Cold Atmospheric Pressure Plasma in Wound Healing and Cancer Treatment

Lars Boeckmann,Thoralf Bernhardt,Steffen Emmert,Tobias Fischer,Barbara Nebe,Kirsten Peters,Sander Bekeschus,Gregor Ojak,Brigitte Müller-Hilke,Mirijam Schäfer,Ole Jung,Christian Seebauer,Marie Luise Semmler

doi:10.3390/app10196898

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.

Highlights

IntroductionThe field of plasma medicine is gaining more and more attention. Cold atmospheric pressure plasma (CAP) is composed of a complex mixture of biologically active components that may act synergistically on the treated materials and tissues and may have a variety of different biologic effects
In recent years, the field of plasma medicine is gaining more and more attention
A case-control study comparing the efficacy of another plasma jet device with octenidine dihydrochloride treatment revealed a similar anti-bacterial effect in the Cold atmospheric pressure plasma (CAP) group compared to the octenidine group [9]

Summary

Introduction

The field of plasma medicine is gaining more and more attention. Cold atmospheric pressure plasma (CAP) is composed of a complex mixture of biologically active components that may act synergistically on the treated materials and tissues and may have a variety of different biologic effects. While safety and the beneficial use of CAP as part of a multi-modular wound treatment has been demonstrated in several structured case reports and randomized case-control studies, the use of CAP for cancer treatment is an active field of research that warrants further investigations for its translation into clinic practice For these two quite different applications of CAP, different properties of CAP are required. This review article provides an overview of the latest literature regarding the clinical use of CAP for wound healing and cancer treatment It discusses possible underlying mechanisms triggered by CAP that grant CAP antiseptic and tissue regenerating or anti-proliferative and cell death-inducing properties

CAP Treatment to Promote Healing of Acute and Chronic Wounds

CAP Application for Cancer Treatment

Findings

Conclusions