Medical applications of cold atmospheric plasma: state of the science

Abstract

Cold atmospheric plasmas (CAP) have been used in multiple medical fields and have become a promising medical technology. CAP-generating devices are safe and easy to operate and can now be manufactured at a low cost due to advancements in electronics and microchips. A primary application of CAP is as a broad-spectrum antimicrobial technology. With the high incidence of infections caused by drug-resistant microorganisms, a non-antibiotic based treatment modality such as CAP holds great therapeutic promise, particularly in the wound care field. In addition to its antimicrobial properties, CAP treatment enhances wound healing by increasing cutaneous microcirculation, monocyte stimulation, and keratinocyte proliferation. CAP has been used by dentists for disinfection of teeth, enhancing gingival fibroblast activity, and even teeth whitening. CAP can combat tumour growth by increasing the efficacy of antitumour therapeutic agents, reactivating apoptotic pathways, or down-regulating growth-related gene sites. Most of the health-care related research on CAP has occurred in the past 15 years; the field is relatively young and needs additional research, as well as confirmation of the existing supporting literature. The purpose of this report is to provide the reader with an overview of the therapeutic application of the cold plasma technology.

Self-disinfecting surfaces and infection control

“…Plasma is known to have high levels of energy and it can change molecules composition making them highly ionized and with many free radicals moving randomly in all directions. For example, when a molecule of hydrogen peroxide is exposed to this technology the double bond on the molecule is broken, creating reactive oxygen species like hydroxyl radicals that in need to seek equilibrium will bind to surrounding microorganisms destroying them by oxidation [54,55] This technology has already been tested in food industry to decontaminate vegetables [56] and meat [57] with good results obtained and also to decontaminate surfaces as packaging materials. Puligundla et al [58] have tested the elimination of different bacteria such as E. coli, Salmonella typhimurium and S. aureus, from several materials often used on food packages such as glass, polypropylene, polyethylene, nylon and paper foil.…”

Cold Atmospheric Plasma: A Powerful Tool for Modern Medicine

“…Moreover, it cannot be hypothetically excluded that CAP application does not have some minimal negative effects at the molecular level. All these findings and possibilities are subject to ongoing analysis, but current results suggest that the unproven adverse effects are outweighed by CAP's many benefits [3,4,12]. Finally, it is likely that more possibilities and greater benefits for CAP use in clinical practice will be demonstrated in the future, because most CAP studies have just taken place in the last 15 years [3,4,12].…”

“…All these findings and possibilities are subject to ongoing analysis, but current results suggest that the unproven adverse effects are outweighed by CAP's many benefits [3,4,12]. Finally, it is likely that more possibilities and greater benefits for CAP use in clinical practice will be demonstrated in the future, because most CAP studies have just taken place in the last 15 years [3,4,12]. While CAP can be employed in aesthetic procedures [30][31][32], herein we summarise CAP use in more serious medical conditions.…”

“…The current plasma term was then initiated almost fifty years later in 1927 by Irvin Langmuir [1]. Plasma has since been applied in many spheres over the past few decades, including medicine [2][3][4]. Plasma is often defined as an ionised gas produced by disintegration of polyatomic gas molecules or the removal of electrons from monatomic gas shells [5].…”

Combinatorial Effect of Cold Atmosphere Plasma (CAP) and the Anticancer Drug Cisplatin on Oral Squamous Cell Cancer Therapy

“…Cold atmospheric plasma (CAP) has been extensively studied in the biomedical field in recent decades due to its biological and physicochemical properties [ 1 , 2 , 3 , 4 ]. Notably, CAP has recently been spotlighted in the local treatment of cancer because CAP in the biological system generates reactive oxygen species (ROS) and/or reactive nitrogen species (RNS), i.e., excessive ROS or RNS generation by CAP treatment induces oxidative stress against cancer cells and subsequently results in apoptotic death [ 5 , 6 , 7 , 8 ].…”