Abstract

Reactive oxygen species (ROS) have been subject of increasing interest in the pathophysiology and therapy of cancers in recent years. In skin cancer, ROS are involved in UV-induced tumorigenesis and its targeted treatment via, e.g., photodynamic therapy. Another recent technology for topical ROS generation is cold physical plasma, a partially ionized gas expelling dozens of reactive species onto its treatment target. Gas plasma technology is accredited for its wound-healing abilities in Europe, and current clinical evidence suggests that it may have beneficial effects against actinic keratosis. Since the concept of hormesis dictates that low ROS levels perform signaling functions, while high ROS levels cause damage, we investigated herein the antitumor activity of gas plasma in non-melanoma skin cancer. In vitro, gas plasma exposure diminished the metabolic activity, preferentially in squamous cell carcinoma cell (SCC) lines compared to non-malignant HaCaT cells. In patient-derived basal cell carcinoma (BCC) and SCC samples treated with gas plasma ex vivo, increased apoptosis was found in both cancer types. Moreover, the immunomodulatory actions of gas plasma treatment were found affecting, e.g., the expression of CD86 and the number of regulatory T-cells. The supernatants of these ex vivo cultured tumors were quantitatively screened for cytokines, chemokines, and growth factors, identifying CCL5 and GM-CSF, molecules associated with skin cancer metastasis, to be markedly decreased. These findings suggest gas plasma treatment to be an interesting future technology for non-melanoma skin cancer topical therapy.

Highlights

  • Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are highly prevalent skin cancers [1,2]

  • Since the concept of hormesis dictates that low Reactive oxygen species (ROS) levels perform signaling functions, while high ROS levels cause damage, we investigated the antitumor activity of gas plasma in non-melanoma skin cancer

  • The immunomodulatory actions of gas plasma treatment were found affecting, e.g., the expression of CD86 and the number of regulatory T-cells. The supernatants of these ex vivo cultured tumors were quantitatively screened for cytokines, chemokines, and growth factors, identifying CCL5 and GM-CSF, molecules associated with skin cancer metastasis, to be markedly decreased

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Summary

Introduction

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are highly prevalent skin cancers [1,2]. Changes and diversity in the tumor microenvironment (TME) and the unknown nature of several other factors partially explain the failure of definitive treatment for these diseases in some cases [4,5]. The tumor microenvironment (TME) plays a significant role in tumor progression, response to treatment, growth, and the acquisition of the metastatic pattern by tumor cells [6]. In addition to all the classic strategies of tumors escaping the immune system responses, e.g., antigen expression reduction, resistance to cell lysis by the immune cells, and the expression and secretion of immune suppressor factors, the tumor escapes the immune system under TME complexity [7,8]. Looking for different treatment methods to target these tumors, especially in cases where resection is impossible, and examining the TME response to treatment is of utmost importance

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