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    Zebrafish larvae as a toxicity model in plasma medicine
    (Hoboken, NJ : Wiley Interscience, 2021) Gandhirajan, Rajesh K.; Endlich, Nicole; Bekeschus, Sander
    Plasma technology has emerged as a promising tool in medicine that, however, requires not only efficacy but also toxicological assessments. Traditional cell culture systems are fast and economical, but they lack in vivo relevance; however, rodent models are highly complex and necessitate extended facilities. Zebrafish larvae bridge this gap, and many larvae can be analyzed in well plates in a single run, giving results in 1–2 days. Using the kINPen, we found plasma exposure to reduce hedging rates and viability in a dose-dependent manner, accompanied with an increase in reactive oxygen species and a decrease of glutathione in plasma-treated fish. Modest growth alterations were also observed. Altogether, zebrafish larvae constitute a fast, reliable, and relevant model for testing the toxicity of plasma sources.
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    Combined toxicity of indirubins with cold physical plasma in skin cancer cells in vitro
    (Bristol : IOP Publ., 2022) Berner, Julia; Bekeschus, Sander
    Cold physical plasma is a partially ionized gas that generates various components identified as potential anticancer compounds. Due to its topical application, cold plasmas are suitable, especially in dermatological applications. We, therefore, tested the cold plasma effects in skin cancer cells in vitro. An atmospheric pressure argon plasma jet was used as the plasma source. The plasma exposure alone reduced the metabolic activity and induced lethal effects in a treatment time-dependent fashion in both cell lines investigated. This was accompanied by executioner caspases 3 and 7, cleavage indicative of apoptosis and reduced cell migration and proliferation. Recent research also indicated roles of novel indirubin derivatives with potent anticancer effects. Three candidates were tested, and reduced metabolic activity and viability in a dose-dependent manner were found. Strikingly, one compound exerted notable synergistic toxicity when combined with plasma in skin cancer cells, which may be promising for future in vivo experiments.
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    Plasma, cancer, immunity
    (Bristol : IOP Publ., 2022) Bekeschus, Sander; Clemen, Ramona
    Albeit heavily investigated for several decades already, the importance of the immune system in targeting cancer has received wide clinical attention only in recent years. This is partly because of long-standing rather traditional concepts on tumor biology on the one hand and the complexity of the immune system and its processes on the other. The viewpoint of evaluating existing and emerging approaches in oncology based on toxicity to tumors and the ability to engage antitumor-immunity is gaining ground across several disciplines. Along those lines, cold physical plasma was suggested as potential anticancer tool more than a decade ago, but solid evidence of the immune system playing a role in plasma cancer treatment only emerged in recent years. Moreover, plasma may support cancer immunotherapies in the future. Cancer immunotherapies are systemic treatments with biologicals that were reported to synergize with existing local physical modalities before, such as radiotherapy and photodynamic therapy. This review outlines key concepts in oncology, immunology, and tumor therapy, links them to plasma research, and discusses immuno-oncological consequences. Finally, promising future clinical applications are summarized. Synoptically, first scientific evidence supports an immuno-oncological dimension of plasma cancer treatment in selected instances, but robust clinical evidence is still lacking. More basic and clinical research is needed to determine the immuno-molecular mechanisms and detailed plasma application modalities to facilitate real patient benefit in the long term.
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    Risk Evaluation of EMT and Inflammation in Metastatic Pancreatic Cancer Cells Following Plasma Treatment
    (Lausanne : Frontiers Media, 2020) Freund, Eric; Spadola, Chiara; Schmidt, Anke; Privat-Maldonado, Angela; Bogaerts, Annemie; Woedtke, Thomas von; Weltmann, Klaus-Dieter; Heidecke, Claus-Dieter; Partecke, Lars-Ivo; Käding, André; Bekeschus, Sander
    The requirements for new technologies to serve as anticancer agents go far beyond their toxicity potential. Novel applications also need to be safe on a molecular and patient level. In a broader sense, this also relates to cancer metastasis and inflammation. In a previous study, the toxicity of an atmospheric pressure argon plasma jet in four human pancreatic cancer cell lines was confirmed and plasma treatment did not promote metastasis in vitro and in ovo. Here, these results are extended by additional types of analysis and new models to validate and define on a molecular level the changes related to metastatic processes in pancreatic cancer cells following plasma treatment in vitro and in ovo. In solid tumors that were grown on the chorion-allantois membrane of fertilized chicken eggs (TUM-CAM), plasma treatment induced modest to profound apoptosis in the tissues. This, however, was not associated with a change in the expression levels of adhesion molecules, as shown using immunofluorescence of ultrathin tissue sections. Culturing of the cells detached from these solid tumors for 6d revealed a similar or smaller total growth area and expression of ZEB1, a transcription factor associated with cancer metastasis, in the plasma-treated pancreatic cancer tissues. Analysis of in vitro and in ovo supernatants of 13 different cytokines and chemokines revealed cell line-specific effects of the plasma treatment but a noticeable increase of, e.g., growth-promoting interleukin 10 was not observed. Moreover, markers of epithelial-to-mesenchymal transition (EMT), a metastasis-promoting cellular program, were investigated. Plasma-treated pancreatic cancer cells did not present an EMT-profile. Finally, a realistic 3D tumor spheroid co-culture model with pancreatic stellate cells was employed, and the invasive properties in a gel-like cellular matrix were investigated. Tumor outgrowth and spread was similar or decreased in the plasma conditions. Altogether, these results provide valuable insights into the effect of plasma treatment on metastasis-related properties of cancer cells and did not suggest EMT-promoting effects of this novel cancer therapy. © Copyright © 2020 Freund, Spadola, Schmidt, Privat-Maldonado, Bogaerts, von Woedtke, Weltmann, Heidecke, Partecke, Käding and Bekeschus.