Gas Flow Shaping via Novel Modular Nozzle System (MoNoS) Augments kINPen-Mediated Toxicity and Immunogenicity in Tumor Organoids

Simple Summary Cancer is a devastating disease. New treatment avenues are demanded to promote successful and safe cancer therapies. Gas plasma is a novel tool recently promoted for cancer treatment. This so-called fourth state of matter is known in its hotter forms, such as fire and lightning. Technology leap innovations enabled the usage of gas plasma for medical purposes. In laboratory models, gas plasma has shown promising antitumor effects in several types of cancer. One particularly successful gas plasma device type is called jet plasma. We here attempted to optimize those by testing two adapters mountable on plasma jet devices, which have two functions. One is to increase the amount of ambient air, similar to a turbo coming close to the plasma jet, to produce more free radicals within the same time for anticancer treatment. The second is to add a filter with varying porosity between the plasma jet and the treatment target. This increases the area of free radical deposition, potentially enabling larger skin or tumor treatment areas compared to the focused treatment area of the plasma jet alone. We here provide evidence that such a filter enhanced the antitumor effects of a certified argon plasma jet. Abstract Medical gas plasma is an experimental technology for anticancer therapy. Here, partial gas ionization yielded reactive oxygen and nitrogen species, placing the technique at the heart of applied redox biomedicine. Especially with the gas plasma jet kINPen, anti-tumor efficacy was demonstrated. This study aimed to examine the potential of using passive flow shaping to enhance the medical benefits of atmospheric plasma jets (APPJ). We used an in-house developed, proprietary Modular Nozzle System (MoNoS; patent-pending) to modify the flow properties of a kINPen. MoNoS increased the nominal plasma jet-derived reactive species deposition area and stabilized the air-plasma ratio within the active plasma zone while shielding it from external flow disturbances or gas impurities. At modest flow rates, dynamic pressure reduction (DPR) adapters did not augment reactive species deposition in liquids or tumor cell killing. However, MoNoS operated at kINPen standard argon fluxes significantly improved cancer organoid growth reduction and increased tumor immunogenicity, as seen by elevated calreticulin and heat-shock protein expression, along with a significantly spurred cytokine secretion profile. Moreover, the safe application of MoNoS gas plasma jet adapters was confirmed by their similar-to-superior safety profiles assessed in the hen’s egg chorioallantoic membrane (HET-CAM) coagulation and scar formation irritation assay.

[1]  L. Miebach,et al.  In ovo model in cancer research and tumor immunology , 2022, Frontiers in Immunology.

[2]  J. C. Park,et al.  Current and Future Biomarkers for Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma , 2022, Current oncology.

[3]  T. Malek,et al.  Engineering IL-2 for immunotherapy of autoimmunity and cancer , 2022, Nature Reviews Immunology.

[4]  Ö. Türeci,et al.  Identification of neoantigens for individualized therapeutic cancer vaccines , 2022, Nature Reviews Drug Discovery.

[5]  T. von Woedtke,et al.  Conductivity augments ROS and RNS delivery and tumor toxicity of an argon plasma jet. , 2022, Free radical biology & medicine.

[6]  G. Curigliano,et al.  Understanding resistance to immune checkpoint inhibitors in advanced breast cancer , 2021, Expert review of anticancer therapy.

[7]  B. Holtfreter,et al.  Repeated exposure of the oral mucosa over 12 months with cold plasma is not carcinogenic in mice , 2021, Scientific Reports.

[8]  R. Wirz,et al.  Portable air-fed cold atmospheric plasma device for postsurgical cancer treatment , 2021, Science advances.

[9]  T. von Woedtke,et al.  Medical gas plasma-stimulated wound healing: Evidence and mechanisms , 2021, Redox biology.

[10]  A. Rengan,et al.  A review of advanced nanoformulations in phototherapy for cancer therapeutics. , 2021, Photodiagnosis and photodynamic therapy.

[11]  S. Loi,et al.  Intratumoral heterogeneity in cancer progression and response to immunotherapy , 2021, Nature Medicine.

[12]  T. von Woedtke,et al.  Risk Evaluation of EMT and Inflammation in Metastatic Pancreatic Cancer Cells Following Plasma Treatment , 2020, Frontiers in Physics.

[13]  F. Ghiringhelli,et al.  Interleukin-1β and Cancer , 2020, Cancers.

[14]  T. von Woedtke,et al.  Long-Term Risk Assessment for Medical Application of Cold Atmospheric Pressure Plasma , 2020, Diagnostics.

[15]  T. von Woedtke,et al.  Risk Assessment of kINPen Plasma Treatment of Four Human Pancreatic Cancer Cell Lines with Respect to Metastasis , 2019, Cancers.

