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Background: The use of cold atmospheric plasma (CAP) in oncology has been intensively investigated over the past 15 years as it inhibits the growth of many tumor cells. It is known that reactive oxidative species (ROS) produced in CAP are responsible for this effect. However, to translate the use of CAP into medical practice, it is essential to know how CAP treatment affects non-malignant cells. Thus, the current in vitro study deals with the effect of CAP on human bone cancer cells and human osteoblasts. Here, identical CAP treatment regimens were applied to the malignant and non-malignant bone cells and their impact was compared. Methods: Two different human bone cancer cell types, U2-OS (osteosarcoma) and A673 (Ewing’s sarcoma), and non-malignant primary osteoblasts (HOB) were used. The CAP treatment was performed with the clinically approved kINPen MED. After CAP treatment, growth kinetics and a viability assay were performed. For detecting apoptosis, a caspase-3/7 assay and a TUNEL assay were used. Accumulated ROS was measured in cell culture medium and intracellular. To investigate the influence of CAP on cell motility, a scratch assay was carried out. Results: The CAP treatment showed strong inhibition of cell growth and viability in bone cancer cells. Apoptotic processes were enhanced in the malignant cells. Osteoblasts showed a higher potential for ROS resistance in comparison to malignant cells. There was no difference in cell motility between benign and malignant cells following CAP treatment. Conclusions: Osteoblasts show better tolerance to CAP treatment, indicated by less affected viability compared to CAP-treated bone cancer cells. This points toward the selective effect of CAP on sarcoma cells and represents a further step toward the clinical application of CAP.
Chondrosarcoma is the second most common malign bone tumor in adults. Surgical
resection of the tumor is recommended because of its resistance to clinical treatment such as
chemotherapy and radiation therapy. Thus, the prognosis for patients mainly depends on sufficient
surgical resection. Due to this, research on alternative therapies is needed. Cold atmospheric plasma
(CAP) is an ionized gas that contains various reactive species. Previous studies have shown an
anti-oncogenic potential of CAP on different cancer cell types. The current study examined the effects
of treatment with CAP on two chondrosarcoma cell lines (CAL-78, SW1353). Through proliferation
assay, the cell growth after CAP-treatment was determined. A strong antiproliferative effect for
both cell lines was detected. By fluorescein diacetate (FDA) assay and ATP release assay, alterations
in the cell membrane and associated translocation of low molecular weight particles through the
cytoplasmic membrane were observed. In supernatant, the non-membrane-permeable FDA and
endogenously synthesized ATP detected suggest an increased membrane permeability after CAP
treatment. Similar results were shown by the dextran-uptake assay. Furthermore, fluorescence
microscopic G-/F-actin assay was performed. G- and F-actin were selectively dyed, and the ratio
was measured. The presented results indicate CAP-induced changes in cell membrane function and
possible alterations in actin-cytoskeleton, which may contribute to the antiproliferative effects of CAP.
Background: Cold atmospheric plasma (CAP) is increasingly used in the field of oncology.
Many of the mechanisms of action of CAP, such as inhibiting proliferation, DNA breakage, or the
destruction of cell membrane integrity, have been investigated in many different types of tumors.
In this regard, data are available from both in vivo and in vitro studies. Not only the direct treatment
of a tumor but also the influence on its blood supply play a decisive role in the success of the therapy
and the patient’s further prognosis. Whether the CAP influences this process is unknown, and the
first indications in this regard are addressed in this study. Methods: Two different devices, kINPen
and MiniJet, were used as CAP sources. Human endothelial cell line HDMEC were treated directly
and indirectly with CAP, and growth kinetics were performed. To indicate apoptotic processes,
caspase-3/7 assay and TUNEL assay were used. The influence of CAP on cellular metabolism
was examined using the MTT and glucose assay. After CAP exposure, tube formation assay was
performed to examine the capillary tube formation abilities of HDMEC and their migration was
messured in separate assays. To investigate in a possible mutagenic effect of CAP treatment,
a hypoxanthine-guanine-phosphoribosyl-transferase assay with non malignant cell (CCL-93) line was
performed. Results: The direct CAP treatment of the HDMEC showed a robust growth-inhibiting
effect, but the indirect one did not. The MMT assay showed an apparent reduction in cell metabolism
in the first 24 h after CAP treatment, which appeared to normalize 48 h and 72 h after CAP application.
These results were also confirmed by the glucose assay. The caspase 3/7 assay and TUNEL assay
showed a significant increase in apoptotic processes in the HDMEC after CAP treatment. These results
were independent of the CAP device. Both the migration and tube formation of HDMEC were
significant inhibited after CAP-treatment. No malignant effects could be demonstrated by the CAP
treatment on a non-malignant cell line.
