Clinical and Biological Principles of Cold Atmospheric Plasma Application in Skin Cancer

Abstract

Plasma-based electrosurgical devices have long been employed for tissue coagulation, cutting, desiccation, and cauterizing. Despite their clinical benefits, these technologies involve tissue heating and their effects are primarily heat-mediated. Recently, there have been significant developments in cold atmospheric pressure plasma (CAP) science and engineering. New sources of CAP with well-controlled temperatures below 40 °C have been designed, permitting safe plasma application on animal and human bodies. In the last decade, a new innovative field, often referred to as plasma medicine, which combines plasma physics, life science, and clinical medicine has emerged. This field aims to exploit effects of mild plasma by controlling the interactions between plasma components (and other secondary species that can be formed from these components) with specific structural elements and functionalities of living cells. Recent studies showed that CAP can exert beneficial effects when applied selectively in certain pathologies with minimal toxicity to normal tissues. The rapid increase in new investigations and development of various devices for CAP application suggest early adoption of cold plasma as a new tool in the biomedical field. This review explores the latest major achievements in the field, focusing on the biological effects, mechanisms of action, and clinical evidence of CAP applications in areas such as skin disinfection, tissue regeneration, chronic wounds, and cancer treatment. This information may serve as a foundation for the design of future clinical trials to assess the efficacy and safety of CAP as an adjuvant therapy for skin cancer.

Cold atmospheric plasma induces apoptosis of melanoma cells via Sestrin2‐mediated nitric oxide synthase signaling

“…In the present study, CAP treated PBS showed increasing levels of nitrated, nitrite as well as H 2 O 2 , and the concentrations of nitrate and nitrite were much higher than H 2 O 2 . As we know, CAP is able to induce many types of cancer cell death by production of many different kind of reactive species, such as superoxide(O 2 −), Hydroxyl superoxide (HO 2 −), Hydroxyl radical (·OH), hydrogen peroxide (H 2 O 2 ), nitric oxide (NO), nitrogen dioxide (NO 2 ) nitrous oxide(N 2 O), and so on . Here, our data confirmed that CAP could induced melanoma cell line A375 and A875 apoptosis.…”

“…It was hypothesized that such an effect was related to reduced expression of cell cycle mediators (eg, cyclins D1, E1 and E2), as well as increased expression of the cell cycle suppressor protein, p27KIP1 . Cold atmospheric plasma (CAP) with well‐controlled temperatures below 40°C has recently been developed with the use of new sources . In preliminary studies of this system, D 2 O + N 2 plasma jets and a helium CAP torch were shown to induce apoptosis of melanoma cells .…”

Effects and mechanisms of cold atmospheric plasma on skin wound healing of rats

“…[1] CAP treatment has been used to inactivate bacteria, [2] enhance blood coagulation, [3] promote cancerous cell apoptosis, [4] and promote wound healing [5] in recent years. (b) Cold atmospheric plasma (CAP) device using helium as the plasma forming gas.…”

Redox‐regulation of activator protein 1 family members in blood cancer cell lines exposed to cold physical plasma‐treated medium

“…[25][26][27] Many studies have provided evidence that cytotoxic effects of plasma in different cancer and/or non-cancer cell lines differ significantly among each other. [28][29][30] Besides the traditional explanation of an altered redox balance, [12] detailed investigation on molecular mechanisms underlying these differences-especially with regard to plasma-is scarce. In a previous comparison of metabolic activity between seven different cell lines, Jurkat were most and THP-1 cells least affected by plasma.…”