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Yoon YJ, Suh MJ, Lee HY, Lee HJ, Choi EH, Moon IS, Song K. Anti-tumor effects of cold atmospheric pressure plasma on vestibular schwannoma demonstrate its feasibility as an intra-operative adjuvant treatment. Free Radic Biol Med 2018; 115:43-56. [PMID: 29138018 DOI: 10.1016/j.freeradbiomed.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/07/2017] [Accepted: 11/10/2017] [Indexed: 12/12/2022]
Abstract
Vestibular schwannoma (VS), although a benign intracranial tumor, causes morbidities by brainstem compression. Since chemotherapy is not very effective in most Nf2-negative schwannomas, surgical removal or radiation therapy is required. However, depending on the size and site of the tumor, these approaches may cause loss of auditory or vestibular functions, and severely decrease the post-surgical wellbeing. Here, we examined the feasibility of cold atmospheric pressure plasma (CAP) as an intra-operative adjuvant treatment for VS after surgery. Cell death was efficiently induced in both human HEI-193 and mouse SC4 VS cell lines upon exposure to CAP for seven minutes. Interestingly, both apoptosis and necroptosis were simultaneously induced by CAP treatment, and cell death was not completely inhibited by pan-caspase and receptor-interacting serine/threonine-protein kinase 1 (RIK1) inhibitors. Upon CAP exposure, cell death phenotype was similarly observed in patient-derived primary VS cells and tumor mass. In addition, CAP exposure after the surgical removal of primary tumor efficiently inhibited tumor recurrence in SC4-grafted mouse models. Collectively, these results strongly suggest that CAP should be developed as an efficient adjuvant treatment for VS after surgery to eliminate the possible remnant tumor cells, and to minimize the surgical area in the brain for post-surgical wellbeing.
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Affiliation(s)
- Yeo Jun Yoon
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul 03722, Korea
| | - Michelle J Suh
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul 03722, Korea
| | - Hyun Young Lee
- Department of Electrical Engineering, Pusan National University, Pusan 46269, Korea
| | - Hae June Lee
- Department of Electrical Engineering, Pusan National University, Pusan 46269, Korea
| | - Eun Ha Choi
- Plasma Bioscience Research Center and Department of Electrical and Biological Physics, Kwangwoon University, Seoul 01897, Korea
| | - In Seok Moon
- Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul 03722, Korea.
| | - Kiwon Song
- Department of Biochemistry, College of Life Science & Biotechnology, Yonsei University, Seoul 03722, Korea.
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Schuster M, Seebauer C, Rutkowski R, Hauschild A, Podmelle F, Metelmann C, Metelmann B, von Woedtke T, Hasse S, Weltmann KD, Metelmann HR. Visible tumor surface response to physical plasma and apoptotic cell kill in head and neck cancer. J Craniomaxillofac Surg 2016; 44:1445-52. [PMID: 27499516 DOI: 10.1016/j.jcms.2016.07.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/27/2016] [Accepted: 07/01/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of the study was to learn, whether clinical application of cold atmospheric pressure plasma (CAP) is able to cause (i) visible tumor surface effects and (ii) apoptotic cell kill in squamous cell carcinoma and (iii) whether CAP-induced visible tumor surface response occurs as often as CAP-induced apoptotic cell kill. Twelve patients with advanced head and neck cancer and infected ulcerations received locally CAP followed by palliative treatment. Four of them revealed tumor surface response appearing 2 weeks after intervention. The tumor surface response expressed as a flat area with vascular stimulation (type 1) or a contraction of tumor ulceration rims forming recesses covered with scabs, in each case surrounded by tumor tissue in visible progress (type 2). In parallel, 9 patients with the same kind of cancer received CAP before radical tumor resection. Tissue specimens were analyzed for apoptotic cells. Apoptotic cells were detectable and occurred more frequently in tissue areas previously treated with CAP than in untreated areas. Bringing together both findings and placing side by side the frequency of clinical tumor surface response and the frequency of analytically proven apoptotic cell kill, detection of apoptotic cells is as common as clinical tumor surface response. There was no patient showing signs of an enhanced or stimulated tumor growth under influence of CAP. CAP was made applicable by a plasma jet, kINPen(®) MED (neoplas tools GmbH, Greifswald, Germany).
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Affiliation(s)
- Matthias Schuster
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany.
| | - Christian Seebauer
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany; Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Rico Rutkowski
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany
| | - Anna Hauschild
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany
| | - Fred Podmelle
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany
| | - Camilla Metelmann
- Greifswald University Medicine, Department of Anesthesiology, Anesthesia, Intensive Care-, Emergency- and Pain Medicine, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Bibiana Metelmann
- Greifswald University Medicine, Department of Anesthesiology, Anesthesia, Intensive Care-, Emergency- and Pain Medicine, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany
| | - Sybille Hasse
- Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany
| | - Klaus-Dieter Weltmann
- Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany
| | - Hans-Robert Metelmann
- Department of Oral and Maxillofacial Surgery/Plastic Surgery (Head: Prof. Dr. Dr. Hans-Robert Metelmann), Greifswald University Medicine, Ferdinand-Sauerbruch-Str. DZ 7, 17475 Greifswald, Germany; National Centre for Plasma Medicine (ZPM), Charitéplatz 1, 10117 Berlin, Germany
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