to increased morbidity and hypertrophic scarring. An optimal antimicrobial agent would have the ability to kill bacteria without negatively affecting the host skin cells that are required for healing. Currently available products provide antimicrobial coverage, but may also cause reductions in cell proliferation and migration. Cold atmospheric plasma is a partially ionized gas that can be produced under atmospheric pressure at room temperature. In this study a novel handheld Aceso Plasma Generator was used to produce and test Aceso Cold Plasma (ACP) in vitro and in vivo. ACP showed a potent ability to eliminate bacterial load in vitro for a number of different species. Deep partial-thickness and full-thickness wounds that were treated with ACP after burning, after excision, after autografting, and at days 5, 7, and 9 did not show any negative effects on their wound healing trajectories. On par with in vitro analysis, bioburden was decreased in treated wounds vs. control. In addition, metrics of hypertrophic scar such as dyschromia, elasticity, trans-epidermal water loss (TEWL), and epidermal and dermal thickness were the same between the two treatment groups.It is likely that ACP can be used to mitigate the risk of bacterial infection during the phase of acute burn injury while patients await surgery for definitive closure. It may also be useful in treating wounds with delayed re-epithelialization that are at risk for infection and hypertrophic scarring. A handheld cold plasma device will be useful in treating all manner of wounds and surgical sites in order to decrease bacterial burden in an efficient and highly effective manner without compromising wound healing.
Collapse
Affiliation(s)
- Mary A Oliver
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Lou'ay K Hussein
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Esteban A Molina
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - John W Keyloun
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Sydney M McKnight
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Lesle M Jimenez
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Lauren T Moffatt
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Jeffrey W Shupp
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, United States; Department of Surgery, Georgetown University School of Medicine, Washington, DC, United States; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States
| | - Bonnie C Carney
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, United States; Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC, United States; Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, United States; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, United States.
| |
Collapse
|
3
|
Liu Z, Du X, Xu L, Shi Q, Tang X, Cao Y, Song K. The therapeutic perspective of cold atmospheric plasma in periodontal disease. Oral Dis 2024; 30:938-948. [PMID: 36825384 DOI: 10.1111/odi.14547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES Periodontal disease (PD) is one of the most common infectious diseases with complex inflammatory conditions, having irreversibly destructive impacts on the periodontal supporting tissues. The application of cold atmospheric plasma (CAP) is a promising adjuvant therapy modality for PD. However, the mechanism of CAP in PD treatment is still poorly understood. The review motivates to outline the latest researches concerning the applications of CAP in PD treatment. METHODS We searched CAP-related literature through utilizing the well-established databases of Pubmed, Scopus and Web of Science according to the following keywords related to periodontal disease (periodontal, gingival, gingivitis, gingiva, periodontium, periodontitis). RESULTS A total of 18 concerning original studies were found. These studies could be classified according to three pathophysiological perspectives of PD. The therapeutic mechanisms of CAP may be attributed to the oxidative stress-related cell death of periodontal bacteria, the suppression of periodontal inflammation and pro-inflammatory cytokine secretion, as well as the acceleration of periodontal soft tissue wound healing and hard tissue reconstruction. CONCLUSIONS Cold atmospheric plasma has potential therapeutic effects on PD through three mechanisms: antimicrobial effect, inflammation attenuation, and tissue remodeling. This review hopefully provides a comprehensive perspective into the potential of CAP in PD therapy.
Collapse
Affiliation(s)
- Zhixin Liu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Xijin Du
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Lianyi Xu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Qi Shi
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Xuezhi Tang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Yingguang Cao
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Ke Song
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Prosthodontics and Implantology, School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| |
Collapse
|
4
|
Marx AH, Oltmanns H, Meißner J, Verspohl J, Fuchsluger T, Busse C. Argon cold atmospheric plasma eradicates pathogens in vitro that are commonly associated with canine bacterial keratitis. Front Vet Sci 2024; 10:1320145. [PMID: 38264471 PMCID: PMC10803497 DOI: 10.3389/fvets.2023.1320145] [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: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024] Open
Abstract
Purpose To investigate the antimicrobial effect of cold atmospheric plasma (CAP) on pathogens associated with canine bacterial keratitis. Materials and methods Pseudomonas aeruginosa, Staphylococcus pseudintermedius, and Streptococcus canis strains, which were obtained from dogs with infectious keratitis, were subjected to testing. For each species, four isolates and a reference strain were cultivated on Columbia sheep blood agar and treated with the kiNPen Vet® plasma pen from Neoplas GmbH, Greifswald, Germany. Various continuous treatment durations (0.5, 2, and 5 min) were applied, along with a 0.5-min treatment repeated four times at short intervals. These treatments were conducted at distances of 3 and 18 mm between the agar surface and the pen. Results CAP treatment reduced bacterial growth in all three species. The most effective treatment duration was 5 min at 3 mm distance, resulting in inhibition zones ranging from 19 to 22 mm for P. aeruginosa, 26-45 mm for S. pseudintermedius and an overall reduction of bacterial growth for Str. canis. Inhibition zones were smaller with decreasing treatment duration and larger distance. Treatment times of 30 s repeated four times and 2 min showed comparable results. Treatment with argon alone did not lead to visible reduction of bacterial growth. Conclusion Argon cold atmospheric plasma demonstrated a potent in vitro antimicrobial effect on P. aeruginosa, S. pseudintermedius and Str. canis strains with the latter showing the highest sensitivity.
Collapse
Affiliation(s)
- Anne Helene Marx
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Hilke Oltmanns
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Jessica Meißner
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Jutta Verspohl
- Department of Microbiology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Thomas Fuchsluger
- Department of Ophthalmology, University of Rostock, Rostock, Germany
| | - Claudia Busse
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| |
Collapse
|
5
|
Prasad K, Sasi S, Weerasinghe J, Levchenko I, Bazaka K. Enhanced Antimicrobial Activity through Synergistic Effects of Cold Atmospheric Plasma and Plant Secondary Metabolites: Opportunities and Challenges. Molecules 2023; 28:7481. [PMID: 38005203 PMCID: PMC10673009 DOI: 10.3390/molecules28227481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The emergence of antibiotic resistant microorganisms possesses a great threat to human health and the environment. Considering the exponential increase in the spread of antibiotic resistant microorganisms, it would be prudent to consider the use of alternative antimicrobial agents or therapies. Only a sustainable, sustained, determined, and coordinated international effort will provide the solutions needed for the future. Plant secondary metabolites show bactericidal and bacteriostatic activity similar to that of conventional antibiotics. However, to effectively eliminate infection, secondary metabolites may need to be activated by heat treatment or combined with other therapies. Cold atmospheric plasma therapy is yet another novel approach that has proven antimicrobial effects. In this review, we explore the physiochemical mechanisms that may give rise to the improved antimicrobial activity of secondary metabolites when combined with cold atmospheric plasma therapy.
Collapse
Affiliation(s)
- Karthika Prasad
- School of Engineering, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, ACT 2600, Australia; (S.S.); (J.W.); (I.L.)
| | - Syamlal Sasi
- School of Engineering, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, ACT 2600, Australia; (S.S.); (J.W.); (I.L.)
| | - Janith Weerasinghe
- School of Engineering, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, ACT 2600, Australia; (S.S.); (J.W.); (I.L.)
| | - Igor Levchenko
- School of Engineering, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, ACT 2600, Australia; (S.S.); (J.W.); (I.L.)
- Plasma Sources and Application Centre, NIE, Nanyang Technological University, Singapore 637616, Singapore
| | - Kateryna Bazaka
- School of Engineering, College of Engineering, Computing and Cybernetics, The Australian National University, Canberra, ACT 2600, Australia; (S.S.); (J.W.); (I.L.)
| |
Collapse
|
6
|
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.
Collapse
|
7
|
Sedik AA, Salama M, Fathy K, Salama A. Cold plasma approach fortifies the topical application of thymoquinone intended for wound healing via up-regulating the levels of TGF-ß, VEGF, and α-SMA in rats. Int Immunopharmacol 2023; 122:110634. [PMID: 37451012 DOI: 10.1016/j.intimp.2023.110634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/25/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Wound healing is a series of coordinated events that involve tissue repair and regeneration. Cold atmospheric plasma approach sheds the light on the mechanism that initiates the inflammatory responses throughout the healing cascade. The present study was planned to assess the effect of thymoquinone treated with cold plasma (TQcp) on the rat wound model compared to thymoquinone (TQ). To assess the wound healing potential of TQcp, a full-thickness wound model was used. The induced wound was smeared, starting just after excision, twice daily with TQcp and TQ for 7 days. Our findings revealed that TQcp improved the skin healing potential by augmenting the skin regeneration indices as evidenced by enhancing the new production of hyaluronic acid and collagen type I. TQcp significantly reduced the skin content of tumor necrosis factor- α and inhibited the hypertrophic scarring by up-regulating the skin content of transforming growth factor-beta. Furthermore, TQcp enhanced the levels of interleukin-10, alpha smooth muscle actin and vascular endothelial growth factor, demonstrating a great potential for wound healing that also reflected in the histopathological and ultra-structural picture of the skin. Finally, our results demonstrated that TQcp revealed a significant potential for wound healing than TQ alone.
