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Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe adverse effect of ChAdOx1 nCoV-19 COVID-19 vaccine (Vaxzevria) and COVID-19 vaccine Janssen (Ad26.COV2.S), and associated with unusual thrombosis. VITT is caused by anti-platelet factor 4 (PF4) antibodies activating platelets through their FcgRIIa receptors. Antibodies activating platelets through FcgRIIa receptors have also been identified in COVID-19 patients. These findings raise concern that vaccination-induced antibodies against anti-SARS-CoV-2 spike protein cause thrombosis by cross-reacting with PF4. Immunogenic epitopes of PF4 and SARS-CoV-2 spike protein were compared using in-silico prediction tools and 3D-modelling. The SARS-CoV-2 spike protein and PF4 share at least one similar epitope. Reactivity of purified anti-PF4 antibodies from patients with VITT was tested against recombinant SARS-CoV-2 spike protein. However, none of the affinity-purified anti-PF4 antibodies from 14 VITT patients cross-reacted with SARS-CoV-2 spike protein. Sera from 222 PCR-confirmed COVID-19 patients from five European centers were tested by PF4/heparin ELISA and PF4-dependent platelet activation assays. We found anti-PF4 antibodies in 19 of 222 (8.6%) COVID-19 patient sera. However, only four showed weak to moderate platelet activation in the presence of PF4, and none of these patients developed thrombotic complications. Among 10 of 222 (4.5%) COVID-19 patients with thrombosis, none showed PF4-dependent platelet-activating antibodies. In conclusion, antibodies against PF4 induced by vaccination do not cross-react with the SARS-CoV-2 spike protein, indicating that the intended vaccine-induced immune response against SARS-CoV-2 spike protein is not the trigger of VITT. PF4-reactive antibodies found in COVID-19 patients of the present study were not associated with thrombotic complications.

Plasma medicine has become an emerging field in medical sciences since cold plasma has demonstrated important antimicrobial properties. As microbial plasma susceptibility data yet are not available, the susceptibility of 194 wound isolates exhibiting multiple antibiotic resistance was tested in vitro to CP and correlated with inhibition zones. Inhibition zones increased in parallel with the number of antibiotic classes to which the tested strain exhibit resistance. CP exhibited strong antimicrobial efficacy against most important clinical skin and wound pathogens in vitro irrespective of multidrug resistance.

As proof of principle, argon-based CAP serves as a potent treatment modality that was shown to limit MDR microbial colonization. The possible role of CAP in clinical MDR decontamination must be evaluated in clinical trials with repeated plasma treatment embedded in a comprehensive hygienic decontamination concept.

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Cold physical plasmas ignited a technological spark in industry, biotechnology, and medicine. Especially the field of hygiene benefited of the plasma's exceptional activity against pathogenic microorganisms. Together with plasma-based surface functionalization, these qualities are highly relevant in a variety of processes in health care, such as the decontamination or sterilization of medical devices, food, packaging materials, waste water, or indoor air. In medicine, plasma has proven to show promising antiseptic results on skin and mucosal membranes in infection-related diseases in dermatology and dentistry. This comprehensive review will discuss the current applications of cold plasma in the fields of hygiene, and will provide a promising outlook on many applications yet to come.

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Human osteosarcoma (OS) is the most common primary malignant bone tumor occurring most commonly in adolescents and young adults. Major improvements in disease-free survival have been achieved by implementing a combination therapy consisting of radical surgical resection of the tumor and systemic multi-agent chemotherapy. However, long-term survival remains poor, so novel targeted therapies to improve outcomes for patients with osteosarcoma remains an area of active research. This includes immunotherapy, photodynamic therapy, or treatment with nanoparticles. Cold atmospheric plasma (CAP), a highly reactive (partially) ionized physical state, has been shown to inherit a significant anticancer capacity, leading to a new field in medicine called “plasma oncology.” The current article summarizes the potential of CAP in the treatment of human OS and reviews the underlying molecular mode of action.