Document Type : Editorial
Author
Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
Abstract
Highlights
Keywords
Main Subjects
Editorial: Plasma term was coined in 1927 for the first time by Irvin Langmuir [1]. Plasma, the fourth state of matter, is a semi-ionized gas comprising ions, radicals, photons, and excited atoms [2]. Thanks to the improvements in plasma technology in creating cold atmospheric plasma (CAP) at room temperature (not higher than 40˚C), utilizing CAP for different applications has become a popular topic in medical science and finally led to the emerging plasma medicine Field. This multidisciplinary field combines chemistry, plasma physics, and biomedical sciences with engineering [3-5]. CAP can be used for wound healing, dental caries, and the inactivation of microorganisms [3, 4]. Hitherto, research showed CAP might better be considered as a combinational therapy strategy along with surgical tumor resection, immunotherapy, radiotherapy, pulsed electric fields, and chemotherapy [6-8]. Intriguingly, a study showed that in comparison with docetaxel, which is a clinically well-established chemotherapy drug for metastatic prostate cancer, CAP showed comparable results [9].
The efficacy of CAP on cancer cell lines and xenografts by inducing apoptosis through DNA damage and curtailing cancer cell viability has been shown by many studies [10]. Particularly in the field of urology, prostate cancer cells like PC3, LNCaP, and DU-145 are successfully treated by CAP treatment [9, 11]. It is suggested that the principal cellular mechanism of CAP efficacy in these cells lies in the morphological changes of cell architecture and pro-apoptotic modulation of caspase-3, Bax, anti-apoptotic proteins like surviving, and cell cycle regulators such as p21, p53. Accordingly, Caspase will be activated after activating the apoptotic pathway, and DNA and nucleus damage will occur [9, 12, 13]. Evidence shows that activation of redox signaling cascades is another event that happens after CAP treatment [14]. On a larger scale, it is recommended that low-temperature plasma be used with the help of accurate imaging techniques for focal prostate therapy [10]. The most critical challenge in establishing this device is assessing the accurate dose of plasma, as lower and higher doses have different results and can even stimulate cell proliferation. Defining plasma dose in vitro and in vivo studies can give the researcher a better scale for precisely comparing the results. This definition should encompass all plasma devices, specifically DBD and jet devices, which are more utilized in studies. This predicament is one of the principal obstacles to introducing plasma to clinical trial studies.
Conclusion
In retrospect, a vast array of studies focused on the usage of plasma on different cell lines, mice, and xenograft tumors. Although most of them used DBD or Plasma jet in their studies, there is no steady definition of plasma dose among them. There is the same situation in prostate cancer research in which plasma is used as the therapy. Indeed, this problem might be one of the essential reasons why researchers who intend to utilize plasma for focal localized prostate cancer or more clinical trial research have a slow speed of progress in their work since no milestone helps the better comparison of research results.
Acknowledgments
Not Applicable.
Conflict of Interest
The author declares that there is no conflict of interest.
Funding
No funding.
Ethical statement
Not applicable.
Data Availability
No additional data are available for this editorial.
Abbreviations
CAP Cold Atmospheric Plasma