Collapse
Affiliation(s)
- Ahmed A Sedik
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, 12622, Egypt.
| | - Mohamed Salama
- Dairy Department, Food Industries and Nutrition Research Institute, National Research Centre, 12622, Egypt
| | - Khaled Fathy
- Electron Microscopy Unit, Mansoura University, El Mansoura, 35516, Egypt
| | - Abeer Salama
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, 12622, Egypt
| |
Collapse
|
8
|
Wang Y, Abazid A, Badendieck S, Mustea A, Stope MB. Impact of Non-Invasive Physical Plasma on Heat Shock Protein Functionality in Eukaryotic Cells. Biomedicines 2023; 11:biomedicines11051471. [PMID: 37239142 DOI: 10.3390/biomedicines11051471] [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: 04/04/2023] [Revised: 05/06/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Recently, biomedical research has increasingly investigated physical plasma as an innovative therapeutic approach with a number of therapeutic biomedical effects. It is known from radiation and chemotherapy that these applications can lead to the induction and activation of primarily cytoprotective heat shock proteins (HSP). HSP protect cells and tissues from physical, (bio)chemical, and physiological stress and, ultimately, along with other mechanisms, govern resistance and treatment failure. These mechanisms are well known and comparatively well studied in drug therapy. For therapies in the field of physical plasma medicine, however, extremely little data are available to date. In this review article, we provide an overview of the current studies on the interaction of physical plasma with the cellular HSP system.
Collapse
Affiliation(s)
- Yanqing Wang
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Alexander Abazid
- Department of General, Visceral and Thorax Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115 Berlin, Germany
| | - Steffen Badendieck
- Department of General, Visceral and Thorax Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115 Berlin, Germany
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Matthias B Stope
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| |
Collapse
|
9
|
Borchardt T, Helmke A, Ernst J, Emmert S, Schilling AF, Felmerer G, Viöl W. Topically Confined Enhancement of Cutaneous Microcirculation by Cold Plasma. Skin Pharmacol Physiol 2022; 35:343-353. [PMID: 36353780 PMCID: PMC9811424 DOI: 10.1159/000527700] [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: 01/31/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION We aim to explore potentials and modalities of cold atmospheric pressure plasma (CAP) for the subsequent development of therapies targeting an increased perfusion of the lower leg skin tissue. In this study, we addressed the question whether the microcirculation enhancement is restricted to the tissue in direct contact with plasma or if adjacent tissue might also benefit. METHODS A dielectric barrier discharge (DBD)-generated CAP device exhibiting an electrode area of 27.5 cm2 was used to treat the anterior lower leg of ten healthy subjects for 4.5 min. Subsequently, hyperspectral imaging was performed to measure the tempospatially resolved characteristics of microcirculation parameters in superficial (up to 1 mm) and deeper (up to 5 mm) skin layers. RESULTS In the tissue area covered by the plasma electrode, DBD-CAP treatment enhances most of the perfusion parameters. The maximum oxygen saturation increase reached 8%, the near-infrared perfusion index (NIR) increased by a maximum of 4%, and the maximum tissue hemoglobin increase equaled 14%. Tissue water index (TWI) was lower in both the control and the plasma groups, thus not affected by the DBD-CAP treatment. Yet, our study reveals that adjacent tissue is hardly affected by the enhancements in the electrode area, and the effects are locally confined. CONCLUSION Application of DBD-CAP to the lower leg resulted in enhancement of cutaneous microcirculation that extended 1 h beyond the treatment period with localization to the tissue area in direct contact with the cold plasma. This suggests the possibility of tailoring application schemes for topically confined enhancement of skin microcirculation, e.g., in the treatment of chronic wounds.
Collapse
Affiliation(s)
- Thomas Borchardt
- Faculty of Engineering and Health, HAWK University of Applied Sciences and Arts, Goettingen, Germany,*Thomas Borchardt,
| | - Andreas Helmke
- Faculty of Engineering and Health, HAWK University of Applied Sciences and Arts, Goettingen, Germany
| | - Jennifer Ernst
- Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Goettingen. Georg-August-University, Goettingen, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, 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
| | - Wolfgang Viöl
- Faculty of Engineering and Health, HAWK University of Applied Sciences and Arts, Goettingen, Germany
| |
Collapse
|
10
|
Cold Atmospheric Plasma Jet Treatment Improves Human Keratinocyte Migration and Wound Closure Capacity without Causing Cellular Oxidative Stress. Int J Mol Sci 2022; 23:ijms231810650. [PMID: 36142561 PMCID: PMC9504313 DOI: 10.3390/ijms231810650] [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: 08/03/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
Cold Atmospheric Plasma (CAP) is an emerging technology with great potential for biomedical applications such as sterilizing equipment and antitumor strategies. CAP has also been shown to improve skin wound healing in vivo, but the biological mechanisms involved are not well known. Our study assessed a possible effect of a direct helium jet CAP treatment on keratinocytes, in both the immortalized N/TERT-1 human cell line and primary keratinocytes obtained from human skin samples. The cells were covered with 200 µL of phosphate buffered saline and exposed to the helium plasma jet for 10−120 s. In our experimental conditions, micromolar concentrations of hydrogen peroxide, nitrite and nitrate were produced. We showed that long-time CAP treatments (≥60 s) were cytotoxic, reduced keratinocyte migration, upregulated the expression of heat shock protein 27 (HSP27) and induced oxidative cell stress. In contrast, short-term CAP treatments (<60 s) were not cytotoxic, did not affect keratinocyte proliferation and differentiation, and did not induce any changes in mitochondria, but they did accelerate wound closure in vitro by improving keratinocyte migration. In conclusion, these results suggest that helium-based CAP treatments improve wound healing by stimulating keratinocyte migration. The study confirms that CAP could be a novel therapeutic method to treat recalcitrant wounds.
Collapse
|
11
|
Wang Y, Ma Y, Jiang Z, Hu H, Wang S, Chi J, Qiao J, Zhang W, Wang Z, Liu W, Han B. Multifunctional effects of wound dressing based on chitosan-coordinated argentum with resistant bacterial penetration. Carbohydr Polym 2022; 288:119329. [PMID: 35450618 DOI: 10.1016/j.carbpol.2022.119329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 11/30/2022]
Abstract
Third-degree scald, causing serious tissue destruction with continuous pain, easily leads to microbial infections and delayed wound healing. Therefore, a multifunctional treatment is attractive for seriously damaged tissue. Herein, carboxymethyl chitosan-coordinated argentum (Ag-CMC) was synthesized via a complexation method, and then the Ag+ release, antibacterial activity, biocompatibility, pain relief and wound healing properties of Ag-CMC were investigated in vitro and in vivo. The results revealed that Ag+ had interacted with carboxymethyl chitosan, containing approximately 1.2% of silver. The Ag-CMC (50-200 μg/mL) with Ag+ sustained release exhibited significant antibacterial activity against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, drug-resistant E. coli, PA, MRSA and good biocompatibility with L929 cells. Furthermore, antibacterial and wound healing experiments demonstrated that Ag-CMC achieved an effective contraction rate of 90% after 28 days by accelerating re-epithelialization, regulating inflammation response, relieving pain and infections. Therefore, Ag-CMC is a safe multifunctional treatment for wound healing and infections.
Collapse
Affiliation(s)
- Yanting Wang
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Yanhui Ma
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Qingdao 266042, PR China
| | - Zhiwen Jiang
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China; Laboratory for Marine Drugs and Bioproducts of Pilot National Laboratory for Marine Science and Technology, Qingdao 266235, PR China
| | - Huiwen Hu
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Shuo Wang
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Jinhua Chi
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Jing Qiao
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Wei Zhang
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Zheng Wang
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao 266071, PR China; Department of Reproductive Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, PR China
| | - Wanshun Liu
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China
| | - Baoqin Han
- Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, PR China; Laboratory for Marine Drugs and Bioproducts of Pilot National Laboratory for Marine Science and Technology, Qingdao 266235, PR China.
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Sorg H, Tilkorn DJ, Hauser J, Ring A. Improving Vascularization of Biomaterials for Skin and Bone Regeneration by Surface Modification: A Narrative Review on Experimental Research. Bioengineering (Basel) 2022; 9:bioengineering9070298. [PMID: 35877349 PMCID: PMC9311595 DOI: 10.3390/bioengineering9070298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 07/02/2022] [Indexed: 11/30/2022] Open
Abstract
Artificial tissue substitutes are of great interest for the reconstruction of destroyed and non-functional skin or bone tissue due to its scarcity. Biomaterials used as scaffolds for tissue regeneration are non-vascularized synthetic tissues and often based on polymers, which need ingrowth of new blood vessels to ensure nutrition and metabolism. This review summarizes previous approaches and highlights advances in vascularization strategies after implantation of surface-modified biomaterials for skin and bone tissue regeneration. The efficient integration of biomaterial, bioactive coating with endogenous degradable matrix proteins, physiochemical modifications, or surface geometry changes represents promising approaches. The results show that the induction of angiogenesis in the implant site as well as the vascularization of biomaterials can be influenced by specific surface modifications. The neovascularization of a biomaterial can be supported by the application of pro-angiogenic substances as well as by biomimetic surface coatings and physical or chemical surface activations. Furthermore, it was confirmed that the geometric properties of the three-dimensional biomaterial matrix play a central role, as they guide or even enable the ingrowth of blood vessels into a biomaterial.
