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Bekeschus S. Medical gas plasma technology: Roadmap on cancer treatment and immunotherapy. Redox Biol 2023; 65:102798. [PMID: 37556976 PMCID: PMC10433236 DOI: 10.1016/j.redox.2023.102798] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 08/11/2023] Open
Abstract
Despite continuous therapeutic progress, cancer remains an often fatal disease. In the early 2010s, first evidence in rodent models suggested promising antitumor action of gas plasma technology. Medical gas plasma is a partially ionized gas depositing multiple physico-chemical effectors onto tissues, especially reactive oxygen and nitrogen species (ROS/RNS). Today, an evergrowing body of experimental evidence suggests multifaceted roles of medical gas plasma-derived therapeutic ROS/RNS in targeting cancer alone or in combination with oncological treatment schemes such as ionizing radiation, chemotherapy, and immunotherapy. Intriguingly, gas plasma technology was recently unraveled to have an immunological dimension by inducing immunogenic cell death, which could ultimately promote existing cancer immunotherapies via in situ or autologous tumor vaccine schemes. Together with first clinical evidence reporting beneficial effects in cancer patients following gas plasma therapy, it is time to summarize the main concepts along with the chances and limitations of medical gas plasma onco-therapy from a biological, immunological, clinical, and technological point of view.
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Affiliation(s)
- Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489, Greifswald, Germany; Clinic and Policlinic for Dermatology and Venerology, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany.
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Mumtaz S, Rana JN, Lim JS, Javed R, Choi EH, Han I. Effect of Plasma On-Time with a Fixed Duty Ratio on Reactive Species in Plasma-Treated Medium and Its Significance in Biological Applications. Int J Mol Sci 2023; 24:ijms24065289. [PMID: 36982365 PMCID: PMC10049170 DOI: 10.3390/ijms24065289] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/22/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Optimizing the therapeutic range of nonthermal atmospheric pressure plasma (NTAPP) for biomedical applications is an active research topic. For the first time, we examined the effect of plasma on-times in this study while keeping the duty ratio and treatment time fixed. We have evaluated the electrical, optical, and soft jet properties for two different duty ratios of 10% and 36%, using the plasma on-times of 25, 50, 75, and 100 ms. Furthermore, the influence of plasma on-time on reactive oxygen and nitrogen species (ROS/RNS) levels in plasma treated medium (PTM) was also investigated. Following treatment, the characteristics of (DMEM media) and PTM (pH, EC, and ORP) were also examined. While EC and ORP rose by raising plasma on-time, pH remained unchanged. Finally, the PTM was used to observe the cell viability and ATP levels in U87-MG brain cancer cells. We found it interesting that, by increasing the plasma on-time, the levels of ROS/RNS dramatically increased in PTM and significantly affected the viability and ATP levels of the U87-MG cell line. The results of this study provide a significant indication of advancement by introducing the optimization of plasma on-time to increase the efficacy of the soft plasma jet for biomedical applications.
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Affiliation(s)
- Sohail Mumtaz
- Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea; (S.M.); (J.S.L.); (E.H.C.)
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
| | - Juie Nahushkumar Rana
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Jun Sup Lim
- Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea; (S.M.); (J.S.L.); (E.H.C.)
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
| | - Rida Javed
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Eun Ha Choi
- Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Republic of Korea; (S.M.); (J.S.L.); (E.H.C.)
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Republic of Korea
| | - Ihn Han
- Plasma Bioscience Research Center (PBRC), Applied Plasma Medicine Center, Kwangwoon University, Seoul 01897, Republic of Korea; (J.N.R.); (R.J.)
