Evaluation of cold atmospheric-pressure plasma against burn wound infections and gene silencing

Abstract

Background and Objectives: Non-thermal atmospheric-pressure plasma or cold plasma is defined as an ionized gas. This study aimed to investigate the effect of cold plasma on Pseudomonas aeruginosa strains. Also, the expression level of the alp virulence gene before and after treatment with cold plasma was compared with the Housekeeping gene gyrA.
 Materials and Methods: P. aeruginosa isolates recovered from hospitalized burn patients at Shahid Motahari Burns Hos- pital, Tehran, Iran. The Kirby Bauer disk diffusion method was used to determine the antimicrobial susceptibility test. Then, the antibacterial effect of atmospheric non-thermal plasma was evaluated on P. aeruginosa in as in vitro and in vivo studies at different times on Muller Hinton agar and in mouse model (treated by plasma every day/ 90 sec). The histopathological study was evaluated by Hematoxylin-Eosin staining. Data were analyzed using SPSS software by the Chi-square test and Pvalues less than 0.05 considered as statistically significant.
 Results: Results indicated that non-thermal atmospheric plasma inhibited the growth of P. aeruginosa. The non-thermal helium plasma accelerates wound healing for 6 days. Results showed that cold plasma decreased virulence gene expression alp after treatment. Therefore, cold plasma can be suggested as a complementary therapeutic protocol to reduce bacterial infection and accelerate wound healing and reduce the expression of virulence genes of pathogens.
 Conclusion: Cold plasma showed pathogen inhibitory properties of P. aeruginosa and virulence alkaline protease and wound healing properties in animal models, so this inexpensive and suitable method can be presented to the medical community to disinfect burn wounds and improve wound healing.

The efficacy and safety of the innovative cold atmospheric‐pressure plasma technology in the treatment of striae distensae: A randomized controlled trial

“…It accelerates wound healing, particularly in chronic venous ulcers, pressure ulcers, chronic infectious and nonhealing wounds, or burn wounds. 15,[45][46][47][48][49][50][51][52][53] Several CAP's qualities may improve the wound healing process, such as UV radiation and reactive gas species (i.e., ozone) disinfecting the wound, nitric oxide (NO) or nitrogen species (NOx) generation stimulating tissue regeneration, electric current stimulating angiogenesis and wound acidification. 54 There is an increased Wnt signaling 55 caused by CAP-generated reactive oxygen species and increased angiogenesis (ex vivo experimental setting).…”

Advances in Gas Therapeutics for Wound Healing: Mechanisms, Delivery Materials, and Prospects

“…[20,21] Three mechanisms are possible: electroporation and oxidation-induced cell wall/membrane dysfunction, which leads to leakage of cellular components; intracellular oxidation and nitrification, which cause protein damage and gene expression disorder; and direct DNA damage, such as those causing breaking of the double strand. [22] Cold plasma treatment could generate additional reaction products, including Cl 2À , ClO À , and HOCl, which result from peroxide formation by the plasma. The oxidation of bacterial macromolecules by HOCl can increase the uptake and processing of bacterial neoantigens by antigen-presenting cells.…”

“…Blood clotting, inflammation, the growth of new tissue, and tissue remodeling are all important components in the complicated process of wound healing. [4] These molecules not only play a role in physiopathological processes but are also crucial in wound repair, performing various functions such as antimicrobial (NO, [5][6][7] H 2 S, [8,9] CO, [10][11][12][13][14][15][16] SO 2 , [17][18][19] and plasma), [20][21][22] anti-inflammatory (NO, [23] H 2 S, [24][25][26] CO, [27] SO 2 , [28] and H 2 ), [29,30] immunomodulatory (O 2 , [31] CO, [27] NO, [32] and H 2 S), [33] provascular (O 2 , [34][35][36][37][38] NO, [39] H 2 S, [40] CO, [41] and CO), 2 [42] extracellular matrix (ECM) formation, and remodeling (O 2 [37,[43][44][45] and NO).[39] However, gas therapy (GT) applied alone is usually limited by its low tissue permeability, poor solubility, and bioavailability.…”

Infection and Burn Injury

“…The resulting partially ionized gas is made up of many ions, electrons, ultraviolet photons and reactive oxygen species that exhibit antimicrobial effects. It can be applied to the wound bed too for disinfection and also stimulates cell migration and proliferation to promote wound healing [99][100][101].…”