Abstract: In recent years, cold atmospheric plasma (CAP) has been proposed as a novel method to enhance transdermal drug delivery, while avoiding tissue damage. However, the underlying mechanism for the increasing skin permeability upon CAP treatment is still undefined. We propose a mechanism in which CAP-generated reactive species induce cross-linking of skin lipids, leading to the generation of nanopores, thereby facilitating the permeation of drug molecules. Molecular dynamics simulations support this proposed mechanism. Furthermore, our results indicate that to achieve maximum enhancement of the permeability, the optimal treatment will depend on the exact lipid composition of the skin, as well as on the CAP source used.

Abstract: We performed molecular dynamics simulations to investigate the effect of lipid peroxidation products on the structural and dynamic properties of the cell membrane. Our simulations predict that the lipid order in a phospholipid bilayer, as a model system for the cell membrane, decreases upon addition of lipid peroxidation products. Eventually, when all phospholipids are oxidized, pore formation can occur. This will allow reactive species, such as reactive oxygen and nitrogen species (RONS), to enter the cell and cause oxidative damage to intracellular macromolecules, such as DNA or proteins. On the other hand, upon increasing the cholesterol fraction of lipid bilayers, the cell membrane order increases, eventually reaching a certain threshold, from which cholesterol is able to protect the membrane against pore formation. This finding is crucial for cancer treatment by plasma technology, producing a large number of RONS, as well as for other cancer treatment methods that cause an increase in the concentration of extracellular RONS. Indeed, cancer cells contain less cholesterol than their healthy counterparts. Thus, they will be more vulnerable to the consequences of lipid peroxidation, eventually enabling the penetration of RONS into the interior of the cell, giving rise to oxidative stress, inducing pro-apoptotic factors. This provides, for the first time, molecular level insight why plasma can selectively treat cancer cells, while leaving their healthy counterparts undamaged, as is indeed experimentally demonstrated.

Abstract: While plasma treatment of skin diseases and wound healing has been proven highly effective, the underlying mechanisms, and more generally the effect of plasma radicals on skin tissue, are not yet completely understood. In this paper, we perform ReaxFF-based reactive molecular dynamics simulations to investigate the interaction of plasma generated OH radicals with a model system composed of free fatty acids, ceramides, and cholesterol molecules. This model system is an approximation of the upper layer of the skin (stratum corneum). All interaction mechanisms observed in our simulations are initiated by H-abstraction from one of the ceramides. This reaction, in turn, often starts a cascade of other reactions, which eventually lead to the formation of aldehydes, the dissociation of ceramides or the elimination of formaldehyde, and thus eventually to the degradation of the skin barrier function.

Abstract: Plasma modelling is an exciting subject in which virtually all physical disciplines are represented. Plasma models combine the electromagnetic, statistical and fluid dynamical theories that have their roots in the 19th century with the modern insights concerning the structure of matter that were developed throughout the 20th century. The present cluster issue consists of 20 invited contributions, which are representative of the state of the art in plasma modelling and numerical simulation. These contributions provide an in-depth discussion of the major theories and modelling and simulation strategies, and their applications to contemporary plasma-based technologies. In this editorial review, we introduce and complement those papers by providing a bird's eye perspective on plasma modelling and discussing the historical context in which it has surfaced.

Abstract: A zero-dimensional, semi-empirical model is used to describe the plasma chemistry in an argon plasma jet flowing into humid air, mimicking the experimental conditions of a setup from the Eindhoven University of Technology. The model provides species density profiles as a function of the position in the plasma jet device and effluent. A reaction chemistry set for an argon/humid air mixture is developed, which considers 84 different species and 1880 reactions. Additionally, we present a reduced chemistry set, useful for higher level computational models. Calculated species density profiles along the plasma jet are shown and the chemical pathways are explained in detail. It is demonstrated that chemically reactive H, N, O and OH radicals are formed in large quantities after the nozzle exit and H2, O2(1Δg), O3, H2O2, NO2, N2O, HNO2 and HNO3 are predominantly formed as 'long living' species. The simulations show that water clustering of positive ions is very important under these conditions. The influence of vibrational excitation on the calculated electron temperature is studied. Finally, the effect of varying gas temperature, flow speed, power density and air humidity on the chemistry is investigated.

