Argon Cold Plasma-A Novel Tool to Treat Therapy-resistant Corneal Infections.

Abstract

PURPOSE:

To test whether therapy-resistant corneal infections can be successfully treated with argon cold plasma to reduce or eliminate pathogen microorganisms without affecting corneal cell viability.

DESIGN:

First-in-human case series and experimental study.

METHODS:

Cold plasma effects on viability of primary human corneal limbal epithelial cells were studied using exposure times from 0.5 to 10 minutes (metabolic activity, oxidative stress, apoptosis). Disinfective potential of cold plasma was tested against common pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans) on culture medium and evaluated by counting colony-forming units and optical density measurements, as well as against S aureus in a human cornea infection model. Additionally, in a first-in-human trial 4 patients with therapy-resistant corneal ulcers were treated to evaluate the clinical potential of cold plasma.

RESULTS:

Cells treated for 0.5-5 minutes completely recovered within 24 hours without changes in morphology; only 10-minute treatment impaired the cells permanently. No evident oxidative stress, apoptosis, or damage to the corneal structure could be found. All pathogens were susceptible to cold plasma treatments, with different levels of sensitivity. The condition of all 4 patients significantly improved after cold plasma treatment combined with antibiotic therapy.

CONCLUSIONS:

Our results indicate that argon cold plasma treatment reduces or eliminates common pathogens without impairing corneal epithelial cells in vitro, ex vivo, and in direct application on patients' eyes. We conclude that argon cold plasma therapy offers a potential supplement or alternative therapy for therapy-resistant corneal infections. A larger, comparative study is necessary to further confirm these findings.

• Authors: Helena H Reitberger, Marta Czugala, Catherine Chow, Andreas Mohr, Andreas Burkovski, Anja K Gruenert, Renate Schoenebeck, Thomas A Fuchsluger
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 190 Pg. 150-163 (06 2018) ISSN: 1879-1891 [Electronic] United States
• PMID: 29580975 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Plasma Gases
• Argon

Topics

• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Apoptosis
• Argon (therapeutic use)
• Bacteria (drug effects, isolation & purification)
• Blotting, Western
• Cold Temperature
• Colony Count, Microbial
• Corneal Ulcer (drug therapy, microbiology)
• Disinfection (methods)
• Drug Resistance, Bacterial
• Drug Therapy, Combination
• Epithelium, Corneal (microbiology)
• Eye Infections, Bacterial (drug therapy, microbiology)
• Eye Infections, Fungal (drug therapy, microbiology)
• Female
• Flow Cytometry
• Fungi (drug effects, isolation & purification)
• Humans
• Limbus Corneae (cytology)
• Male
• Middle Aged
• Organ Culture Techniques
• Plasma Gases (therapeutic use)
• Staphylococcal Infections
• Tissue Donors