This introductory review on plasma health care is intended to provide the interested reader with a summary of the current status of this emerging field, its scope, and its broad interdisciplinary approach, ranging from plasma physics, chemistry and technology, to microbiology, biochemistry, biophysics, medicine and hygiene. Apart from the basic plasma processes and the restrictions and requirements set by international health standards, the review focuses on plasma interaction with prokaryotic cells (bacteria), eukaryotic cells (mammalian cells), cell membranes, DNA etc. In so doing, some of the unfamiliar terminology—an unavoidable by-product of interdisciplinary research—is covered and explained. Plasma health care may provide a fast and efficient new path for effective hospital (and other public buildings) hygiene— helping to prevent and contain diseases that are continuously gaining ground as resistance of pathogens to antibiotics grows. The delivery of medically active 'substances' at the molecular or ionic level is another exciting topic of research through effects on cell walls (permeabilization), cell excitation (paracrine action) and the introduction of reactive species into cell cytoplasm. Electric fields, charging of surfaces, current flows etc can also affect tissue in a controlled way. The field is young and hopes are high. It is fitting to cover the beginnings in New Journal of Physics, since it is the physics (and non- equilibrium chemistry) of room temperature atmospheric pressure plasmas that have made this development of plasma health care possible.

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Plasma medicine: an introductory review

A new method for the ablation of undesirable tissue such as cells of a cancerous or non-cancerous tumor is disclosed. It involves the placement of electrodes into or near the vicinity of the undesirable tissue through the application of electrical pulses causing irreversible electroporation of the cells throughout the entire area of the undesirable tissue. The electric pulses irreversibly permeate the cell membranes, thereby invoking cell death. The irreversibly permeabilized cells are left in situ and are removed by the body immune system. The amount of tissue ablation achievable through the use of irreversible electroporation without inducing thermal damage is considerable.

Tissue ablation with irreversible electroporation

Electroporation designates the use of short high-voltage pulses to overcome the barrier of the cell membrane. By applying an external electric field, which just surpasses the capacitance of the cell membrane, transient and reversible breakdown of the membrane can be induced. This transient, permeabilized state can be used to load cells with a variety of different molecules, either through simple diffusion in the case of small molecules, or through electrophoretically driven processes allowing passage through the destabilized membrane--as is the case for DNA transfer. Initially developed for gene transfer, electroporation is now in use for delivery of a large variety of molecules: From ions to drugs, dyes, tracers, antibodies, and oligonucleotides to RNA and DNA. Electroporation has proven useful both in vitro, in vivo and in patients, where drug delivery to malignant tumours has been performed. Whereas initial electroporation procedures caused considerable cell damage, developments over the past decades have led to sophistication of equipment and optimization of protocols. The electroporation procedures used in many laboratories could be optimized with limited effort. This review (i) outlines the theory of electroporation, (ii) discusses factors of importance for optimization of electroporation protocols for mammalian cells, (iii) addresses particular concerns when using electroporation in vivo, e.g. effects on blood flow and considerations regarding choice of electrodes, (iv) describes DNA electrotransfer with emphasis on use in the in vivo setting, and (v) sums up data on safety and efficacy of electroporation used to enhance delivery of chemotherapy to tumours in cancer patients.

Electroporation: theory and methods, perspectives for drug delivery, gene therapy and research

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Methods and apparatus for renal neuromodulation

Irreversible electroporation (IRE) is a new tissue ablation technique in which micro to millisecond electrical pulses are delivered to undesirable tissue to produce cell necrosis through irreversible cell membrane permeabilization. IRE affects only the cell membrane and no other structure in the tissue. The goal of the study is to test our IRE tissue ablation methodology in the pig liver, provide first experience results on long term histopathology of IRE ablated tissue, and discuss the clinical implications of the findings. The study consists of: a) designing an IRE ablation protocol through a mathematical analysis of the electrical field during electroporation; b) using ultrasound to position the electroporation electrodes in the predetermined locations and subsequently to monitor the process; c) applying the predetermined electrotroporation pulses; d) performing histolopathology on the treated samples for up to two weeks after the procedure; and e) correlating the mathematical analysis, ultrasound data...

https://journals.sagepub.com/doi/pdf/10.1177/153303460700600106

Irreversible electroporation: a new ablation modality--clinical implications.

A validated model of in vivo electric field distribution in tissues for electrochemotherapy and for DNA electrotransfer for gene therapy.

The Importance of Electric Field Distribution for Effective in Vivo Electroporation of Tissues

Electrochemotherapy is a novel technique to enhance the delivery of chemotherapeutic drugs into tumor cells. In this procedure, electric pulses are delivered to cancerous cells, which induce membrane permeabilization, to facilitate the passage of cytotoxic drugs through the cell membrane. This study examines how electric fields interact with and polarize a system of cells. Specifically, we consider how cell density and organization impact on induced cell transmembrane potential due to an external electric field. First, in an infinite volume of spherical cells, we examined how cell packing density impacts on induced transmembrane potential. With high cell density, we found that maximum induced transmembrane potential is suppressed and that the transmembrane potential distribution is altered. Second, we considered how orientation of cell sheets and strands, relative to the applied field, affects induced transmembrane potential. Cells that are parallel to the field direction suppress induced transmembrane po...

Dejan Šemrov

Papers

A validated model of in vivo electric field distribution in tissues for electrochemotherapy and for DNA electrotransfer for gene therapy.

The Importance of Electric Field Distribution for Effective in Vivo Electroporation of Tissues

Electric Field-Induced Transmembrane Potential Depends on Cell Density and Organizatio

Changing electrode orientation improves the efficacy of electrochemotherapy of solid tumors in mice

Calculation of the electrical parameters in electrochemotherapy of solid tumours in mice