[16]  E. Brint,et al.  IL-1 Family Members in Cancer; Two Sides to Every Story , 2019, Front. Immunol..

[17]  Hans-Robert Metelmann,et al.  Treating cancer with cold physical plasma: On the way to evidence‐based medicine , 2018 .

[18]  T. von Woedtke,et al.  The kINPen—a review on physics and chemistry of the atmospheric pressure plasma jet and its applications , 2018 .

[19]  A. Kramer,et al.  High throughput image cytometry micronucleus assay to investigate the presence or absence of mutagenic effects of cold physical plasma , 2018, Environmental and molecular mutagenesis.

[20]  K. Weltmann,et al.  Plasma, cancer, immunity , 2018, Clinical Plasma Medicine.

[21]  A. Reichert,et al.  Nanotherapy and Reactive Oxygen Species (ROS) in Cancer: A Novel Perspective , 2018, Antioxidants.

[22]  Ronny Brandenburg,et al.  Dielectric barrier discharges: progress on plasma sources and on the understanding of regimes and single filaments , 2017 .

[23]  T. von Woedtke,et al.  One Year Follow-Up Risk Assessment in SKH-1 Mice and Wounds Treated with an Argon Plasma Jet , 2017, International journal of molecular sciences.

[24]  J. Gardeniers,et al.  Plasma–liquid interactions , 2016, Journal of Applied Physics.

[25]  A. Sckell,et al.  Investigating the Mutagenicity of a Cold Argon-Plasma Jet in an HET-MN Model , 2016, PloS one.

[26]  David B. Graves,et al.  Reactive species in non-equilibrium atmospheric-pressure plasmas: Generation, transport, and biological effects , 2016 .

[27]  Ronny Brandenburg,et al.  Atmospheric pressure plasma jets: an overview of devices and new directions , 2015 .

[28]  P. Bruggeman,et al.  Nitric oxide density distributions in the effluent of an RF argon APPJ: effect of gas flow rate and substrate , 2014 .

[29]  P. Agostinis,et al.  Physical modalities inducing immunogenic tumor cell death for cancer immunotherapy , 2014, Oncoimmunology.

[30]  B. Shen,et al.  Norcantharidin Induced DU145 Cell Apoptosis through ROS-Mediated Mitochondrial Dysfunction and Energy Depletion , 2013, PloS one.

[31]  Laurence Zitvogel,et al.  Immunogenic cell death in cancer therapy. , 2013, Annual review of immunology.

[32]  K. Weltmann,et al.  Atomic oxygen in a cold argon plasma jet: TALIF spectroscopy in ambient air with modelling and measurements of ambient species diffusion , 2012 .

[33]  Wilhelm Stolz,et al.  Cold atmospheric plasma: a successful treatment of lesions in Hailey-Hailey disease. , 2011, Archives of dermatology.

[34]  D. Hanahan,et al.  Hallmarks of Cancer: The Next Generation , 2011, Cell.

[35]  A. Kramer,et al.  The modified HET-CAM as a model for the assessment of the inflammatory response to tissue tolerable plasma. , 2011, Toxicology in vitro : an international journal published in association with BIBRA.

[36]  N. Bibinov,et al.  Characterization of DBD plasma source for biomedical applications , 2009 .

[37]  Jörg Ehlbeck,et al.  Antimicrobial treatment of heat sensitive products by miniaturized atmospheric pressure plasma jets (APPJs) , 2008 .

[38]  L. Zitvogel,et al.  Calreticulin exposure is required for the immunogenicity of γ-irradiation and UVC light-induced apoptosis , 2007, Cell Death and Differentiation.

[39]  Kap-Seok Yang,et al.  Reversible oxidation and inactivation of the tumor suppressor PTEN in cells stimulated with peptide growth factors. , 2004, Proceedings of the National Academy of Sciences of the United States of America.

[40]  M. Renschler The emerging role of reactive oxygen species in cancer therapy. , 2004, European journal of cancer.

[41]  R Gopalakrishna,et al.  Protein kinase C signaling and oxidative stress. , 2000, Free radical biology & medicine.

[42]  H. Sies Strategies of antioxidant defense , 1993 .

[43]  B. Freeman,et al.  Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. , 1990, Proceedings of the National Academy of Sciences of the United States of America.

[44]  S. Marklund Spectrophotometric study of spontaneous disproportionation of superoxide anion radical and sensitive direct assay for superoxide dismutase. , 1976, The Journal of biological chemistry.

[45]  O. Warburg [Origin of cancer cells]. , 1956, Oncologia.

[46]  J. Crowley,et al.  Vitamin E and the Risk of Prostate Cancer The Selenium and Vitamin E Cancer Prevention Trial ( SELECT ) , 2011 .

[47]  D. Albanes,et al.  The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. , 1994, The New England journal of medicine.