Plasma Medicine: A Brief Introduction
19 Feb 2018-Vol. 1, Iss: 1, pp 47-60
TL;DR: This mini review is to introduce the readers of Plasma to the field of plasma medicine, a multidisciplinary field of research at the intersection of physics, engineering, biology and medicine.
Abstract: This mini review is to introduce the readers of Plasma to the field of plasma medicine. This is a multidisciplinary field of research at the intersection of physics, engineering, biology and medicine. Plasma medicine is only about two decades old, but the research community active in this emerging field has grown tremendously in the last few years. Today, research is being conducted on a number of applications including wound healing and cancer treatment. Although a lot of knowledge has been created and our understanding of the fundamental mechanisms that play important roles in the interaction between low temperature plasma and biological cells and tissues has greatly expanded, much remains to be done to get a thorough and detailed picture of all the physical and biochemical processes that enter into play.
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TL;DR: This study summarises the available literature on cold plasma action mechanisms and analyses of its current in vivo and in vitro use, primarily in the fields of regenerative and dental medicine and oncology.
Abstract: Cold atmospheric plasma use in clinical studies is mainly limited to the treatment of chronic wounds, but its application in a wide range of medical fields is now the goal of many analyses. It is therefore likely that its application spectrum will be expanded in the future. Cold atmospheric plasma has been shown to reduce microbial load without any known significant negative effects on healthy tissues, and this should enhance its possible application to any microbial infection site. It has also been shown to have anti-tumour effects. In addition, it acts proliferatively on stem cells and other cultivated cells, and the highly increased nitric oxide levels have a very important effect on this proliferation. Cold atmospheric plasma use may also have a beneficial effect on immunotherapy in cancer patients. Finally, it is possible that the use of plasma devices will not remain limited to surface structures, because current endeavours to develop sufficiently miniature microplasma devices could very likely lead to its application in subcutaneous and internal structures. This study summarises the available literature on cold plasma action mechanisms and analyses of its current in vivo and in vitro use, primarily in the fields of regenerative and dental medicine and oncology.
131 citations
Cites background from "Plasma Medicine: A Brief Introducti..."
...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]....
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...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]....
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...The antimicrobial effect of CAP was demonstrated in the 1990s and this led to its use in medicine [12]....
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...In contrast, the benefits of cold atmospheric plasma (CAP) in reducing microbial load were discovered only in the second half of the 1990s [12,13]....
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TL;DR: The progress in detection of plasma-generated short-lived reactive oxygen and nitrogen species in aqueous solutions is summarized, the potential and limitations of various analytical methods in plasma-liquid systems are discussed, and an outlook on the possible future research goals are provided for a general nonspecialist audience.
Abstract: This Feature addresses the analysis of the reactive species generated by nonthermal atmospheric pressure plasmas, which are widely employed in industrial and biomedical research, as well as first clinical applications. We summarize the progress in detection of plasma-generated short-lived reactive oxygen and nitrogen species in aqueous solutions, discuss the potential and limitations of various analytical methods in plasma−liquid systems, and provide an outlook on the possible future research goals in development of short-lived reactive species analysis methods for a general nonspecialist audience.
89 citations
Journal Article•
TL;DR: In this paper, the authors discuss the fundamental physics of the guided streamer-like structures-plasma bullets which are produced in cold atmospheric-pressure plasma jets and introduce the basic theories and recent advances on the experimental and computational studies of guided streamers, in particular related to the propagation dynamics of ionization waves and the various parameters of relevance to plasma streamers.
