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The relevance of cold atmospheric plasmas (CAPs) in biomedicine has recently grown. The potential of CAPs has been discussed in multiple scientific works, highlighting its effectiveness in promoting wound healing, limiting cancer progression, and for sterilization of surfaces. Main bioactive molecules, such as reactive oxygen and nitrogen species (RONS), are proposed as key candidates in these processes. Indeed, the generation of cold plasma induces noble gas ionization which, reacting with atmospheric air molecules, generates species such as singlet oxygen, atomic oxygen radicals, nitric oxide radicals. Although molecular simulations have been conducted, the mechanism of action on biological molecules, as well as the possibility to tune plasmas to produce specific species cocktails (e.g., with different degree of oxidation power) has been not fully unleashed. In this dissertation, presented in form of 5 published scientific articles, focus has been placed on the interaction of plasmas with peptides and proteins, which are main biological effectors in cellular compartments. Precisely, through the development of liquid chromatography coupled mass spectrometry (LC-MS) methods, the effects of plasmas on peptides and proteins in form of oxidative post-translational modifications (oxPTMs) has been investigated. The characterization of these oxPTMs has been performed by treating peptide or protein aqueous solutions and on porcine skin tissues. It has been found that, introducing small amounts of different gases (oxygen, nitrogen, or both) or even water molecules, can made CAPs tunable tools to produce oxygen-species dominating effects versus nitrogen-species dominating effects. In addition to this, it was found that the amino acid position in a peptide or protein influences the quality and quantity of the resulting oxPTMs. Besides this, other important parameters like driven gases, admixture gases or treatment duration were identified as relevant factors for the modification of amino acids in the peptide structure. By comparing the effects between peptide solutions and complex matrices such as porcine skin, water has been identified as a valid vehicle to transport and amplify the plasma chemistry. In an experimental study, the inactivation of a protein (PLA2) was observed after CAP treatment and together with simulation studies, the specific dioxidation of tryptophane W128 was detected as a potential explanation for this inactivation, indicating the strong impact of plasma on biological targets. In summary, oxidative modifications found in peptide solutions were observed also in complex protein structures and sample matrices. In conclusion, this work provides a starting point for future studies of oxidative modifications in complex models and may thus be helpful for further investigations in the fields of plasma medicine and redox chemistry.
Objectives
Biofilm removal is the decisive factor for the control of peri-implantitis. Cold atmospheric pressure plasma (CAP) can become an effective aid due to its ability to destroy and to inactivate bacterial biofilm residues. This study evaluated the cleaning efficiency of CAP, and air-polishing with glycine (APG) or erythritol (APE) containing powders alone or in combination with CAP (APG + CAP, APE + CAP) on sandblasted/acid etched, and anodised titanium implant surface.
Materials and methods
On respective titanium discs, a 7-day ex vivo human biofilm was grown. Afterwards, the samples were treated with CAP, APG, APE, APG + CAP, and APE + CAP. Sterile and untreated biofilm discs were used for verification. Directly after treatment and after 5 days of incubation in medium at 37 °C, samples were prepared for examination by fluorescence microscopy. The relative biofilm fluorescence was measured for quantitative analyses.
Results
Air-polishing with or without CAP removed biofilms effectively. The combination of air-polishing with CAP showed the best cleaning results compared to single treatments, even on day 5. Immediately after treatment, APE + CAP showed insignificant higher cleansing efficiency than APG + CAP.
Conclusions
CAP supports mechanical cleansing and disinfection to remove and inactivate microbial biofilm on implant surfaces significantly. Here, the type of the powder was not important. The highest cleansing results were obtained on sandblasted/etched surfaces.
Clinical relevance.
Microbial residuals impede wound healing and re-osseointegration after peri-implantitis treatment. Air-polishing treatment removes biofilms very effectively, but not completely. In combination with CAP, microbial free surfaces can be achieved. The tested treatment regime offers an advantage during treatment of peri-implantitis.