Collapse
Affiliation(s)
- Heiko Sorg
- Department of Plastic and Reconstructive Surgery, Marien Hospital Witten, Marienplatz 2, 58452 Witten, Germany;
- Department of Health, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany
| | - Daniel J. Tilkorn
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Alfried Krupp Krankenhaus, Hellweg 100, 45276 Essen, Germany; (D.J.T.); (J.H.)
| | - Jörg Hauser
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Alfried Krupp Krankenhaus, Hellweg 100, 45276 Essen, Germany; (D.J.T.); (J.H.)
| | - Andrej Ring
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, St. Rochus Hospital Castrop-Rauxel, Katholische St. Lukas Gesellschaft, Glückaufstraße 10, 44575 Castrop-Rauxel, Germany
- Correspondence: ; Tel.: +49-2305-294-2801
| |
Collapse
|
14
|
Inhibitory Effects of Cold Atmospheric Plasma on Inflammation and Tumor-Like Feature of Fibroblast-Like Synoviocytes from Patients with Rheumatoid Arthritis. Inflammation 2022; 45:2433-2448. [PMID: 35713788 DOI: 10.1007/s10753-022-01703-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/05/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic, debilitating systemic disease characterized by chronic inflammation and progressive joint destruction. Fibroblast-like synoviocytes (FLSs) are one of the most important players in the pathophysiology of RA, acting like tumor cells and secreting inflammatory cytokines. Previous research has shown that cold atmospheric plasma (CAP) inhibits cancer cells and may have anti-inflammatory properties. This study examined the effects of argon plasma jet-produced CAP on the suppression of invasion and inflammation caused by cultured RA-FLS. The findings revealed that CAP reduced cell viability and elevated the percentage of apoptotic RA-FLS by producing reactive oxygen species. Carboxyfluorescein diacetate succinimidyl ester (CFSE) staining confirmed that CAP could decrease the proliferation of RA-FLS. Furthermore, CAP effectively reduced the production of inflammatory factors (e.g., NF-κB and IL-6) as well as destructive factors like receptor activator of nuclear factor kappa-B ligand (RANKL) and matrix metalloproteinases-3 (MMP-3). These data suggest that CAP could be a promising treatment for slowing the progression of RA by reducing tumor-like features and inflammation in RA-FLS.
Collapse
|
15
|
Zhai SY, Kong MG, Xia YM. Cold Atmospheric Plasma Ameliorates Skin Diseases Involving Reactive Oxygen/Nitrogen Species-Mediated Functions. Front Immunol 2022; 13:868386. [PMID: 35720416 PMCID: PMC9204314 DOI: 10.3389/fimmu.2022.868386] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Skin diseases are mainly divided into infectious diseases, non-infectious inflammatory diseases, cancers, and wounds. The pathogenesis might include microbial infections, autoimmune responses, aberrant cellular proliferation or differentiation, and the overproduction of inflammatory factors. The traditional therapies for skin diseases, such as oral or topical drugs, have still been unsatisfactory, partly due to systematic side effects and reappearance. Cold atmospheric plasma (CAP), as an innovative and non-invasive therapeutic approach, has demonstrated its safe and effective functions in dermatology. With its generation of reactive oxygen species and reactive nitrogen species, CAP exhibits significant efficacies in inhibiting bacterial, viral, and fungal infections, facilitating wound healing, restraining the proliferation of cancers, and ameliorating psoriatic or vitiligous lesions. This review summarizes recent advances in CAP therapies for various skin diseases and implicates future strategies for increasing effectiveness or broadening clinical indications.
Collapse
Affiliation(s)
- Si-yue Zhai
- Department of Dermatology, The Second Affiliated Hospital of 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
| | - Michael G. Kong
- 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
| | - Yu-min Xia
- Department of Dermatology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| |
Collapse
|
16
|
Kugler P, Becker S, Welz C, Wiesmann N, Sax J, Buhr CR, Thoma MH, Brieger J, Eckrich J. Cold Atmospheric Plasma Reduces Vessel Density and Increases Vascular Permeability and Apoptotic Cell Death in Solid Tumors. Cancers (Basel) 2022; 14:cancers14102432. [PMID: 35626037 PMCID: PMC9139209 DOI: 10.3390/cancers14102432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Cold atmospheric plasma (CAP) resembles a physical state of matter, best described as ionized gas. CAP has demonstrated promising anti-cancer effects. Despite their relevance for the treatment of solid tumors, effects of CAP on tumor vessels and tumor-blood-circulation are still insufficiently investigated. CAP exposure reduced the vessel network inside the tumor and increased vascular leakiness, leading to an elevated tumor cell death and bleeding into the tumor tissue. These effects highlight the potential of CAP as a promising and yet underrated therapeutic modality for addressing the tumor vasculature in the treatment of solid tumors. Abstract Cold atmospheric plasma (CAP) has demonstrated promising anti-cancer effects in numerous in vitro and in vivo studies. Despite their relevance for the treatment of solid tumors, effects of CAP on tumor vasculature and microcirculation have only rarely been investigated. Here, we report the reduction of vessel density and an increase in vascular permeability and tumor cell apoptosis after CAP application. Solid tumors in the chorioallantoic membrane of chicken embryos were treated with CAP and evaluated with respect to effects of CAP on embryo survival, tumor size, and tumor morphology. Furthermore, intratumoral blood vessel density, apoptotic cell death and the tumor-associated microcirculation were investigated and compared to sham treatment. Treatment with CAP significantly reduced intratumoral vessel density while increasing the rate of intratumoral apoptosis in solid tumors. Furthermore, CAP treatment increased vascular permeability and attenuated the microcirculation by causing vessel occlusions in the tumor-associated vasculature. These effects point out the potential of CAP as a promising and yet underrated therapeutic modality for addressing the tumor vasculature in the treatment of solid tumors.
Collapse
Affiliation(s)
- Philipp Kugler
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany; (P.K.); (N.W.); (C.R.B.); (J.B.)
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen Medical Center, 72016 Tübingen, Germany;
| | - Christian Welz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Nadine Wiesmann
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany; (P.K.); (N.W.); (C.R.B.); (J.B.)
- Department of Oral and Maxillofacial Surgery—Plastic Surgery, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Jonas Sax
- Department of Oral and Maxillofacial Surgery—Plastic Surgery, University Medical Center Mainz, 55131 Mainz, Germany;
| | - Christoph R. Buhr
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany; (P.K.); (N.W.); (C.R.B.); (J.B.)
| | - Markus H. Thoma
- Institute of Experimental Physics I, Justus Liebig University Giessen, 35392 Giessen, Germany;
| | - Juergen Brieger
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany; (P.K.); (N.W.); (C.R.B.); (J.B.)
| | - Jonas Eckrich
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany; (P.K.); (N.W.); (C.R.B.); (J.B.)
- Department of Otorhinolaryngology, University Medical Center Bonn (UKB), 53127 Bonn, Germany
- Correspondence: ; Tel.: +49-228-287-13712
| |
Collapse
|
17
|
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]
|
18
|
Cold Physical Plasma in Cancer Therapy: Mechanisms, Signaling, and Immunity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9916796. [PMID: 35284036 PMCID: PMC8906949 DOI: 10.1155/2021/9916796] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/26/2021] [Indexed: 12/11/2022]
Abstract
Despite recent advances in therapy, cancer still is a devastating and life-threatening disease, motivating novel research lines in oncology. Cold physical plasma, a partially ionized gas, is a new modality in cancer research. Physical plasma produces various physicochemical factors, primarily reactive oxygen and nitrogen species (ROS/RNS), causing cancer cell death when supplied at supraphysiological concentrations. This review outlines the biomedical consequences of plasma treatment in experimental cancer therapy, including cell death modalities. It also summarizes current knowledge on intracellular signaling pathways triggered by plasma treatment to induce cancer cell death. Besides the inactivation of tumor cells, an equally important aspect is the inflammatory context in which cell death occurs to suppress or promote the responses of immune cells. This is mainly governed by the release of damage-associated molecular patterns (DAMPs) to provoke immunogenic cancer cell death (ICD) that, in turn, activates cells of the innate immune system to promote adaptive antitumor immunity. The pivotal role of the immune system in cancer treatment, in general, is highlighted by many clinical trials and success stories on using checkpoint immunotherapy. Hence, the potential of plasma treatment to induce ICD in tumor cells to promote immunity targeting cancer lesions systemically is also discussed.
Collapse
|
19
|
Nejat F, Jadidi K, Aghamollaei H, Nejat MA, Nabavi NS, Eghtedari S. The assessment of the concentration of candidate cytokines in response to conjunctival-exposure of atmospheric low-temperature plasma in an animal model. BMC Ophthalmol 2021; 21:417. [PMID: 34863132 PMCID: PMC8642870 DOI: 10.1186/s12886-021-02167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atmospheric Low-Temperature Plasma (ALTP) can be used as an effective tool in conjunctival cyst ablation, but little is known about how conjunctival ALTP-exposure affects the concentration of inflammatory mediators and also the duration of inflammatory responses. METHODS We used 8 female adult Lewis rats that were followed up in 4 groups. The right eye of each rat was selected for the test, whereas the left eye was considered as a control. The ALTP was generated and used to target 3 spots of the conjunctiva. The digital camera examinations were performed to follow-up the clinical outcomes after ALTP exposure. Tear and serum samples were isolated-at 2 days, 1 week, 1 month, and 6 months after treatment-from each rat and the concentration of candidate pro-inflammatory (i.e. IL-1α, IL-2, IL-6, IFN-γ, and TNF-α) and anti-inflammatory cytokines (i.e. IL-4 and IL-10) were measured using flow cytometry. RESULTS The external and digital camera examinations showed no ocular surface complications in all ALTP-exposed rats after 1 week. The analyses revealed that the ALTP transiently increases the concentration of pro-inflammatory cytokines-IL-1α and IL-2 in tear samples in 1 week and 2 days after exposure, respectively; no differences were observed regarding other pro- and anti-inflammatory cytokines in the tear or serum samples. CONCLUSIONS ALTP can probably be used as a minimally-invasive therapeutic method that triggers no permanent or continual inflammatory responses. The results of this study might help the patients to shorten the consumption of immunosuppressive drugs, e.g. corticosteroids, that are prescribed to mitigate the inflammation after ALTP-surgery.