Abstract: This review focuses on one of the fundamental phenomena that occur upon application of sufficiently strong electric fields to gases, namely the formation and propagation of ionization waves-streamers. The dynamics of streamers is controlled by strongly nonlinear coupling, in localized streamer tip regions, between enhanced (due to charge separation) electric field and ionization and transport of charged species in the enhanced field. Streamers appear in nature (as initial stages of sparks and lightning, as huge structures-sprites above thunderclouds), and are also found in numerous technological applications of electrical discharges. Here we discuss the fundamental physics of the guided streamer-like structures-plasma bullets which are produced in cold atmospheric-pressure plasma jets. Plasma bullets are guided ionization waves moving in a thin column of a jet of plasma forming gases (e.g.,He or Ar) expanding into ambient air. In contrast to streamers in a free (unbounded) space that propagate in a stochastic manner and often branch, guided ionization waves are repetitive and highly-reproducible and propagate along the same path-the jet axis. This property of guided streamers, in comparison with streamers in a free space, enables many advanced time-resolved experimental studies of ionization waves with nanosecond precision. In particular, experimental studies on manipulation of streamers by external electric fields and streamer interactions are critically examined. This review also introduces the basic theories and recent advances on the experimental and computational studies of guided streamers, in particular related to the propagation dynamics of ionization waves and the various parameters of relevance to plasma streamers. This knowledge is very useful to optimize the efficacy of applications of plasma streamer discharges in various fields ranging from health care and medicine to materials science and nanotechnology.
80 citations
TL;DR: In this paper, cold atmospheric pressure plasma (CAPP) technology has received substantial attention due to its valuable properties including operational simplicity, low running cost, and environmental friendliness, which can be used to generate plasma at atmospheric pressure and low temperature.
Abstract: In recent years, cold atmospheric pressure plasma (CAPP) technology has received substantial attention due to its valuable properties including operational simplicity, low running cost, and environmental friendliness. Several different gases (air, nitrogen, helium, argon) and techniques (corona discharge, dielectric barrier discharge, plasma jet) can be used to generate plasma at atmospheric pressure and low temperature. Plasma treatment is routinely used in materials science to modify the surface properties (e.g., wettability, chemical composition, adhesion) of a wide range of materials (e.g., polymers, textiles, metals, glasses). Moreover, CAPP seems to be a powerful tool for the inactivation of various pathogens (e.g., bacteria, fungi, viruses) in the food industry (e.g., food and packing material decontamination, shelf life extension), agriculture (e.g., disinfection of seeds, fertilizer, water, soil) and medicine (e.g., sterilization of medical equipment, implants). Plasma medicine also holds great promise for direct therapeutic treatments in dentistry (tooth bleaching), dermatology (atopic eczema, wound healing) and oncology (melanoma, glioblastoma). Overall, CAPP technology is an innovative, powerful and effective tool offering a broad application potential. However, its limitations and negative impacts need to be determined in order to receive regulatory approval and consumer acceptance.
71 citations
TL;DR: There is a need identified to establish both guidelines and safety limits that ensure an absence of (long-term) side effects and to define treatments as safe for applications, where cell stimulation is desired, e.g. in wound healing, or those aimed at inducing cell death in the treatment of cancer.
Abstract: Cold atmospheric plasma is a versatile new tool in the biomedical field with applications ranging from disinfection, wound healing and tissue regeneration to blood coagulation, and cancer treatment. Along with improved insights into the underlying physical, chemical and biological principles, plasma medicine has also made important advances in the introduction into the clinic. However, in the absence of a standard plasma 'dose' definition, the diversity of the field poses certain difficulties in terms of comparability of plasma devices, treatment parameters and resulting biological effects, particularly with regards to the question of what constitutes a safe plasma application. Data from various in vitro cytotoxic and genotoxic studies along with in vivo findings from animal and human trials are reviewed to provide an overview of the current state of knowledge on the safety of plasma for biological applications. Treatment parameters employed in clinical studies were well tolerated but intense treatment conditions can also induce tissue damage or genotoxicity. There is a need identified to establish both guidelines and safety limits that ensure an absence of (long-term) side effects and to define treatments as safe for applications, where cell stimulation is desired, e.g. in wound healing, or those aimed at inducing cell death in the treatment of cancer.
41 citations
References
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TL;DR: In this article, the authors discuss the history, discharge physics, and plasma chemistry of dielectric-barrier discharges and their applications and discuss the applications of these discharges.
Abstract: Dielectric-barrier discharges (silent discharges) are used on a large industrial scale. They combine the advantages of non-equilibrium plasma properties with the ease of atmospheric-pressure operation. A prominent feature is the simple scalability from small laboratory reactors to large industrial installations with megawatt input powers. Efficient and cost-effective all-solid-state power supplies are available. The preferred frequency range lies between 1 kHz and 10 MHz, the preferred pressure range between 10 kPa and 500 kPa. Industrial applications include ozone generation, pollution control, surface treatment, high power CO2 lasers, ultraviolet excimer lamps, excimer based mercury-free fluorescent lamps, and flat large-area plasma displays. Depending on the application and the operating conditions the discharge can have pronounced filamentary structure or fairly diffuse appearance. History, discharge physics, and plasma chemistry of dielectric-barrier discharges and their applications are discussed in detail.