Abstract: In this paper we study two cold atmospheric pressure plasma jets, operating in Ar + 2% air, with a different electrode geometry but with the same power dissipated in the plasma. The density profiles of the biomedically active NO and O species throughout the plasma jet, previously obtained by laser diagnostics, are calculated by means of a zero-dimensional semi-empirical reaction kinetics model. A good agreement between the calculated and measured data is demonstrated. Furthermore, the most probable spatial power distribution in an RF driven plasma jet is obtained for the first time by comparing measured and calculated species density profiles. This was possible due to the strong effect of the power distribution on the NO and O density profiles. In addition the dominant reaction pathways for both the NO and the O species are identified. The model allows us to obtain key information on the reactive species production inside the jet, which is difficult to access by laser diagnostics in a coaxial geometry. Finally, we demonstrate that water impurities in the order of 100 ppm in the gas feed can have a significant effect on the spatial distribution of the NO and O density.

Abstract: Non-destructive 14-MeV neutron activation analysis for silicon in steel has been applied with 56Mn as internal standard.56Mn is formed from the iron matrix via the 56Fe(n,p)56Mn reaction. Several methods of internal standardisation via56Mn are discussed. The 0.84-MeV photopeak of 56Mn is recommended if steel samples of about the same composition are to be analysed. Chemically analysed steel samples are used as silicon standards. A precision of 0.7% was obtained for an analysis plus standardisation time of 13 min. Special attention was paid to interferences produced by concentration changes of impurity elements. Several possible sources of errors were investigated.

Abstract: The use of plasma technology for CO2 splitting is gaining increasing interest, but one of the major obstacles to date for industrial implementation is the considerable energy cost. We demonstrate that the introduction of a packing of dielectric zirconia (ZrO2) beads into a dielectric barrier discharge (DBD) plasma reactor can enhance the CO2 conversion and energy efficiency up to a factor 1.9 and 2.2, respectively, compared to that in a normal (unpacked) DBD reactor. We obtained a maximum conversion of 42 % and a maximum energy efficiency of 9.6 %. However, it is the ability of the packing to almost double both the conversion and the energy efficiency simultaneously at certain input parameters that makes it very promising. The improved conversion and energy efficiency can be explained by the higher values of the local electric field and electron energy near the contact points of the beads and the lower breakdown voltage, demonstrated by 2 D fluid modeling.

Abstract: Packed bed plasma reactors (PBPRs) are gaining increasing interest for use in environmental applications, such as greenhouse gas conversion into value-added chemicals or renewable fuels and volatile pollutant removal (e.g. NOx, VOC, K), as they enhance the conversion and energy efficiency of the process compared to a non-packed reactor. However, the plasma behaviour in a PBPR is not well understood. In this paper we demonstrate, by means of a fluid model, that the discharge behaviour changes considerably when changing the size of the packing beads and their dielectric constant, while keeping the interelectrode spacing constant. At low dielectric constant, the plasma is spread out over the full discharge gap, showing significant density in the voids as well as in the connecting void channels. The electric current profile shows a strong peak during each half cycle. When the dielectric constant increases, the plasma becomes localised in the voids, with a current profile consisting of many smaller peaks during each half cycle. For large bead sizes, the shift from full gap discharge to localised discharges takes place at a higher dielectric constant than for smaller beads. Furthermore, smaller beads or beads with a lower dielectric constant require a higher breakdown voltage to cause plasma formation.

