Nonthermal atmospheric pressure plasma jets (APPJ) have been developed and applied in biomedical research as a cancer treatment or bacterial sterilization. However, the drawback of APPJ on normal oral cells during plasma treatment and underlying cell death mechanisms have not been studied and clearly explained, although there is known to be an influence from reactive oxygen species (ROS). Hence, this study investigates whether and how a nonthermal atmospheric pressure air plasma jet kills human normal gingival cells using immortalized human gingival fibroblasts (hTERT-hNOF cells). In this study, a set of physicochemical or biological methods were used to illuminate the killing mechanisms. It was found that ROS were induced intracellularly without a breakdown of the cell wall and apoptosis was involved in cell death when an air APPJ treatment was performed on the cells directly without media; the air treatment only supported a detachment of the cells without increase of ROS. It was also revealed that a correlation between intracellular ROS concentration and cells viability existed. These results indicated that the direct air APPJ treatment possibly raises safety issue to normal tissue and thereby APPJ application in biomedical field needs more in vitro and in vivo study to optimize it.
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