Collapse
Affiliation(s)
- Farhad Nejat
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Khosrow Jadidi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Hosein Aghamollaei
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Amin Nejat
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nazanin-Sadat Nabavi
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Shima Eghtedari
- Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| |
Collapse
|
20
|
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.
Collapse
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.)
| |
Collapse
|
21
|
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.
Collapse
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;
| |
Collapse
|
22
|
Cold Atmospheric Plasma Jet as a Possible Adjuvant Therapy for Periodontal Disease. Molecules 2021; 26:molecules26185590. [PMID: 34577061 PMCID: PMC8470429 DOI: 10.3390/molecules26185590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Due to the limitations of traditional periodontal therapies, and reported cold atmospheric plasma anti-inflammatory/antimicrobial activities, plasma could be an adjuvant therapy to periodontitis. Porphyromonas gingivalis was grown in blood agar. Standardized suspensions were plated on blood agar and plasma-treated for planktonic growth. For biofilm, dual-species Streptococcus gordonii + P. gingivalis biofilm grew for 48 h and then was plasma-treated. XTT assay and CFU counting were performed. Cytotoxicity was accessed immediately or after 24 h. Plasma was applied for 1, 3, 5 or 7 min. In vivo: Thirty C57BI/6 mice were subject to experimental periodontitis for 11 days. Immediately after ligature removal, animals were plasma-treated for 5 min once-Group P1 (n = 10); twice (Day 11 and 13)-Group P2 (n = 10); or not treated-Group S (n = 10). Mice were euthanized on day 15. Histological and microtomography analyses were performed. Significance level was 5%. Halo diameter increased proportionally to time of exposure contrary to CFU/mL counting. Mean/SD of fibroblasts viability did not vary among the groups. Plasma was able to inhibit P. gingivalis in planktonic culture and biofilm in a cell-safe manner. Moreover, plasma treatment in vivo, for 5 min, tends to improve periodontal tissue recovery, proportionally to the number of plasma applications.
Collapse
|
23
|
Thiem A, Has C, Diem A, Klausegger A, Hamm H, Emmert S. [Wound therapy with cold atmospheric plasma in severe recessive dystrophic epidermolysis bullosa : A pilot study]. Hautarzt 2021; 73:384-390. [PMID: 34519836 DOI: 10.1007/s00105-021-04883-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cold atmospheric pressure plasma (CAP) has antimicrobial and wound-healing properties. Patients affected by severe autosomal recessive dystrophic epidermolysis bullosa (RDEB) suffer from widespread, difficult-to-treat wounds, which require complex wound management. OBJECTIVE In a pilot project, we investigated over a period of 5 months the response and tolerability of a CAP wound therapy in a 21-year-old and a 28-year-old female patient with severe generalized RDEB and following cutaneous squamous cell cancer (cSSC) in the older patient. MATERIALS AND METHODS In both patients, diagnosis of RDEB was confirmed by molecular genetics. Individual- and patient-specific wound therapy was continued during the study period, and additionally CAP therapy with a dielectric barrier discharge (DBE) device was initiated. CAP treatment was performed for 90 s per wound and could be applied every day or every other day. Clinical evaluation included photographic documentation and regular interviews of patients and parents. RESULTS CAP-treated wounds largely demonstrated improved wound healing and signs of a reduced bacterial contamination. Furthermore, CAP proved to prevent wound chronification. When applied on a polyester mesh, it was well-tolerated on most body sites. CONCLUSION The introduction of CAP could improve the wound management of EB patients and should be evaluated in clinical studies. The effect of CAP on cSSC development should be particularly studied.
Collapse
Affiliation(s)
- Alexander Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland.
| | - Cristina Has
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Anja Diem
- EB-Ambulanz, Universitätsklinik für Dermatologie und Allergologie, Universitätsklinikum Salzburg, Salzburg, Österreich
| | - Alfred Klausegger
- EB-Ambulanz, Universitätsklinik für Dermatologie und Allergologie, Universitätsklinikum Salzburg, Salzburg, Österreich
| | - Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Steffen Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| |
Collapse
|
24
|
Terabe Y, Kaneko N, Ando H. Treating hard-to-heal skin and nail onychomycosis of diabetic foot with plasma therapy. Dermatol Ther 2021; 34:e15127. [PMID: 34505330 PMCID: PMC9285594 DOI: 10.1111/dth.15127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Yuta Terabe
- Limb Salvage Center, Kasukabe Chuo General Hospital, Saitama, Japan
| | - Nobuhito Kaneko
- Limb Salvage Center, Kasukabe Chuo General Hospital, Saitama, Japan
| | - Hiroshi Ando
- Limb Salvage Center, Kasukabe Chuo General Hospital, Saitama, Japan
| |
Collapse
|
25
|
Non-thermal atmospheric pressure plasma activates Wnt/β-catenin signaling in dermal papilla cells. Sci Rep 2021; 11:16125. [PMID: 34373562 PMCID: PMC8352944 DOI: 10.1038/s41598-021-95650-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
There is an unmet need for novel, non-pharmacological therapeutics to treat alopecia. Recent studies have shown the potential biological benefits of non-thermal atmospheric pressure plasma (NTAPP), including wound healing, angiogenesis, and the proliferation of stem cells. We hypothesized that NTAPP might have a stimulatory effect on hair growth or regeneration. We designed an NTAPP-generating apparatus which is applicable to in vitro and in vivo experiments. The human dermal papilla (DP) cells, isolated fresh hair follicles, and mouse back skin were exposed with the NTAPP. Biological outcomes were measured using RNA-sequencing, RT-PCR, Western blots, and immunostaining. The NTAPP treatment increased the expression levels of Wnt/β-catenin pathway-related genes (AMER3, CCND1, LEF1, and LRG1) and proteins (β-catenin, p-GSK3β, and cyclin D1) in human DP cells. In contrast, inhibitors of Wnt/β-catenin signaling, endo-IWR1 and IWP2, attenuated the levels of cyclin D1, p-GSK3β, and β-catenin proteins induced by NTAPP. Furthermore, we observed that NTAPP induced the activation of β-catenin in DP cells of hair follicles and the mRNA levels of target genes of the β-catenin signaling pathway (CCND1, LEF1, and TCF4). NTAPP-treated mice exhibited markedly increased anagen induction, hair growth, and the protein levels of β-catenin, p-GSK3β, p-AKT, and cyclin D1. NTAPP stimulates hair growth via activation of the Wnt/β-catenin signaling pathway in DP cells. These findings collectively suggest that NTAPP may be a potentially safe and non-pharmacological therapeutic intervention for alopecia.
Collapse
|
26
|
Jin HJ, Hwang CY, Kang JH, Baek SJ, Hyun JE. In vitro antimicrobial activity of cold atmospheric microwave plasma against bacteria causing canine skin and ear infections. Vet Dermatol 2021; 32:462-e126. [PMID: 34374169 DOI: 10.1111/vde.13012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Cold atmospheric plasma (CAP) is a new generation medical therapeutic option for bacterial infections. CAP causes physical cell wall rupture and DNA damage, therefore making it highly useful in the treatment of various conditions such as skin infections. HYPOTHESIS/OBJECTIVES The antimicrobial activity of cold atmospheric microwave plasma (CAMP) against major strains in canine skin infections was tested and the difference in antimicrobial activity between the antibiotic-resistant and antibiotic-susceptible strains of Staphylococcus pseudintermedius was evaluated. METHODS AND MATERIALS American Type Culture Collection (ATCC) strains (Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli) and clinical isolates identified as methicillin-resistant S. pseudintermedius (n = 27) and methicillin-susceptible S. pseudintermedius (n = 13) were exposed to CAMP for 10 s, 30 s and 60 s. Afterwards, the bacterial survival rate was confirmed. RESULTS Gram-negative bacteria (P. aeruginosa and E. coli) were more susceptible than Gram-positive bacteria (S. aureus and S. pseudintermedius) for the same duration of CAMP exposure. Only the Gram-negative bacteria were completely killed after 60 s exposure. In S. pseudintermedius isolates, CAMP exposure had similar antibacterial effects regardless of antibiotic resistance. CONCLUSIONS AND CLINICAL IMPORTANCE CAMP has sufficient antimicrobial activity against major bacterial strains that cause pyoderma and otitis externa in dogs, and may be an alternative therapeutic option for S. pseudintermedius skin infections, for which antibiotics often are ineffective because of antimicrobial resistance in clinical veterinary medicine.
Collapse
Affiliation(s)
- Hee-Jung Jin
- Laboratory of Veterinary Dermatology and The Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Cheol-Yong Hwang
- Laboratory of Veterinary Dermatology and The Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Jung-Hun Kang
- Origin Veterinary Dermatologic Hospital, Busan, 48280, Korea
| | - Seung-Joon Baek
- Laboratory of Signal Transduction, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Jae-Eun Hyun
- Department of Veterinary Internal Medicine, Konkuk Veterinary Medical Teaching Hospital, Konkuk University, Seoul, 05029, Korea
| |
Collapse
|
27
|
Guo P, Liu Y, Li J, Zhang N, Zhou M, Li Y, Zhao G, Wang N, Wang A, Wang Y, Wang F, Huang L. A novel atmospheric-pressure air plasma jet for wound healing. Int Wound J 2021; 19:538-552. [PMID: 34219379 PMCID: PMC8874047 DOI: 10.1111/iwj.13652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 11/29/2022] Open
Abstract
Current low‐temperature plasma (LTP) devices essentially use a rare gas source with a short working distance (8 to 20 mm), low gas flow rate (0.12 to 0.3 m3/h), and small effective treatment area (1‐5 cm2), limiting the applications for which LTP can be utilised in clinical therapy. In the present study, a novel type of LTP equipment was developed, having the advantages of a free gas source (surrounding air), long working distance (8 cm), high gas flow rate (10 m3/h), large effective treatment area (20 cm2), and producing an abundance of active substances (NOγ, OH, N2, and O), effectively addressing the shortcomings of current LTP devices. Furthermore, it has been verified that the novel LTP device displays therapeutic efficacy in terms of acceleration of wound healing in normal and Type I diabetic rats, with enhanced wound kinetics, rate of condensation of wound area, and recovery ratio. Cellular and molecular analysis indicated that LTP treatment significantly reduced inflammation and enhanced re‐epithelialization, fibroblast proliferation, deposition of collagen, neovascularization, and expression of TGF‐β, superoxide dismutase, glutathione peroxidase, and catalase in Type I diabetic rats. In conclusion, the novel LTP device provides a convenient and efficient tool for the treatment of clinical wounds.