Abstract: Pancreatic ductal adenocarcinoma (PDAC) and glioblastoma multiforme (GBM) are two of the most malignant solid tumor types with poor survival rates, which underscore the urgency of novel and efficacious treatment strategies. Within the last decade, immunotherapy has been established as a breakthrough in cancer therapy. This mainly has been driven by the clinical data and approval associated with several immune checkpoint inhibitors (e.g. anti-CTLA-4 and anti-PD-1/L1). Despite the clinical benefit in specific tumor types, these inhibitors have not yet fulfilled their promise in low immunogenic tumors such as PDAC and GBM. Oxidative stress in cancer cells due to elevated reactive oxygen species (ROS) and an inability to balance intracellular redox state has recently been highlighted as promising target for anticancer treatment strategies with possible immunogenic effects. In this PhD dissertation, I investigated novel oxidative stress-mediated treatment approaches to target PDAC and GBM and to enhance immunogenicity by inducing immunogenic cell death (ICD). In the first part of this thesis (chapter 2), I reviewed the mechanistic responses of cancer cells towards different oxidative stress-inducing treatment strategies and their immunomodulating effects. The resulting literature demonstrated that different exogenous and endogenous ROS-inducing therapies show direct and indirect immunomodulating effects, which can be either immunostimulatory or immunosuppressive. One of the indirect immunostimulatory effects of the ROS-mediating therapies is the capacity of inducing immunogenic cell death (ICD) in tumor cells, which can increase the immunogenicity and consequently can trigger an antitumoral immune response. In chapter 3, I investigated a novel exogenous ROS-inducing treatment method, namely cold atmospheric plasma, to determine the therapeutic and ICD-inducing effects in PDAC, in vitro. I revealed that plasma-treated PBS (pPBS) has the potential to induce ICD in pancreatic cancer cells (PCCs) and to reduce the immunosuppressive tumor microenvironment (TME) by attacking the tumor supportive pancreatic stellate cells (PSCs). Although the cell death induced in PSCs was non-immunogenic as seen by the lack of danger-associated molecular patterns (DAMPs) emission and DC activation, I showed that pPBS could disrupt the physical barrier and lower the immunosuppressive secretion profile (lower TGF-β) of PSCs. In contrast, DAMPs were released by PCCs after treatment with pPBS which resulted in activation and maturation of DCs and a more immunostimulatory secretion profile (higher TNF-α, IFN-γ). Hence, indirect plasma treatment via pPBS has the potential to enhance immunogenicity in PDAC by triggering ICD and by attacking the immunosuppressive PSCs. Tumor cells can evolve adaptation mechanisms to protect themselves against intrinsic oxidative stress by upregulation of pro-survival molecules and their antioxidant defense system to maintain the redox balance. As such, tumor cells can become resistant towards exogenous ROS-inducing therapies, like plasma. Dual targeting of the redox balance of tumor cells by increasing exogenous levels of ROS and inhibiting the antioxidant defense system can maximally exploit ROS-mediated cell death mechanisms as therapeutic anticancer strategy. In this regard, cold atmospheric plasma was combined with auranofin, a thioredoxin reductase inhibitor, in GBM (chapter 4). A synergistic effect was shown after this combination treatment in 2D and 3D, however, in 3D only high concentrations of auranofin synergized with plasma treatment. I confirmed a ROS-mediated response after combination treatment, which was able to induce distinct cell death mechanisms, specifically apoptosis and ferroptosis. Additionally, the auranofin and plasma combined treatment strategy induced cell death, which resulted in an increased release of DAMPs. Together with the observed DC maturation, these results indicates the potential increase in immunogenicity, though, the phagocytotic capacity of DCs was inhibited by auranofin. In chapter 5, I evaluated this promising oxidative stress combination therapy in GBM, in vivo. A decrease in tumor kinetics and an increased survival in GBM-bearing mice was observed when auranofin was sequentially combined with direct plasma treatment. No T cell infiltration was observed after auranofin monotherapy. However, further characterization of the TME after the combination therapy is necessary to provide more insight in the immunogenic effects in vivo. In conclusion, this PhD dissertation comprises novel and important therapeutic and immunogenic insights in cold atmospheric plasma and auranofin as promising oxidative stress-mediated treatment strategies for low immunogenic tumors, like PDAC and GBM. These preclinical results provide a solid basis for future research towards combinations with immunotherapeutic approaches.

Abstract: Targeting the redox balance of malignant cells via the delivery of high oxidative stress unlocks a potential therapeutic strategy against glioblastoma (GBM). We investigated a novel reactive oxygen species (ROS)-inducing combination treatment strategy, by increasing exogenous ROS via cold atmospheric plasma and inhibiting the endogenous protective antioxidant system via auranofin (AF), a thioredoxin reductase 1 (TrxR) inhibitor. The sequential combination treatment of AF and cold atmospheric plasma-treated PBS (pPBS), or AF and direct plasma application, resulted in a synergistic response in 2D and 3D GBM cell cultures, respectively. Differences in the baseline protein levels related to the antioxidant systems explained the cell-line-dependent sensitivity towards the combination treatment. The highest decrease of TrxR activity and GSH levels was observed after combination treatment of AF and pPBS when compared to AF and pPBS monotherapies. This combination also led to the highest accumulation of intracellular ROS. We confirmed a ROS-mediated response to the combination of AF and pPBS, which was able to induce distinct cell death mechanisms. On the one hand, an increase in caspase-3/7 activity, with an increase in the proportion of annexin V positive cells, indicates the induction of apoptosis in the GBM cells. On the other hand, lipid peroxidation and inhibition of cell death through an iron chelator suggest the involvement of ferroptosis in the GBM cell lines. Both cell death mechanisms induced by the combination of AF and pPBS resulted in a significant increase in danger signals (ecto-calreticulin, ATP and HMGB1) and dendritic cell maturation, indicating a potential increase in immunogenicity, although the phagocytotic capacity of dendritic cells was inhibited by AF. In vivo, sequential combination treatment of AF and cold atmospheric plasma both reduced tumor growth kinetics and prolonged survival in GBM-bearing mice. Thus, our study provides a novel therapeutic strategy for GBM to enhance the efficacy of oxidative stress-inducing therapy through a combination of AF and cold atmospheric plasma.