- Department of Plasma Bio-Display, Kwangwoon University, Seoul 01897, Republic of Korea
- Correspondence: ; Tel.: +82-2-940-5666; Fax: +82-2-940-5664
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Miebach L, Mohamed H, Wende K, Miller V, Bekeschus S. Pancreatic Cancer Cells Undergo Immunogenic Cell Death upon Exposure to Gas Plasma-Oxidized Ringers Lactate. Cancers (Basel) 2023; 15:cancers15010319. [PMID: 36612315 PMCID: PMC9818580 DOI: 10.3390/cancers15010319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023] Open
Abstract
Survival rates among patients with pancreatic cancer, the most lethal gastrointestinal cancer, have not improved compared to other malignancies. Early tumor dissemination and a supportive, cancer-promoting tumor microenvironment (TME) limit therapeutic options and consequently impede tumor remission, outlining an acute need for effective treatments. Gas plasma-oxidized liquid treatment showed promising preclinical results in other gastrointestinal and gynecological tumors by targeting the tumor redox state. Here, carrier solutions are enriched with reactive oxygen (ROS) and nitrogen (RNS) species that can cause oxidative distress in tumor cells, leading to a broad range of anti-tumor effects. Unfortunately, clinical relevance is often limited, as many studies have forgone the use of medical-grade solutions. This study investigated the efficacy of gas plasma-oxidized Ringer's lactate (oxRilac), a physiological solution often used in clinical practice, on two pancreatic cancer cell lines to induce tumor toxicity and provoke immunogenicity. Tumor toxicity of the oxRilac solutions was further confirmed in three-dimensional tumor spheroids monitored over 72 h and in ovo using stereomicroscope imaging of excised GFP-expressing tumors. We demonstrated that cell death signaling was induced in a dose-dependent fashion in both cell lines and was paralleled by the increased surface expression of key markers of immunogenic cell death (ICD). Nuclear magnetic resonance (NMR) spectroscopy analysis suggested putative reaction pathways that may cause the non-ROS related effects. In summary, our study suggests gas plasma-deposited ROS in clinically relevant liquids as an additive option for treating pancreatic cancers via immune-stimulating and cytotoxic effects.
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Affiliation(s)
- Lea Miebach
- Department of General, Thoraxic, Vascular, and Visceral Surgery, Greifswald University Medical Center, 17489 Greifswald, Germany
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Hager Mohamed
- Emergex Vaccines Holding Limited, Doylestown, PA 18902, USA
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Kristian Wende
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Vandana Miller
- Department of Microbiology and Immunology, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Sander Bekeschus
- ZIK plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
- Correspondence:
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Gunes S, He Z, Tsoukou E, Ng SW, Boehm D, Pinheiro Lopes B, Bourke P, Malone R, Cullen PJ, Wang W, Curtin J. Cell death induced in glioblastoma cells by Plasma-Activated-Liquids (PAL) is primarily mediated by membrane lipid peroxidation and not ROS influx. PLoS One 2022; 17:e0274524. [PMID: 36137100 PMCID: PMC9498962 DOI: 10.1371/journal.pone.0274524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/28/2022] [Indexed: 12/24/2022] Open
Abstract
Since first identified in 1879, plasma, the fourth state of matter, has been developed and utilised in many fields. Nonthermal atmospheric plasma, also known as cold plasma, can be applied to liquids, where plasma reactive species such as reactive Oxygen and Nitrogen species and their effects can be retained and mediated through plasma-activated liquids (PAL). In the medical field, PAL is considered promising for wound treatment, sterilisation and cancer therapy due to its rich and relatively long-lived reactive species components. This study sought to identify any potential antagonistic effect between antioxidative intracellularly accumulated platinum nanoparticles (PtNPs) and PAL. We found that PAL can significantly reduce the viability of glioblastoma U-251MG cells. This did not involve measurable ROS influx but instead lead to lipid damage on the plasma membrane of cells exposed to PAL. Although the intracellular antioxidative PtNPs showed no protective effect against PAL, this study contributes to further understanding of principle cell killing routes of PAL and discovery of potential PAL-related therapy and methods to inhibit side effects.
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Affiliation(s)
- Sebnem Gunes
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
- * E-mail: (JC); (SG)
| | - Zhonglei He
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Evanthia Tsoukou
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
| | - Sing Wei Ng
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
- Plasma Research Group, School of Biosystems and Food Engineering, University College Dublin, Belfield, D4, Dublin, Ireland
| | - Daniela Boehm
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
| | - Beatriz Pinheiro Lopes
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
| | - Paula Bourke
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
- Plasma Research Group, School of Biosystems and Food Engineering, University College Dublin, Belfield, D4, Dublin, Ireland
| | - Renee Malone
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
| | - Patrick J. Cullen
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- School of Chemical and Biomolecular Engineering, University of Sydney, Sydney, Australia
| | - Wenxin Wang
- Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - James Curtin
- BioPlasma Research Group, School of Food Science and Environmental Health, Technological University Dublin, Dublin, Ireland
- Environmental Sustainability & Health Institute (ESHI), Technological University Dublin, Dublin, Ireland
- Faculty of Engineering and Built Environment, Technological University Dublin, Dublin, Ireland
- * E-mail: (JC); (SG)
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Paradox Role of Oxidative Stress in Cancer: State of the Art. Antioxidants (Basel) 2022; 11:antiox11051027. [PMID: 35624891 PMCID: PMC9138152 DOI: 10.3390/antiox11051027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
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Non-Invasive Physical Plasma Treatment after Tooth Extraction in a Patient on Antiresorptive Medication Promotes Tissue Regeneration. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Postoperative tissue regeneration can be negatively affected by bisphosphonate administration, especially in patients with oncologic diseases. A serious complication of bisphosphonate therapy is the medication-related osteonecrosis of the jaw (MRONJ), which can be observed mainly after dental surgery. MRONJ is a progressive destruction of the bone that requires patients to stay in hospital for extended periods of time. For this reason, primary wound closure is particularly important in surgical procedures. In the case of wound dehiscence, there is a very high risk for MRONJ. In recent years, non-invasive physical plasma (NIPP) has become known for improving wound healing on the one hand, but also for its promising efficacy in cancer therapy on the other hand. We report on a 63-year-old patient with a history of multiple myeloma and receiving zoledronate, who developed wound dehiscence after tooth extraction. NIPP treatment resulted in complete epithelialization of the entire wound dehiscence. In conclusion, the use of NIPP in patients receiving antiresorptive drugs seems to support tissue regeneration and thus could be an important tool for the prevention of MRONJ.