Collapse
Affiliation(s)
- Peng Guo
- Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, China
| | - Yang Liu
- Department of Comparative Medicine, Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning, China
| | - Juan Li
- Yantai Healing Technology Co. Ltd, Yantai, Shandong, China
| | - Nan Zhang
- Department of Comparative Medicine, Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning, China
| | - Ming Zhou
- Department of Rehabilitation Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yi Li
- Yantai Healing Technology Co. Ltd, Yantai, Shandong, China
| | - Guozhu Zhao
- Yantai Healing Technology Co. Ltd, Yantai, Shandong, China
| | - Ning Wang
- Department of Rehabilitation Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Aiguo Wang
- Department of Comparative Medicine, Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning, China
| | - Yupeng Wang
- Yantai Healing Technology Co. Ltd, Yantai, Shandong, China
| | - Fujin Wang
- Department of Comparative Medicine, Laboratory Animal Center, Dalian Medical University, Dalian, Liaoning, China
| | - Liping Huang
- Department of Rehabilitation Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
28
|
Kupke LS, Arndt S, Lenzer S, Metz S, Unger P, Zimmermann JL, Bosserhoff AK, Gruber M, Karrer S. Cold Atmospheric Plasma Promotes the Immunoreactivity of Granulocytes In Vitro. Biomolecules 2021; 11:902. [PMID: 34204360 PMCID: PMC8235417 DOI: 10.3390/biom11060902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/01/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022] Open
Abstract
Cold atmospheric plasma (CAP) reduces bacteria and interacts with tissues and cells, thus improving wound healing. The CAP-related induction of neutrophils was recently described in stained sections of wound tissue in mice. Consequently, this study aimed to examine the functionality of human polymorphonuclear cells (PMN)/granulocytes through either a plasma-treated solution (PTS) or the direct CAP treatment with different plasma modes and treatment durations. PTS analysis yielded mode-dependent differences in the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS) after CAP treatment. Live-cell imaging did not show any chemo-attractive or NETosis-inducing effect on PMNs treated with PTS. The time to maximum ROS production (TmaxROS) in PMNs was reduced by PTS and direct CAP treatment. PMNs directly treated with CAP showed an altered cell migration dependent on the treatment duration as well as decreased TmaxROS without inducing apoptosis. Additionally, flow cytometry showed enhanced integrin and selectin expression, as a marker of activation, on PMN surfaces. In conclusion, the modification of PMN immunoreactivity may be a main supporting mechanism for CAP-induced improvement in wound healing.
Collapse
Affiliation(s)
- Laura S. Kupke
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Stephanie Arndt
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Simon Lenzer
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | - Sophia Metz
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
| | - Petra Unger
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| | | | - Anja-Katrin Bosserhoff
- Emil-Fischer-Center, Institute of Biochemistry, University of Erlangen-Nuernberg (FAU), 91054 Erlangen, Germany;
| | - Michael Gruber
- Department of Anesthesiology, University Hospital Regensburg, 93053 Regensburg, Germany; (L.S.K.); (S.L.); (S.M.); (M.G.)
| | - Sigrid Karrer
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany; (P.U.); (S.K.)
| |
Collapse
|
29
|
The synergistic effect of Canady Helios cold atmospheric plasma and a FOLFIRINOX regimen for the treatment of cholangiocarcinoma in vitro. Sci Rep 2021; 11:8967. [PMID: 33903679 PMCID: PMC8076226 DOI: 10.1038/s41598-021-88451-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/12/2021] [Indexed: 12/30/2022] Open
Abstract
Cholangiocarcinoma (CCA) is a rare biliary tract cancer with a low five-year survival rate and high recurrence rate after surgical resection. Currently treatment approaches include systemic chemotherapeutics such as FOLFIRINOX, a chemotherapy regimen is a possible treatment for severe CCA cases. A limitation of this chemotherapy regimen is its toxicity to patients and adverse events. There exists a need for therapies to alleviate the toxicity of a FOLFIRINOX regimen while enhancing or not altering its anticancer properties. Cold atmospheric plasma (CAP) is a technology with a promising future as a selective cancer treatment. It is critical to know the potential interactions between CAP and adjuvant chemotherapeutics. In this study the aim is to characterize the efficacy of FOLFIRINOX and CAP in combination to understand potential synergetic effect on CCA cells. FOLFIRINOX treatment alone at the highest dose tested (53.8 µM fluorouracil, 13.7 µM Leucovorin, 5.1 µM Irinotecan, and 3.7 µM Oxaliplatin) reduced CCA cell viability to below 20% while CAP treatment alone for 7 min reduced viability to 3% (p < 0.05). An analysis of cell viability, proliferation, and cell cycle demonstrated that CAP in combination with FOLFIRINOX is more effective than either treatment alone at a lower FOLFIRINOX dose of 6.7 µM fluorouracil, 1.7 µM leucovorin, 0.6 µM irinotecan, and 0.5 µM oxaliplatin and a shorter CAP treatment of 1, 3, or 5 min. In conclusion, CAP has the potential to reduce the toxicity burden of FOLFIRINOX and warrants further investigation as an adjuvant therapy.
Collapse
|
30
|
Amini M, Momeni M, Jahandideh A, Ghoranneviss M, Soudmand S, Yousefi P, Khandan S, Amini M. Tendon repair by plasma jet treatment. J Diabetes Metab Disord 2021; 20:621-626. [PMID: 34178855 DOI: 10.1007/s40200-021-00789-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/22/2021] [Indexed: 02/01/2023]
Abstract
Objective In recent years many researchers applied cold plasma for wound healing. The cold plasma is irradiated on the surface of wound. In this paper the effect of irradiation of cold plasma on the skin for healing of injured tissue which is located inside body, such as tendon, is evaluated. Methods The male, white New Zealand, (20-week-old) were selected. Aloxan injection induced for diabetes induction and a week later the blood glucose level was measured. The standard tendon injury was created. The rabbits was divided in 3 groups. Control group, Plasma treated group at 5 kv, plasma treated group at 10 kv. Cold plasma was applied to the rabbits for 21 days. Results After 21 days the tendon tissue were considered histologically. The results show that inflammatory cells were significantly lower in the tendon treated with cold plasma at 10 kv than the others, which confirms that cold plasma treatment reduce the inflammation phase. Cold plasma treatment led to increase neovascularation and collagen production. Conclusion The results of this study confirm that the cold plasma treatment of skin has positive effect on healing of tissue inside body.
Collapse
Affiliation(s)
- Maryam Amini
- Faculty of Physics, Shahrood University of Technology, Shahrood, Iran
| | - Mahdi Momeni
- Faculty of Physics, Shahrood University of Technology, Shahrood, Iran
| | - Alireza Jahandideh
- Department of Veterinary Medicine, Tehran Azad University Science and Research Branch, Tehran, Iran
| | - Mahmood Ghoranneviss
- Diabetes Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Sahar Soudmand
- Department of Veterinary Medicine, Tehran Azad University Science and Research Branch, Tehran, Iran
| | - Paniz Yousefi
- Department of Veterinary Medicine, Tehran Azad University Science and Research Branch, Tehran, Iran
| | - Saeed Khandan
- Diabetes Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Mohammadreza Amini
- Diabetes Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Science, Tehran, Iran
| |
Collapse
|
31
|
Intracellular Responses Triggered by Cold Atmospheric Plasma and Plasma-Activated Media in Cancer Cells. Molecules 2021; 26:molecules26051336. [PMID: 33801451 PMCID: PMC7958621 DOI: 10.3390/molecules26051336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 02/07/2023] Open
Abstract
Cold atmospheric plasma (CAP), an ionized gas operating at room temperature, has been increasingly studied with respect to its potential use in medicine, where its beneficial effects on tumor reduction in oncology have been demonstrated. This review discusses the cellular changes appearing in cell membranes, cytoplasm, various organelles, and DNA content upon cells’ direct or indirect exposure to CAP or CAP-activated media/solutions (PAM), respectively. In addition, the CAP/PAM impact on the main cellular processes of proliferation, migration, protein degradation and various forms of cell death is addressed, especially in light of CAP use in the oncology field of plasma medicine.
Collapse
|
32
|
Abstract
Plasma is an electrically conducting medium that responds to electric and magnetic fields. It consists of large quantities of highly reactive species, such as ions, energetic electrons, exited atoms and molecules, ultraviolet photons, and metastable and active radicals. Non-thermal or cold plasmas are partially ionized gases whose electron temperatures usually exceed several tens of thousand degrees K, while the ions and neutrals have much lower temperatures. Due to the presence of reactive species at low temperature, the biological effects of non-thermal plasmas have been studied for application in the medical area with promising results. This review outlines the application of cold atmospheric pressure plasma (CAPP) in dentistry for the control of several pathogenic microorganisms, induction of anti-inflammatory, tissue repair effects and apoptosis of cancer cells, with low toxicity to healthy cells. Therefore, CAPP has potential to be applied in many areas of dentistry such as cariology, periodontology, endodontics and oral oncology.
