Cold plasma selectivity and the possibility of a paradigm shift in cancer therapy

Restoration of sensitivity in chemo-resistant glioma cells by cold atmospheric plasma

Glioblastoma (GBM) is the most common and aggressive brain tumor in adults. Despite multimodal treatments including surgery, chemotherapy and radiotherapy the prognosis remains poor and relapse occurs regularly. The alkylating agent temozolomide (TMZ) has been shown to improve the overall survival in patients with malignant gliomas, especially in tumors with methylated promoter of the O6-methylguanine-DNA-methyltransferase (MGMT) gene. However, intrinsic and acquired resistance towards TMZ makes it crucial to find new therapeutic strategies aimed at improving the prognosis of patients suffering from malignant gliomas. Cold atmospheric plasma is a new auspicious candidate in cancer treatment. In the present study we demonstrate the anti-cancer properties of different dosages of cold atmospheric plasma (CAP) both in TMZ-sensitive and TMZ-resistant cells by proliferation assay, immunoblotting, cell cycle analysis, and clonogenicity assay. Importantly, CAP treatment restored the responsiveness of resistant glioma cells towards TMZ therapy. Concomitant treatment with CAP and TMZ led to inhibition of cell growth and cell cycle arrest, thus CAP might be a promising candidate for combination therapy especially for patients suffering from GBMs showing an unfavorable MGMT status and TMZ resistance.

Assessing cellular DNA damage from a helium plasma needle

The aim of the present study is to determine the deoxyribonucleic acid (DNA) damage by cells exposed to atmospheric pressure non-thermal plasma (APNTP). Mouse leukocytes embedded in agarose were exposed to the plasma at two different distances from a helium plasma needle outlet and during three different exposure periods. Damage was assessed by the single cell gel electrophoresis assay. The results indicate that, at 0.1 cm from the plasma needle, the exposure caused complete DNA fragmentation determined by the presence of so called "clouds". Samples exposed at 0.5 cm from the slide sample surface presented damage proportional to the exposure periods in terms of tail intensity, tail moment and "clouds" frequency. Studies performed with alkaline single cell gel electrophoresis assay to determine DNA breaks and alkali-labile sites, indicates that DNA damage produced by exposure to APNTP was caused mainly by oxidative radicals, rather than by UV light which causes cyclobutane pyrimidine dimers. These results allow us to conclude that plasma needle induced DNA breaks in mice leukocytes proportionally to exposure time.

A preliminary study of the effect of DBD plasma and osmolytes on T98G brain cancer and HEK non-malignant cells

Non-thermal plasmas are emerging as a novel tool for the treatment of living tissues for biological and medical purpose. In this study, we described the effect of 4 min dielectric barrier discharge (DBD) plasma on both T98G cancer and HEK normal cell lines in the presence of different concentrations of osmolytes. This treatment strategy shows a specific inhibitory effect of a 240 s plasma exposure in the presence of osmolytes against T98G brain cancer cells only, but not on HEK normal cells. Based on these interesting properties of osmolytes, a non-thermal plasma appears to be a potential anticancer treatment strategy for different kinds of cancers in the presence of osmolytes.

Influence of non-thermal atmospheric pressure plasma on cellular structures and processes in human keratinocytes (HaCaT)

BACKGROUND

The use of non-thermal atmospheric pressure plasma in dermatology to improve the healing of chronic wounds is a promising application. The antimicrobial properties of physical plasma offer on the one hand the killing of bacteria, which are often a problem in chronic wounds. On the other hand, plasma can activate cells which are involved in the wound closure.

OBJECTIVE

To guarantee a safe application it is essential to understand basic interactions between physical plasma and human skin cells.

METHODS

In our study, human keratinocytes (HaCaT cells) were directly plasma treated with a dielectric barrier discharge (DBD) plasma source and effects on viability, DNA, cell cycle, intracellular concentration of reactive oxygen species and induction of apoptosis were observed.

RESULTS

A treatment time-dependent loss of recovered adherent HaCaT cells after 24h and a linear increase of DNA damage were observed, which was no longer evident 24h after plasma stimulation, except for long treatment times. An accumulation of HaCaT cells in G2/M phase and a decrease in the G1 phase was caused by DBD plasma. The increasing formation of intracellular ROS is also attributed to plasma treatment. In contrast to other studies we did not find clear evidences for apoptosis in adherent HaCaT cells. A culture medium exchange subsequently after plasma treatment weakened the observed effects.

CONCLUSION

DBD plasma treatment resulted in oxidative stress in human keratinocytes which is related to deficient cell performance.

Cold atmospheric plasma for the ablative treatment of neuroblastoma

BACKGROUND

Recent breakthroughs have allowed for production of plasma at room temperature. Cold atmospheric plasma (CAP) may offer the capability of delivering reactive oxygen species directly into tissues, representing a novel modality for targeted cancer therapy. We studied helium-based CAP's effect on neuroblastoma, both in-vitro and in an in-vivo murine model.

METHODS

Mouse neuroblastoma cultures were treated with CAP for 0, 30, 60, and 120 s and assayed for apoptotic and metabolic activity immediately and at 24 and 48 h post-treatment. Five-millimeter tumors were ablated with a single transdermal CAP treatment, and tumor volume and mouse survival were measured.

RESULTS

CAP decreased metabolic activity, induced apoptosis, and reduced viability of cancer cells in proportion to both duration of exposure and time post-treatment. In-vivo, a single treatment ablated tumors and eventual tumor growth was decelerated. Furthermore, survival nearly doubled, with median survival of 15 vs. 28 days (p<0.001).

