Cold atmospheric plasma in medical technology

The plasma care® inactivates bacteria including multi-resistent pathogenes, viruses, fungi and spores. Cold plasma technology is already used in routine clinical practice for wound treatment. Further areas of application within dermatology, intensive care medicine and others are being researched.

News:

 As the result of collaboration with the von Brunn working group at the Max von Pettenkofer Institute in Munich, there are first indications that cold atmospheric plasma can also inactivate coronaviruses in solution.

In recent weeks, the promising use of cold plasma for treating COVID-19  has been discussed with virologists, microbiologists, anaesthesiologists, intensive care physicians, and pulmonologists. It is known that cold plasmas have a very broad spectrum of efficacy against bacteria – including multi-resistant germs such as MRSA  – and viruses. The latter has been demonstrated on adenoviruses, noroviruses and influenza viruses, among others. The conclusion that coronaviruses can also be inactivated by cold plasma therefore seemed obvious. This was confirmed in initial tests as part of a collaboration with the von Brunn working group at the Max von Pettenkofer Institute in Munich. With these promising results, the development of the so-called ‘plasma intensive care’ started at terraplasma medical GmbH – a device for generating gaseous cold plasma, which, in contrast to antiseptic liquids, can also reach angled or hard-to-reach areas in the upper respiratory tract.

The plasma care® is a CE-approved medical device that inactivates bacteria – including multi-resistant pathogens – viruses and fungi using cold atmospheric plasma. It was developed for mobile treatment of acute and chronic wounds. A new ventilation applicator was developed for the plasma care for use in the pharyngeal cavity.

With this applicator, the viral load in the oral and pharyngeal cavities of intubated, ventilated patients can be significantly reduced or even eliminated by using cold plasma. This would reduce the microaspiration of, among other things, bacteria and germs into the bronchial tree and prevent additional entry of the virus due to microaspiration.

Especially the microaspiration of germs and bacteria often leads to a secondary (nosocomial) bacterial superinfection, which led to 30 – 55% of deaths in the SARS epidemic, among others (source: J.L. Gerberding, Antibiotic resistance: the hidden threat lurking behind COVID-19 , STAT March 2020).

In addition to the treatment of intubated patients, the treatment of patients at an earlier stage of the disease is also being examined in order to prevent the virus from spreading to the bronchial tree and later to the lungs as well as the associated intensive care treatment and intubation.

What is cold atmospheric plasma?

The fourth aggregate state is called plasma, which arises from the supply of energy to gas. 

 

Cold atmospheric plasma (CAP) is a partially ionized room temperature gas. It consists of a reactive mix of electrons, ions, excited atoms and molecules, reactive species (such as O3, NO, NO2, etc.), UV-radiation, electromagnetic fields and heat. It penetrates bacteria, viruses and fungi and destroys their DNA, which is freely available in the cell, to inactivate the microorganisms. Human eukaryotic cells however are safe from the effects of temporarily applied CAP, because their DNA is additionally protected by the nuclear membrane. So far no tissue damage due to treatment with the plasma care® is known.

Use of cold plasma in medical technology

 

This is how cold plasma affects microorganisms 

Cold plasmas are partially ionized gases, which make the cell membrane porous for a few microseconds. Thus, intercellular structures, such as the DNA, can be destroyed. In contrast, human eukaryotic cells are significantly better protected through the DNA lying in a cell nucleus and other mechanisms. According to current knowledge, human cells are therefore not damaged by treatment with the plasma care®.

The patient is neither exposed to radiation nor does electricity flow through the skin. You can find more about plasma technology under “Technology”



This is how cold plasma affects human cells


Human cells are protected against the effects of plasma due to the cell nucleus and the cellular repair mechanisms. It was observed in-vitro that the oxidative stress caused by the cold plasma stimulates cell biological survival mechanisms. This is one possible explanation for the improved wound healing seen on some patients.