Collapse
|
33
|
Could cold plasma act synergistically with allogeneic mesenchymal stem cells to improve wound skin regeneration in a large size animal model? Res Vet Sci 2021; 136:97-110. [PMID: 33596495 DOI: 10.1016/j.rvsc.2021.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/05/2021] [Accepted: 01/24/2021] [Indexed: 02/06/2023]
Abstract
Skin wound healing may sometimes lead to open sores that persist for long periods and expensive hospitalization is needed. Among different kinds of therapeutic innovative approaches, mesenchymal stem cells (MSCs) and low-temperature atmospheric pressure cold plasma (ionized gas) have been recently tested to improve this regenerative process. To optimize wound healing the present study intended to combine, for the first time, these two novel approaches in a large size animal wound healing model with the aim of assessing the putative dual beneficial effects. Based on clinical, histopathological, and molecular results a synergistic action in a second intention healing wound in sheep has been observed. Experimental wounds treated with cold plasma and MSCs showed a slower but more effective healing compared to the single treatment, as observed in previous studies. The combined treatment improved the correct development of skin appendages and structural proteins of the dermis showing the potential of the dual combination as a safe and effective tool for skin regeneration in the veterinary clinical field.
Collapse
|
34
|
Koch F, Salva KA, Wirtz M, Hadaschik E, Varaljai R, Schadendorf D, Roesch A. Efficacy of cold atmospheric plasma vs. diclofenac 3% gel in patients with actinic keratoses: a prospective, randomized and rater-blinded study (ACTICAP). J Eur Acad Dermatol Venereol 2020; 34:e844-e846. [PMID: 32531115 DOI: 10.1111/jdv.16735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- F Koch
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| | - K A Salva
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| | - M Wirtz
- SanaSkin, Zürich, Switzerland
| | - E Hadaschik
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| | - R Varaljai
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital of Essen, University Duisburg-Essen and German Cancer Consortium (DKTK) partner site Essen/Düsseldorf, Essen, Germany
| |
Collapse
|
35
|
Zubor P, Wang Y, Liskova A, Samec M, Koklesova L, Dankova Z, Dørum A, Kajo K, Dvorska D, Lucansky V, Malicherova B, Kasubova I, Bujnak J, Mlyncek M, Dussan CA, Kubatka P, Büsselberg D, Golubnitschaja O. Cold Atmospheric Pressure Plasma (CAP) as a New Tool for the Management of Vulva Cancer and Vulvar Premalignant Lesions in Gynaecological Oncology. Int J Mol Sci 2020; 21:ijms21217988. [PMID: 33121141 PMCID: PMC7663780 DOI: 10.3390/ijms21217988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022] Open
Abstract
Vulvar cancer (VC) is a specific form of malignancy accounting for 5–6% of all gynaecologic malignancies. Although VC occurs most commonly in women after 60 years of age, disease incidence has risen progressively in premenopausal women in recent decades. VC demonstrates particular features requiring well-adapted therapeutic approaches to avoid potential treatment-related complications. Significant improvements in disease-free survival and overall survival rates for patients diagnosed with post-stage I disease have been achieved by implementing a combination therapy consisting of radical surgical resection, systemic chemotherapy and/or radiotherapy. Achieving local control remains challenging. However, mostly due to specific anatomical conditions, the need for comprehensive surgical reconstruction and frequent post-operative healing complications. Novel therapeutic tools better adapted to VC particularities are essential for improving individual outcomes. To this end, cold atmospheric plasma (CAP) treatment is a promising option for VC, and is particularly appropriate for the local treatment of dysplastic lesions, early intraepithelial cancer, and invasive tumours. In addition, CAP also helps reduce inflammatory complications and improve wound healing. The application of CAP may realise either directly or indirectly utilising nanoparticle technologies. CAP has demonstrated remarkable treatment benefits for several malignant conditions, and has created new medical fields, such as “plasma medicine” and “plasma oncology”. This article highlights the benefits of CAP for the treatment of VC, VC pre-stages, and postsurgical wound complications. There has not yet been a published report of CAP on vulvar cancer cells, and so this review summarises the progress made in gynaecological oncology and in other cancers, and promotes an important, understudied area for future research. The paradigm shift from reactive to predictive, preventive and personalised medical approaches in overall VC management is also considered.
Collapse
Affiliation(s)
- Pavol Zubor
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
- OBGY Health & Care, Ltd., 010 01 Zilina, Slovakia
- Correspondence: or
| | - Yun Wang
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
| | - Alena Liskova
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Marek Samec
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Lenka Koklesova
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Zuzana Dankova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Anne Dørum
- Department of Gynaecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (Y.W.); (A.D.)
| | - Karol Kajo
- Department of Pathology, St. Elizabeth Cancer Institute Hospital, 81250 Bratislava, Slovakia;
| | - Dana Dvorska
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Vincent Lucansky
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Bibiana Malicherova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Ivana Kasubova
- Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.D.); (D.D.); (V.L.); (B.M.); (I.K.)
| | - Jan Bujnak
- Department of Obstetrics and Gynaecology, Kukuras Michalovce Hospital, 07101 Michalovce, Slovakia;
| | - Milos Mlyncek
- Department of Obstetrics and Gynaecology, Faculty Hospital Nitra, Constantine the Philosopher University, 949 01 Nitra, Slovakia;
| | - Carlos Alberto Dussan
- Department of Surgery, Orthopaedics and Oncology, University Hospital Linköping, 581 85 Linköping, Sweden;
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia; (A.L.); (M.S.); (L.K.); (P.K.)
| | - Dietrich Büsselberg
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, P.O. Box 24144 Doha, Qatar;
| | - Olga Golubnitschaja
- Predictive, Preventive Personalised (3P) Medicine, Department of Radiation Oncology, Rheinische Friedrich-Wilhelms-Universität Bonn, 53105 Bonn, Germany;
| |
Collapse
|
36
|
Cold Atmospheric Pressure Plasma in Wound Healing and Cancer Treatment. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10196898] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Plasma medicine is gaining increasing attention and is moving from basic research into clinical practice. While areas of application are diverse, much research has been conducted assessing the use of cold atmospheric pressure plasma (CAP) in wound healing and cancer treatment—two applications with entirely different goals. In wound healing, a tissue-stimulating effect is intended, whereas cancer therapy aims at killing malignant cells. In this review, we provide an overview of the latest clinical and some preclinical research on the efficacy of CAP in wound healing and cancer therapy. Furthermore, we discuss the current understanding of molecular signaling mechanisms triggered by CAP that grant CAP its antiseptic and tissue regenerating or anti-proliferative and cell death-inducing properties. For the efficacy of CAP in wound healing, already substantial evidence from clinical studies is available, while evidence for therapeutic effects of CAP in oncology is mainly from in vitro and in vivo animal studies. Efforts to elucidate the mode of action of CAP suggest that different components, such as ultraviolet (UV) radiation, electromagnetic fields, and reactive species, may act synergistically, with reactive species being regarded as the major effector by modulating complex and concentration-dependent redox signaling pathways.
Collapse
|
37
|
Eggers B, Marciniak J, Memmert S, Kramer FJ, Deschner J, Nokhbehsaim M. The beneficial effect of cold atmospheric plasma on parameters of molecules and cell function involved in wound healing in human osteoblast-like cells in vitro. Odontology 2020; 108:607-616. [PMID: 32030565 PMCID: PMC7438292 DOI: 10.1007/s10266-020-00487-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/19/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to analyse the effect of cold atmospheric plasma (CAP) on human osteoblast-like cells in vitro. Additionally, underlying intracellular mechanisms were to be studied. Human osteoblast-like (MG63) cells were exposed to CAP for 60 s. The effects of CAP on key molecules essential for the wound healing response were studied using real-time PCR, ELISA and immunocytochemistry. For studying intracellular signalling pathways, MAP kinase MEK 1/2 was blocked. Cell viability was analysed by an XTT assay and with an EVE automated cell counter. Cell migration was examined by an in vitro wound healing assay.CAP exposition on osteoblast-like cells caused a significant upregulation of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)α, cyclooxygenase (COX)2, collagen (COL) 1α, matrix metalloproteinase (MMP)1, Ki67, proliferating-cell-nuclear-antigen (PCNA) and chemokine ligand (CCL)2 mRNA expression at 1 day. Interestingly, after blocking of MAP kinase, CAP-induced upregulation of Ki67 was inhibited by 57%. Moreover, CAP treatment improved significantly osteoblast-like cell viability as compared to untreated cells at 1 day. Beneficial effect of CAP treatment was shown by an in vitro wound healing assay, displaying a significant faster wound closure. Our findings provide evidence that CAP exposure effects gene and protein regulation in human osteoblast-like cells. Furthermore, CAP treatment has a positive impact on wound closure in an in vitro setting and might improve existing concepts of hard tissue regeneration in the future.
