Combination of Cold Atmospheric Plasma and Vitamin C Effectively Disrupts Bacterial Biofilms

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Cold atmospheric plasma (CAP) is increasingly used in medical applications for eradication of bacterial and tumor cells. CAP treatment devices, known as plasma jet pens, produce reactive oxygen and nitrogen species at atmospheric pressure and room temperature. The produced reactive species are concentrated in a small and precisely defined area, allowing for high precision medical treatments. CAP has been demonstrated as very effective against planktonic bacterial cells. Unfortunately, bacterial cells in biofilms are typically aggregated and protected by dense exopolymeric matrix, synthesized and secreted by the bacterial community. The main limitation in using CAP against bacterial biofilms is the thick protective matrix of extracellular polymers that shields bacterial cells within this complex architecture. CAP has also been shown to effectively eradicate tumor cells, but the main current limitation is the susceptibility of the surrounding healthy tissues to higher doses. We have recently demonstrated that vitamin C, a natural food supplement, can be used to destabilize bacterial biofilms and render them more susceptible to the CAP killing treatment. Here we discuss the possible impact that a pre-treatment with vitamin C could have on CAP applications in medicine. Specifically, we argue that vitamin C could enhance the effectiveness of CAP treatments against both the bacterial biofilms and some selected tumors.