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Abstract
Type 1 diabetes mellitus (T1DM) represents one of the most common chronic diseases in childhood. It is associated with high morbidity and mortality rates due to metabolic dysregulation, immunosuppressive effects, and a predisposition to fungal infections. Candidiasis is a severe infection and its prevalence has increased throughout the last decades. We report the case of a 19‐year‐old female patient admitted to our intensive care unit with T1DM and Candida infection associated with severe metabolic acidosis. In the absence of response to high dose catecholamine cardiovascular therapy and the presence of severe metabolic acidosis, a CytoSorb cartridge was implemented into the extracorporeal dialysis circuit resulting in a stabilization of hemodynamics accompanied by a tremendous decrease in vasopressor requirements, control of the hyperinflammatory response, as well as a resolution of metabolic acidosis and regeneration of renal function. Treatment with CytoSorb was safe and feasible without technical problems. Notably, this is the first case description reporting on the effects of CytoSorb in a patient with Candida infection as part of T1DM.
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.