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Cancers (Basel). 2020 Jan 22;12(2). doi: 10.3390/cancers12020269.

Molecular Mechanisms of the Efficacy of Cold Atmospheric Pressure Plasma (CAP) in Cancer Treatment.

Cancers

Marie Luise Semmler, Sander Bekeschus, Mirijam Schäfer, Thoralf Bernhardt, Tobias Fischer, Katharina Witzke, Christian Seebauer, Henrike Rebl, Eberhard Grambow, Brigitte Vollmar, J Barbara Nebe, Hans-Robert Metelmann, Thomas von Woedtke, Steffen Emmert, Lars Boeckmann

Affiliations

  1. Clinic and Polyclinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany.
  2. ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP Greifswald), 17489 Greifswald, Germany.
  3. Oral & Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17489 Greifswald, Germany.
  4. Department of Cell Biology, University Medical Center Rostock, 18057 Rostock, Germany.
  5. Institute for Experimental Surgery, Rostock University Medical Center, 18057 Rostock, Germany.

PMID: 31979114 PMCID: PMC7072164 DOI: 10.3390/cancers12020269

Abstract

Recently, the potential use of cold atmospheric pressure plasma (CAP) in cancer treatment has gained increasing interest. Especially the enhanced selective killing of tumor cells compared to normal cells has prompted researchers to elucidate the molecular mechanisms for the efficacy of CAP in cancer treatment. This review summarizes the current understanding of how CAP triggers intracellular pathways that induce growth inhibition or cell death. We discuss what factors may contribute to the potential selectivity of CAP towards cancer cells compared to their non-malignant counterparts. Furthermore, the potential of CAP to trigger an immune response is briefly discussed. Finally, this overview demonstrates how these concepts bear first fruits in clinical applications applying CAP treatment in head and neck squamous cell cancer as well as actinic keratosis. Although significant progress towards understanding the underlying mechanisms regarding the efficacy of CAP in cancer treatment has been made, much still needs to be done with respect to different treatment conditions and comparison of malignant and non-malignant cells of the same cell type and same donor. Furthermore, clinical pilot studies and the assessment of systemic effects will be of tremendous importance towards bringing this innovative technology into clinical practice.

Keywords: cold physical plasma; plasma medicine; reactive oxygen and nitrogen species

Conflict of interest statement

The authors declare no conflict of interest.

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