2,730 citations
"Plasma Medicine: A Brief Introducti..." refers background in this paper
...For more information on the working of the DBD see references [61,78,79]....
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TL;DR: Non-equilibrium plasmas will be shown to be non-destructive to tissue, safe, and effective in inactivation of various parasites and foreign organisms.
Abstract: An emerging field of plasma medicine is discussed, where non-equilibrium plasmas are shown to be able to initiate, promote, control, and catalyze various complex behaviors and responses in biological systems. More importantly, it will be shown that plasma can be tuned to achieve the desired medical effect, especially in medical sterilization and treatment of different kind of skin diseases. Wound healing and tissue regeneration can be achieved following various types of plasma treatment in a multitude of wound pathologies. Non-equilibrium plasmas will be shown to be non-destructive to tissue, safe, and effective in inactivation of various parasites and foreign organisms.
1,819 citations
TL;DR: The importance of ROS and RNS to plant biology has been relatively little appreciated in the plasma biomedicine community, but it appears that there are opportunities for useful applications of plasmas in this area as well.
Abstract: Reactive oxygen species (ROS) and the closely related reactive nitrogen species (RNS) are often generated in applications of atmospheric pressure plasmas intended for biomedical purposes. These species are also central players in what is sometimes referred to as ‘redox’ or oxidation‐reduction biology. Oxidation‐reduction biochemistry is fundamental to all of aerobic biology. ROS and RNS are perhaps best known as disease-associated agents, implicated in diabetes, cancer, heart and lung disease, autoimmune disease and a host of other maladies including ageing and various infectious diseases. These species are also known to play active roles in the immune systems of both animals and plants and are key signalling molecules, among many other important roles. Indeed, the latest research has shown that ROS/RNS play a much more complex and nuanced role in health and ageing than previously thought. Some of the most potentially profound therapeutic roles played by ROS and RNS in various medical interventions have emerged only in the last several years. Recent research suggests that ROS/RNS are significant and perhaps even central actors in the actions of antimicrobial and anti-parasite drugs, cancer therapies, wound healing therapies and therapies involving the cardiovascular system. Understanding the ways ROS/RNS act in established therapies may help guide future efforts in exploiting novel plasma medical therapies. The importance of ROS and RNS to plant biology has been relatively little appreciated in the plasma biomedicine community, but these species are just as important in plants. It appears that there are opportunities for useful applications of plasmas in this area as well. (Some figures may appear in colour only in the online journal)
1,218 citations
TL;DR: Low temperature, high pressure, non-equilibrium plAsmas are now routinely used in several material processing applications, and in some cases are competing with low pressure plasmas in areas where these have historically been dominant.
Abstract: Summary: Low temperature, high pressure, non-equilibrium plasmas are now routinely used in several material processing applications, and in some cases are competing with low pressure plasmas in areas where these have historically been dominant. Etching and deposition are examples of such applications. Amongst the novel applications of non-equilibrium plasmas, biomedical applications such as electrosurgery, surface modification of biocompatible materials, and the sterilization of heat-sensitive medical tools are particularly interesting. In this paper, first a brief overview of recent research on reduced-pressure plasma-based sterilization/decontamination methods is given. Then a detailed review and discussion on the effects of atmospheric pressure non-equilibrium plasmas on the cells of bacteria is presented. This includes the evaluation of the inactivation kinetics and the roles of the various plasma agents in the inactivation process. Measurements of the plasma temperature, the UV emission, and concentrations of various reactive species for the case of air plasma are presented. Plasma sub-lethal effects are also briefly discussed, and the prospects of the use of “cold” plasmas in the biomedical field are outlined.
992 citations
TL;DR: In this paper, the most important mechanisms of generation and transport of the key species in the plasmas of atmospheric-pressure plasma jets and other non-equilibrium atmospheric pressure plasms are introduced and examined from the viewpoint of their applications in plasma hygiene and medicine and other relevant fields.
825 citations