Collapse
Affiliation(s)
- B Eggers
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany.
| | - J Marciniak
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - S Memmert
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Orthodontics, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - F J Kramer
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
- Department of Craniomaxillofacial Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| | - J Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, Bonn, Germany
| |
Collapse
|
38
|
Mariachiara DA, Anna V, Alessandra G, Edoardo GP, Stefania B, Mariateresa R, Piergiacomo CP. Cold atmospheric plasma (CAP) as a promising therapeutic option for mild to moderate acne vulgaris: Clinical and non-invasive evaluation of two cases. CLINICAL PLASMA MEDICINE 2020. [DOI: 10.1016/j.cpme.2020.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
39
|
Rotering H, Al Shakaki M, Welp H, Dell'Aquila AM. Preliminary Results of a New Treatment Strategy for Relapsed Left Ventricular Assist Device-Specific Infections. Ann Thorac Surg 2020; 110:1302-1307. [PMID: 32169499 DOI: 10.1016/j.athoracsur.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 12/27/2019] [Accepted: 02/04/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Relapsed ventricular assist device-specific infections are associated with high morbidity, mortality, and hospital costs. A new combination of cold atmospheric plasma and special dressing technique with negative pressure wound therapy with an additional underlay of carbon cloth and hypochlorite rinsing solutions has been developed and reported in this study. METHODS Between January 2016 and January 2018, 9 patients with relapsed infected driveline or pump pocket infection were treated with this new combined strategy. The primary endpoint was complete wound healing without recurrence of infection, defined as the presence at the same site within the first year after treatment. The secondary endpoint was control of infection, defined as a marked reduction of the infected area. RESULTS After a median treatment time of 3 weeks, an immediate response was observed in all patients, and complete healing was achieved in 6 patients. Five patients met the primary endpoint, and infection did not recur after a median follow-up of 17.5 (range, 12.1 to 21.8) months. One patient underwent heart transplantation 6 months after successful wound treatment (complete wound healing). The remaining 3 patients were discharged with controlled infection. After a median follow-up of 5.7 months, 1 destination therapy patient died at home, and 2 patients underwent urgent heart transplantation because of recurrence of infection caused by Pseudomonas aeruginosa. Side effects were not observed. CONCLUSIONS The new combination treatment offers a promising option for patients with ventricular assist device-relapsed infection. Despite this, further studies are warranted to confirm those encouraging preliminary results.
Collapse
Affiliation(s)
- Heinrich Rotering
- Department of Cardiac Surgery, University Hospital Münster, Münster, Germany
| | - Mosab Al Shakaki
- Department of Cardiac Surgery, University Hospital Münster, Münster, Germany
| | - Henryk Welp
- Department of Cardiac Surgery, University Hospital Münster, Münster, Germany
| | | |
Collapse
|
40
|
Wound healing improvement in large animals using an indirect helium plasma treatment. CLINICAL PLASMA MEDICINE 2020. [DOI: 10.1016/j.cpme.2020.100095] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
41
|
The HIPPO Transducer YAP and Its Targets CTGF and Cyr61 Drive a Paracrine Signalling in Cold Atmospheric Plasma-Mediated Wound Healing. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:4910280. [PMID: 32104533 PMCID: PMC7040405 DOI: 10.1155/2020/4910280] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/27/2020] [Accepted: 01/29/2020] [Indexed: 12/15/2022]
Abstract
Reactive species play a pivotal role in orchestrating wound healing responses. They act as secondary messengers and drive redox-signalling pathways that are involved in the homeostatic, inflammatory, proliferative, and remodelling phases of wound healing. The application of Cold Atmospheric Plasma (CAP) to the wound site produces a profusion of short- and long-lived reactive species that have been demonstrated to be effective in promoting wound healing; however, knowledge of the mechanisms underlying CAP-mediated wound healing remains scarce. To address this, an in vitro coculture model was used to study the effects of CAP on wound healing and on paracrine crosstalk between dermal keratinocytes and fibroblasts. Using this coculture model, we observed a stimulatory effect on the migration ability of HaCaT cells that were cocultured with dermal fibroblasts. Additionally, CAP treatment resulted in an upregulation of the HIPPO transcription factor YAP in HaCaTs and fibroblasts. Downstream effectors of the HIPPO signalling pathway (CTGF and Cyr61) were also upregulated in dermal fibroblasts, and the administration of antioxidants could inhibit CAP-mediated wound healing and abrogate the gene expression of the HIPPO downstream effectors. Interestingly, we observed that HaCaT cells exhibited an improved cell migration rate when incubated with CAP-treated fibroblast-conditioned media compared to that observed after incubation with untreated media. An induction of CTGF and Cyr61 secretion was also observed upon CAP treatment in the fibroblast-conditioned media. Finally, exposure to recombinant CTGF and Cyr61 could also significantly improve HaCaT cell migration. In summary, our results validated that CAP activates a regenerative signalling pathway at the onset of wound healing. Additionally, CAP also stimulated a reciprocal communication between dermal fibroblasts and keratinocytes, resulting in improved keratinocyte wound healing in coculture.
Collapse
|
42
|
Kaltes atmosphärisches Plasma und „advanced negative pressure wound therapy“. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2020. [DOI: 10.1007/s00398-019-00355-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
43
|
Küçük D, Savran L, Ercan UK, Yarali ZB, Karaman O, Kantarci A, Sağlam M, Köseoğlu S. Evaluation of efficacy of non-thermal atmospheric pressure plasma in treatment of periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2020; 24:3133-3145. [PMID: 31897708 DOI: 10.1007/s00784-019-03187-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/23/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVES In this clinical study, we aim to evaluate the effectiveness of non-thermal atmospheric pressure plasma (NAPP), which is a novel procedure used in periodontal pocket decontamination adjunctive to non-surgical periodontal treatment (NSPT). METHODS The study included 25 systemically healthy periodontitis patients. In the split-mouth design, NAPP application into the pockets, in addition to NSPT, was performed. Clinical periodontal data, gingival crevicular fluid, and subgingival plaque samples of patients were taken before and during the first and third months of treatment. Biochemical assays were conducted using enzyme-linked immunosorbent assay. Analysis of bacteria was performed with polymerase chain reaction method. RESULTS There was more clinical attachment level (CAL) gain in the 3rd month in the test group (deep pockets: 3.90 mm, pockets ≥ 5 mm: 2.72 mm) compared to the control group (deep pockets: 3.40 mm, pockets ≥ 5 mm: 2.58 mm) (p < 0.05), but no significant difference between groups in CAL. Clinical periodontal parameters improved in both study groups (p < 0.05). However, the gingival index (GI) and the bleeding on probing (BOP) rate decreased more in the test group (GI: 0.55, BOP: 9.48%, and GI: 0.38, BOP: 8.46% in the 1st and 3rd months, respectively) compared to the control group (GI: 0.68, BOP: 13.43%, and GI: 0.52, BOP: 14.58%) (p < 0.05). In addition, there was no significant difference in probing depth and biochemical markers between groups (p > 0.05). It was observed that NAPP reduced the number of bacteria more than the control group in the 1st and 3rd months. CONCLUSIONS It was seen that the single-time NAPP application concurrent with NSPT provided additional CAL gain, elimination of putative periodontopathogens and reduced their recolonization. Longitudinal studies with larger population and longer time are required. CLINICAL RELEVANCE NSPT is an effective method for the treatment of periodontitis but bacteria recolonization that causes recurrence of the periodontal disease occurs within a short period. NAPP can reduce the recurrence of periodontal disease by providing better bacterial elimination and should, therefore, be used in maintenance of periodontitis.
Collapse
Affiliation(s)
- Diğdem Küçük
- Faculty of Dentistry, Department of Periodontology, Katip Celebi University, Izmir, Turkey.,Private Practice, Izmir, Turkey
| | - Levent Savran
- Faculty of Dentistry, Department of Periodontology, Katip Celebi University, Izmir, Turkey
| | - Utku Kürşat Ercan
- Faculty of Engineering and Architecture, Department of Biomedical Engineering, Katip Celebi University, Izmir, Turkey
| | - Ziyşan Buse Yarali
- Department of Biomedical Engineering, Tissue Engineering and Regenerative Medicine Laboratory, Katip Celebi University, Izmir, Turkey
| | - Ozan Karaman
- Faculty of Engineering and Architecture, Department of Biomedical Engineering, Katip Celebi University, Izmir, Turkey
| | - Alpdoğan Kantarci
- The Forsyth Institute, Department of Applied Oral Sciences, Center for Periodontology, Cambridge, USA
| | - Mehmet Sağlam
- Faculty of Dentistry, Department of Periodontology, Katip Celebi University, Izmir, Turkey
| | - Serhat Köseoğlu
- Faculty of Dentistry, Department of Periodontology, Katip Celebi University, Izmir, Turkey. .,Hamidiye Faculty of Dentistry, Department of Periodontology, Health Sciences University, 34668, Istanbul, Turkey.
| |
Collapse
|
44
|
ROS from Physical Plasmas: Redox Chemistry for Biomedical Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9062098. [PMID: 31687089 PMCID: PMC6800937 DOI: 10.1155/2019/9062098] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/17/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022]
Abstract
Physical plasmas generate unique mixes of reactive oxygen and nitrogen species (RONS or ROS). Only a bit more than a decade ago, these plasmas, operating at body temperature, started to be considered for medical therapy with considerably little mechanistic redox chemistry or biomedical research existing on that topic at that time. Today, a vast body of evidence is available on physical plasma-derived ROS, from their spatiotemporal resolution in the plasma gas phase to sophisticated chemical and biochemical analysis of these species once dissolved in liquids. Data from in silico analysis dissected potential reaction pathways of plasma-derived reactive species with biological membranes, and in vitro and in vivo experiments in cell and animal disease models identified molecular mechanisms and potential therapeutic benefits of physical plasmas. In 2013, the first medical plasma systems entered the European market as class IIa devices and have proven to be a valuable resource in dermatology, especially for supporting the healing of chronic wounds. The first results in cancer patients treated with plasma are promising, too. Due to the many potentials of this blooming new field ahead, there is a need to highlight the main concepts distilled from plasma research in chemistry and biology that serve as a mechanistic link between plasma physics (how and which plasma-derived ROS are produced) and therapy (what is the medical benefit). This inevitably puts cellular membranes in focus, as these are the natural interphase between ROS produced by plasmas and translation of their chemical reactivity into distinct biological responses.