CONCLUSIONS

Our findings demonstrate the sensitivity of neuroblastoma to CAP treatment, both in-vitro and in an in-vivo mouse model of established tumor. While further investigation is necessary to establish the mechanism and optimize the treatment protocol, these initial observations establish cold atmospheric plasma as a potentially useful ablative therapy in neuroblastoma.

Effects of a non thermal plasma treatment alone or in combination with gemcitabine in a MIA PaCa2-luc orthotopic pancreatic carcinoma model

Pancreatic tumors are the gastrointestinal cancer with the worst prognosis in humans and with a survival rate of 5% at 5 years. Nowadays, no chemotherapy has demonstrated efficacy in terms of survival for this cancer. Previous study focused on the development of a new therapy by non thermal plasma showed significant effects on tumor growth for colorectal carcinoma and glioblastoma. To allow targeted treatment, a fibered plasma (Plasma Gun) was developed and its evaluation was performed on an orthotopic mouse model of human pancreatic carcinoma using a MIA PaCa2-luc bioluminescent cell line. The aim of this study was to characterize this pancreatic carcinoma model and to determine the effects of Plasma Gun alone or in combination with gemcitabine. During a 36 days period, quantitative BLI could be used to follow the tumor progression and we demonstrated that plasma gun induced an inhibition of MIA PaCa2-luc cells proliferation in vitro and in vivo and that this effect could be improved by association with gemcitabine possibly thanks to its radiosensitizing properties.

Tissue tolerable plasma (TTP) induces apoptosis in pancreatic cancer cells in vitro and in vivo

Background

The rate of microscopic incomplete resections of gastrointestinal cancers including pancreatic cancer has not changed considerably over the past years. Future intra-operative applications of tissue tolerable plasmas (TTP) could help to address this problem. Plasma is generated by feeding energy, like electrical discharges, to gases. The development of non-thermal atmospheric plasmas displaying spectra of temperature within or just above physiological ranges allows biological or medical applications of plasmas.

Methods

We have investigated the effects of tissue tolerable plasmas (TTP) on the human pancreatic cancer cell line Colo-357 and PaTu8988T and the murine cell line 6606PDA in vitro (Annexin-V-FITC/DAPI-Assay and propidium iodide DNA staining assay) as well as in the in vivo tumour chorio-allantoic membrane (TUM-CAM) assay using Colo-357.

Results

TTP of 20 seconds (s) induced a mild elevation of an experimental surface temperature of 23.7 degree Celsius up to 26.63+/−0.40 degree Celsius. In vitro TTP significantly (p=0.0003) decreased cell viability showing the strongest effects after 20s TTP. Also, TTP effects increased over time levelling off after 72 hours (30.1+/−4.4% of dead cells (untreated control) versus 78.0+/−9.6% (20s TTP)). However, analyzing these cells for apoptosis 10s TTP revealed the largest proportion of apoptotic cells (34.8+/−7.2%, p=0.0009 versus 12.3+/−6.6%, 20s TTP) suggesting non-apoptotic cell death in the majority of cells after 20s TTP. Using solid Colo-357 tumours in the TUM-CAM model TUNEL-staining showed TTP-induced apoptosis up to a depth of tissue penetration (DETiP) of 48.8+/−12.3μm (20s TTP, p<0.0001). This was mirrored by a significant (p<0.0001) reduction of Ki-67+ proliferating cells (80.9+/−13.2% versus 37.7+/−14.6%, p<0.0001) in the top cell layers as well as typical changes on HE specimens. The bottom cell layers were not affected by TTP.

Conclusions

Our data suggest possible future intra-operative applications of TTP to reduce microscopic residual disease in pancreatic cancer resections. Further promising applications include other malignancies (central liver/lung tumours) as well as synergistic effects combining TTP with chemotherapies. Yet, adaptations of plasma sources as well as of the composition of effective components of TTP are required to optimize their synergistic apoptotic actions.

Targeting the cancer cell cycle by cold atmospheric plasma

Cold atmospheric plasma (CAP), a technology based on quasi-neutral ionized gas at low temperatures, is currently being evaluated as a new highly selective alternative addition to existing cancer therapies. Here, we present a first attempt to identify the mechanism of CAP action. CAP induced a robust ~2-fold G2/M increase in two different types of cancer cells with different degrees of tumorigenicity. We hypothesize that the increased sensitivity of cancer cells to CAP treatment is caused by differences in the distribution of cancer cells and normal cells within the cell cycle. The expression of γH2A.X (pSer139), an oxidative stress reporter indicating S-phase damage, is enhanced specifically within CAP treated cells in the S phase of the cell cycle. Together with a significant decrease in EdU-incorporation after CAP, these data suggest that tumorigenic cancer cells are more susceptible to CAP treatment.

Measurements of streamer head potential and conductivity of streamer column in the cold nonequilibrium atmospheric plasmas

This work presents a simple method for the characterization of streamers developing in cold atmospheric plasma jets. The method is based upon stopping ("scattering") of streamer by means of external DC potential in order to determine the potential of the streamer head. The experimental evidence presented in this work does not support the model of the electrically insulated streamer head. On the contrary, it is shown that the electrode potential is transferred to the streamer head along the streamer column to which it is attached with no significant voltage drop. Based on the proposed method, we determine various streamer parameters such as head charge (1-2×108 electrons), electrical field in the head vicinity (about 100 kV/cm), average conductivity (10-2 Ω-1cm-1) and plasma density of the streamer column (2×1013 cm-3).