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Ricciardi EF, Del Nobile MA, Conte A, Fracassi F, Sardella E. Effects of plasma treatments applied to fresh ricotta cheese. INNOV FOOD SCI EMERG 2022. [DOI: 10.1016/j.ifset.2022.102935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Patient-Derived Human Basal and Cutaneous Squamous Cell Carcinoma Tissues Display Apoptosis and Immunomodulation following Gas Plasma Exposure with a Certified Argon Jet. Int J Mol Sci 2021; 22:ijms222111446. [PMID: 34768877 PMCID: PMC8584092 DOI: 10.3390/ijms222111446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
Reactive oxygen species (ROS) have been subject of increasing interest in the pathophysiology and therapy of cancers in recent years. In skin cancer, ROS are involved in UV-induced tumorigenesis and its targeted treatment via, e.g., photodynamic therapy. Another recent technology for topical ROS generation is cold physical plasma, a partially ionized gas expelling dozens of reactive species onto its treatment target. Gas plasma technology is accredited for its wound-healing abilities in Europe, and current clinical evidence suggests that it may have beneficial effects against actinic keratosis. Since the concept of hormesis dictates that low ROS levels perform signaling functions, while high ROS levels cause damage, we investigated herein the antitumor activity of gas plasma in non-melanoma skin cancer. In vitro, gas plasma exposure diminished the metabolic activity, preferentially in squamous cell carcinoma cell (SCC) lines compared to non-malignant HaCaT cells. In patient-derived basal cell carcinoma (BCC) and SCC samples treated with gas plasma ex vivo, increased apoptosis was found in both cancer types. Moreover, the immunomodulatory actions of gas plasma treatment were found affecting, e.g., the expression of CD86 and the number of regulatory T-cells. The supernatants of these ex vivo cultured tumors were quantitatively screened for cytokines, chemokines, and growth factors, identifying CCL5 and GM-CSF, molecules associated with skin cancer metastasis, to be markedly decreased. These findings suggest gas plasma treatment to be an interesting future technology for non-melanoma skin cancer topical therapy.
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Selective Apoptotic Effect of Plasma Activated Liquids on Human Cancer Cell Lines. Molecules 2021; 26:molecules26144254. [PMID: 34299530 PMCID: PMC8304656 DOI: 10.3390/molecules26144254] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 12/17/2022] Open
Abstract
Plasma medicine is a new field focusing on biomedical and clinical applications of cold gas plasmas, including their anticancer effects. Cold plasmas can be applied directly or indirectly as plasma-activated liquids (PAL). The effects of plasma-activated cell growth medium (PAM) and plasma-activated phosphate buffered saline (PAPBS) were tested, using a plasma pen generating streamer corona discharge in ambient air, on different cancer cell lines (melanoma A375, glioblastoma LN229 and pancreatic cancer MiaPaCa-2) and normal cells (human dermal fibroblasts HDFa). The viability reduction and apoptosis induction were detected in all cancer cells after incubation in PAL. In melanoma cells we focused on detailed insights to the apoptotic pathways. The anticancer effects depend on the plasma treatment time or PAL concentration. The first 30 min of incubation in PAL were enough to start processes leading to cell death. In fibroblasts, no apoptosis induction was observed, and only PAPBS, activated for a longer time, slightly decreased their viability. Effects of PAM and PAPBS on cancer cells showed selectivity compared to normal fibroblasts, depending on correctly chosen activation time and PAL concentration, which is very promising for potential clinical applications. This selectivity effect of PAL is conceivably induced by plasma-generated hydrogen peroxide.
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