Collapse
|
45
|
Izadjoo M, Zack S, Kim H, Skiba J. Medical applications of cold atmospheric plasma: state of the science. J Wound Care 2019; 27:S4-S10. [PMID: 30207843 DOI: 10.12968/jowc.2018.27.sup9.s4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
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.
Collapse
Affiliation(s)
- Mina Izadjoo
- President and Chief Science Officer, Trideum Biosciences, Integrated Pharma Services, Integrated MicroSciences, Frederick, Maryland, US
| | | | - Hosan Kim
- Senior Scientist, Trideum Biosciences, Integrated Pharma Services
| | - Jeffry Skiba
- Chief Technology Officer, Integrated Pharma Services, Integrated MicroSciences, Frederick, Maryland, US
| |
Collapse
|
46
|
Non-Thermal Plasma Accelerates Astrocyte Regrowth and Neurite Regeneration Following Physical Trauma In Vitro. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9183747] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Non-thermal plasma (NTP), defined as a partially ionized gas, is an emerging technology with several biomedical applications, including tissue regeneration. In particular, NTP treatment has been shown to activate endogenous biological processes to promote cell regrowth, differentiation, and proliferation in multiple cell types. However, the effects of this therapy on nervous system regeneration have not yet been established. Accordingly, the current study explored the effects of a nanosecond-pulsed dielectric barrier discharge plasma on neural regeneration. Following mechanical trauma in vitro, plasma was applied either directly to (1) astrocytes alone, (2) neurons alone, or (3) neurons or astrocytes in a non-contact co-culture. Remarkably, we identified NTP treatment intensities that accelerated both neurite regeneration and astrocyte regrowth. In astrocyte cultures alone, an exposure of 20–90 mJ accelerated astrocyte re-growth up to three days post-injury, while neurons required lower treatment intensities (≤20 mJ) to achieve sub-lethal outgrowth. Following injury to neurons in non-contact co-culture with astrocytes, 20 mJ exposure of plasma to only neurons or astrocytes resulted in increased neurite regeneration at three days post-treatment compared to the untreated, but no enhancement was observed when both cell types were treated. At day seven, although regeneration further increased, NTP did not elicit a significant increase from the control. However, plasma exposure at higher intensities was found to be injurious, underscoring the need to optimize exposure levels. These results suggest that growth-promoting physiological responses may be elicited via properly calibrated NTP treatment to neurons and/or astrocytes. This could be exploited to accelerate neurite re-growth and modulate neuron-astrocyte interactions, thereby hastening nervous system regeneration.
Collapse
|
47
|
Boehm D, Bourke P. Safety implications of plasma-induced effects in living cells - a review of in vitro and in vivo findings. Biol Chem 2019; 400:3-17. [PMID: 30044756 DOI: 10.1515/hsz-2018-0222] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
Abstract
Cold atmospheric plasma is a versatile new tool in the biomedical field with applications ranging from disinfection, wound healing and tissue regeneration to blood coagulation, and cancer treatment. Along with improved insights into the underlying physical, chemical and biological principles, plasma medicine has also made important advances in the introduction into the clinic. However, in the absence of a standard plasma 'dose' definition, the diversity of the field poses certain difficulties in terms of comparability of plasma devices, treatment parameters and resulting biological effects, particularly with regards to the question of what constitutes a safe plasma application. Data from various in vitro cytotoxic and genotoxic studies along with in vivo findings from animal and human trials are reviewed to provide an overview of the current state of knowledge on the safety of plasma for biological applications. Treatment parameters employed in clinical studies were well tolerated but intense treatment conditions can also induce tissue damage or genotoxicity. There is a need identified to establish both guidelines and safety limits that ensure an absence of (long-term) side effects and to define treatments as safe for applications, where cell stimulation is desired, e.g. in wound healing, or those aimed at inducing cell death in the treatment of cancer.
Collapse
Affiliation(s)
- Daniela Boehm
- School of Food Science and Environmental Health, Plasma Research Group, College of Sciences and Health, Dublin Institute of Technology, Dublin 1, Ireland
| | - Paula Bourke
- School of Food Science and Environmental Health, Plasma Research Group, College of Sciences and Health, Dublin Institute of Technology, Dublin 1, Ireland
| |
Collapse
|
48
|
Bekeschus S, Seebauer C, Wende K, Schmidt A. Physical plasma and leukocytes - immune or reactive? Biol Chem 2019; 400:63-75. [PMID: 30030959 DOI: 10.1515/hsz-2018-0224] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/20/2018] [Indexed: 12/15/2022]
Abstract
Leukocytes are professionals in recognizing and removing pathogenic or unwanted material. They are present in virtually all tissues, and highly motile to enter or leave specific sites throughout the body. Less than a decade ago, physical plasmas entered the field of medicine to deliver their delicate mix of reactive species and other physical agents for mainly dermatological or oncological therapy. Plasma treatment thus affects leukocytes via direct or indirect means: immune cells are either present in tissues during treatment, or infiltrate or exfiltrate plasma-treated areas. The immune system is crucial for human health and resolution of many types of diseases. It is therefore vital to study the response of leukocytes after plasma treatment in vitro and in vivo. This review gathers together the major themes in the plasma treatment of innate and adaptive immune cells, and puts these into the context of wound healing and oncology, the two major topics in plasma medicine.
Collapse
Affiliation(s)
- Sander Bekeschus
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
| | - Christian Seebauer
- Greifswald University Medical Center, Department of Oral and Maxillofacial Surgery/Plastic Surgery, Ferdinand-Sauerbruch-Str. DZ 7, D-17475 Greifswald, Germany
| | - Kristian Wende
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
| | - Anke Schmidt
- Leibniz-Institute for Plasma Science and Technology (INP Greifswald), ZIK plasmatis, Felix-Hausdorff-Str. 2, D-17489 Greifswald, Germany
| |
Collapse
|
49
|
Schneider C, Arndt S, Zimmermann JL, Li Y, Karrer S, Bosserhoff AK. Cold atmospheric plasma treatment inhibits growth in colorectal cancer cells. Biol Chem 2019; 400:111-122. [PMID: 29908123 DOI: 10.1515/hsz-2018-0193] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022]
Abstract
Plasma oncology is a relatively new field of research. Recent developments have indicated that cold atmospheric plasma (CAP) technology is an interesting new therapeutic approach to cancer treatment. In this study, p53 wildtype (LoVo) and human p53 mutated (HT29 and SW480) colorectal cancer cells were treated with the miniFlatPlaSter - a device particularly developed for the treatment of tumor cells - that uses the Surface Micro Discharge (SMD) technology for plasma production in air. The present study analyzed the effects of plasma on colorectal cancer cells in vitro and on normal colon tissue ex vivo. Plasma treatment had strong effects on colon cancer cells, such as inhibition of cell proliferation, induction of cell death and modulation of p21 expression. In contrast, CAP treatment of murine colon tissue ex vivo for up to 2 min did not show any toxic effect on normal colon cells compared to H2O2 positive control. In summary, these results suggest that the miniFlatPlaSter plasma device is able to kill colorectal cancer cells independent of their p53 mutation status. Thus, this device presents a promising new approach in colon cancer therapy.
Collapse
Affiliation(s)
- Christin Schneider
- Institute of Biochemistry (Emil-Fischer-Center), University of Erlangen-Nürnberg, Fahrstrasse 17, D-91054 Erlangen, Germany
| | - Stephanie Arndt
- Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, D-93053 Regensburg, Germany
| | | | - Yangfang Li
- Terraplasma GmbH, Lichtenbergstrasse 8, D-85748 Garching, Germany
| | - Sigrid Karrer
- Department of Dermatology, University Medical Center Regensburg, Franz-Josef-Strauss Allee 11, D-93053 Regensburg, Germany
| | - Anja K Bosserhoff
- Institute of Biochemistry (Emil-Fischer-Center), University of Erlangen-Nürnberg, Fahrstrasse 17, D-91054 Erlangen, Germany
| |
Collapse
|
50
|
Gelbrich N, Stope MB, Burchardt M. [Cold atmospheric plasma for the treatment of urological tumors]. Urologe A 2019; 58:673-679. [PMID: 30097666 DOI: 10.1007/s00120-018-0754-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cold atmospheric plasma (CAP) is a highly reactive ionized physical state consisting of electrically charged particles, radicals and photons as well as electromagnetic radiation. Due to the high energy and reactivity of plasma components, physical plasmas are also referred to as the 4th aggregate state. In biological systems, CAP promotes antimicrobial, immunomodulatory, anti-inflammatory, and wound-healing effects. Moreover, CAP bears antineoplastic properties which may be applied as a potential intraoperative option in the treatment of wound and resection margins during surgery of urological tumors. Some properties such as the penetration depth in various biological tissues, the effect on physiological healthy tissue, and the molecular mode of action regarding signalling and effector pathways are the subject of further investigation. CAP treatment effectively attenuates malignant cell growth. As an intraoperative application, CAP may represent a promising option particularly for the treatment of tissue regions that are close to critical structures (e. g., nerves, adjacent organs). The present review article summarizes the current status of CAP-related studies in the field of urological oncology.
Collapse
Affiliation(s)
- N Gelbrich
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, 17475, Greifswald, Deutschland.
| | - M B Stope
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, 17475, Greifswald, Deutschland
| | - M Burchardt
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, 17475, Greifswald, Deutschland
| |
Collapse
|