Osteosarcoma and Ewing’s sarcoma are the most common malignant bone tumors.Conventional therapies such as polychemotherapy, local surgery, and radiotherapy improve theclinical outcome for patients. However, they are accompanied by acute and chronic side effectsthat affect the quality of life of patients, motivating novel research lines on therapeutic optionsfor the treatment of sarcomas. Previous experimental work with physical plasma operated atbody temperature (cold atmospheric plasma, CAP) demonstrated anti-oncogenic effects on differentcancer cell types. This study investigated the anti-cancer effect of CAP on two bone sarcomaentities, osteosarcoma and Ewing’s sarcoma, which were represented by four cell lines (U2-OS,MNNG/HOS, A673, and RD-ES). A time-dependent anti-proliferative effect of CAP on all cell lineswas observed. CAP-induced alterations in cell membrane functionality were detected by performinga fluorescein diacetate (FDA) release assay and an ATP release assay. Additionally, modifications ofthe cell membrane and modifications in the actin cytoskeleton composition were examined usingfluorescence microscopy monitoring dextran-uptake assay and G-/F-actin distribution. Furthermore,the CAP-induced induction of apoptosis was determined by TUNEL and active caspases assays.The observations suggest that a single CAP treatment of bone sarcoma cells may have significantanti-oncogenic effects and thus may be a promising extension to existing applications.
Reactive species play an essential role in orchestrating wound healing responses. They act as secondary messengers and drive redox-signaling pathways that are involved in the hemostatic, inflammatory, proliferative and remodeling phases of wound healing. Cold plasma produces a profusion of short- and long-lived redox species that promotes wound healing, however, until today, the knowledge of CAP mediated wound healing remained scarce. In this thesis, CAP mediated wound healing mechanism and their effect on extracellular matrix and adhesion molecules have been investigated. To this end, a keratinocyte cell line (HaCaT), skin fibroblast cell line (GM Fbs) and an in vitro coculture model including both HaCaT and GM Fbs at a 2:1 ratio, were employed to investigate the cross talk between these two skin cell types.
We examined the impact of CAP on extracellular matrix proteins and cell adhesion molecules in GM Fbs and observed a significant impact of cold plasma treatment on the expression level of collagen moieties, cell adhesion molecule like integrin, cadherin, versican, MMPs as well as extracellular matrix proteins.
Moreover, scratch assays with monocultures of HaCaT, GM Fbs and coculture of these two cell types were performed. We detected that, CAP accelerated the migratory capability of HaCaT cells cocultured with fibroblasts. In fact, compared to HaCaT monoculture, a significant acceleration on cell migration was observed in coculture upon CAP treatment. NAC, a potent antioxidant could abrogate this CAP-stimulated cell migration in coculture, further pointing towards the importance of well-orchestrated reactive species in wound healing. To better understand this CAP-mediated effect on cell migration, we examined the signaling pathways involved in tissue homeostasis and regeneration. We checked the HIPPO signaling pathway and observed an upregulation of several signaling molecules at transcriptional level in GM Fbs upon CAP treatment.
YAP is the central nuclear executer of HIPPO signaling pathway. YAP was upregulated in both HaCaT cells and GM Fbs. The major downstream effectors of the HIPPO signaling pathway (CTGF and Cyr61) were also upregulated in dermal fibroblasts at both transcriptional and protein level. However, administration of antioxidant NAC inhibited CAP-mediated wound healing and abrogated the gene expression of the HIPPO downstream effectors. These results confirm that the upregulation of YAP-CTGF-CYR61 axis is due to CAP-generated redox species. In HaCaT cells, both CTGF and Cyr61 was minimally transcribed. Even though CTGF was rarely detected in HaCaT cells on the protein level,Cyr61 remained undetected. This again shows the importance of the cross talk between fibroblasts and keratinocytes.
The coculture with the inclusion of fibroblasts showed an accelerated migration rate, compared to HaCaT monoculture which specifies a cross talk between these two cell types. Thus, monoculture of HaCaT cells were incubated with CAP-treated and untreated fibroblast conditioned medium. Interestingly, we observed that HaCaT cells exhibited an improved cell migration rate when incubated with CAP-treated fibroblast-conditioned media compared to that observed after incubation with untreated media. Upon investigation, an induction of CTGF and Cyr61 secretion was observed upon CAP treatment in the fibroblast-conditioned media. Furthermore, exposure to recombinant CTGF and Cyr61 could also significantly improve HaCaT cell migration which confirms that CAP mediated accelerated cell migration is due to activation of YAP-CTGF-Cyr61 axis.
In conclusion, this study revealed a completely new mechanical insight of CAP mediated wound healing. Along with several other ECM molecules, CAP activates a regenerative signaling pathway i.e., HIPPO signaling pathway in dermal fibroblasts at the onset of wound healing. Dermal fibroblasts drive a paracrine interaction by secreting CTGF and Cyr61 in close vicinity of wound, resulting in accelerated keratinocyte migration and wound healing in coculture.