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

Clinic and Polyclinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany
ZIK plasmatis, Leibniz-Institute for Plasma Science and Technology (INP Greifswald), 17489 Greifswald, Germany
Oral & Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17489 Greifswald, Germany
Department of Cell Biology, University Medical Center Rostock, 18057 Rostock, Germany
Institute for Experimental Surgery, Rostock University Medical Center, 18057 Rostock, Germany
Author to whom correspondence should be addressed.
Cancers 2020, 12(2), 269; (registering DOI)
Received: 29 November 2019 / Revised: 16 January 2020 / Accepted: 20 January 2020 / Published: 22 January 2020
(This article belongs to the Special Issue Plasma in Cancer Treatment)
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. View Full-Text
Keywords: cold physical plasma; plasma medicine; reactive oxygen and nitrogen species cold physical plasma; plasma medicine; reactive oxygen and nitrogen species
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Semmler, M.L.; Bekeschus, S.; Schäfer, M.; Bernhardt, T.; Fischer, T.; Witzke, K.; Seebauer, C.; Rebl, H.; Grambow, E.; Vollmar, B.; Nebe, J.B.; Metelmann, H.-R.; Woedtke, T.; Emmert, S.; Boeckmann, L. Molecular Mechanisms of the Efficacy of Cold Atmospheric Pressure Plasma (CAP) in Cancer Treatment. Cancers 2020, 12, 269.

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