Literature DB >> 34926141

Innovative Cold Atmospheric Plasma (iCAP) Decreases Mucopurulent Corneal Ulcer Formation and Edema and Reduces Bacterial Load in Pseudomonas Keratitis.

Wahaj Saleem1, Angela H Benton2, Mary E Marquart2, Shuli Wang1, Waqas Saleem1, Randy Vigil1, Bo Huang3, Anjal C Sharma1.   

Abstract

PURPOSE: To evaluate the effect of application of 3% air in helium cold atmospheric plasma jet, using an inexpensive device termed iCAP, in corneal scratch wound closure in vitro and the treatment of Pseudomonas aeruginosa (P. aeruginosa) keratitis in vivo.
METHODS: Thermal imaging to measure temperature of surfaces to which iCAP was applied and UV energy density delivered by iCAP were measured. Scratch wounds inflicted on in vitro cultures of a human corneal epithelial cell line were treated with iCAP and wound widths at various times post-application were measured. Rabbit eyes infected with P. aeruginosa were treated with iCAP and slit lamp biomicroscope examination conducted to determine corneal health outcomes 25h post infection. Corneal homogenates were plated on agar and viable bacterial colonies enumerated to determine the effect of iCAP on bacterial load in vivo in P. aeruginosa keratitis.
RESULTS: iCAP was shown to operate in the non-thermal regime and also shown to deliver much lower UV energy density than that necessary to cause harmful effects on ocular tissue. iCAP treatment significantly improved the rate of scratch wound gap closure in vitro in a human corneal epithelial cell line compared to controls. In vivo, iCAP treatment of P. aeruginosa keratitis infection in the rabbit eyes (N = 20) significantly reduced the incidence of corneal ulcer (P = 0.003) and corneal edema (P = 0.011) and significantly improved total cornea health (P = 0.034) compared to untreated (N = 10). Finally, in vivo iCAP treatment of P. aeruginosa keratitis infection in the rabbit eyes (N = 19) significantly reduced bacterial loads (P = 0.012) compared to untreated (N = 9).
CONCLUSION: Our results strongly suggest that iCAP treatment was effective in improving corneal epithelial defect closure in vitro, reducing ulcer formation and decreasing inflammation in P. aeruginosa infected corneas in vivo and decreasing bacterial loads in P. aeruginosa infected corneas in vivo which led to improved overall cornea health outcomes in vivo. Further studies to investigate iCAP's safety and efficacy against other infectious microbes responsible for causing ulcerative keratitis, with and without co-treatment with antimicrobial therapies are warranted.

Entities:  

Keywords:  Bacterial keratitis; Bacterial load reduction; Cold atmospheric plasma; Corneal epithelial defect closure; Pseudomonas aeruginosa; Ulcer and inflammation reduction

Year:  2019        PMID: 34926141      PMCID: PMC8681885          DOI: 10.1016/j.cpme.2019.100093

Source DB:  PubMed          Journal:  Clin Plasma Med        ISSN: 2212-8166


  40 in total

1.  The Glenn A. Fry award lecture 2005. The pathogenesis of contact lens-related keratitis.

Authors:  Suzanne M J Fleiszig
Journal:  Optom Vis Sci       Date:  2006-12       Impact factor: 1.973

2.  Atmospheric pressure, nonthermal plasma inactivation of MS2 bacteriophage: effect of oxygen concentration on virucidal activity.

Authors:  N H Alshraiedeh; M Y Alkawareek; S P Gorman; W G Graham; B F Gilmore
Journal:  J Appl Microbiol       Date:  2013-09-12       Impact factor: 3.772

3.  Bacterial keratitis: perspective on epidemiology, clinico-pathogenesis, diagnosis and treatment.

Authors:  Abdullah Al-Mujaini; Nadia Al-Kharusi; Archana Thakral; Upender K Wali
Journal:  Sultan Qaboos Univ Med J       Date:  2009-06-30

Review 4.  The pathogenesis of bacterial keratitis: studies with Pseudomonas aeruginosa.

Authors:  Suzanne M J Fleiszig; David J Evans
Journal:  Clin Exp Optom       Date:  2002-09       Impact factor: 2.742

5.  Cholesterol as treatment for pneumococcal keratitis: cholesterol-specific inhibition of pneumolysin in the cornea.

Authors:  Mary E Marquart; Kathryn S Monds; Clare C McCormick; Sherrina N Dixon; Melissa E Sanders; Julian M Reed; Larry S McDaniel; Armando R Caballero; Richard J O'Callaghan
Journal:  Invest Ophthalmol Vis Sci       Date:  2007-06       Impact factor: 4.799

6.  Infectious keratitis progressing to endophthalmitis: a 15-year study of microbiology, associated factors, and clinical outcomes.

Authors:  Christopher R Henry; Harry W Flynn; Darlene Miller; Richard K Forster; Eduardo C Alfonso
Journal:  Ophthalmology       Date:  2012-08-01       Impact factor: 12.079

7.  Disinfection of ocular cells and tissues by atmospheric-pressure cold plasma.

Authors:  Paola Brun; Paola Brun; Maria Vono; Paola Venier; Elena Tarricone; Velika Deligianni; Emilio Martines; Matteo Zuin; Silvia Spagnolo; Roberto Cavazzana; Romilda Cardin; Ignazio Castagliuolo; Alvise La Gloria Valerio; Andrea Leonardi
Journal:  PLoS One       Date:  2012-03-14       Impact factor: 3.240

8.  Infectious keratitis: secreted bacterial proteins that mediate corneal damage.

Authors:  Mary E Marquart; Richard J O'Callaghan
Journal:  J Ophthalmol       Date:  2013-01-08       Impact factor: 1.909

9.  Pseudomonas keratitis. The role of an uncharacterized exoprotein, protease IV, in corneal virulence.

Authors:  R J O'Callaghan; L S Engel; J A Hobden; M C Callegan; L C Green; J M Hill
Journal:  Invest Ophthalmol Vis Sci       Date:  1996-03       Impact factor: 4.925

10.  Repeated applications of cold atmospheric pressure plasma does not induce resistance in Staphylococcus aureus embedded in biofilms.

Authors:  Rutger Matthes; Ojan Assadian; Axel Kramer
Journal:  GMS Hyg Infect Control       Date:  2014-09-30
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