Reactive Nitrogen-Dominant Plasma Accelerates Diabetic Wound Healing Through Regulated Angiogenesis and TGF-β...

Area of Science:

• Biomedical Engineering
• Wound Healing Research
• Plasma Medicine

Background:

• Chronic diabetic wounds exhibit impaired angiogenesis, dysregulated transforming growth factor beta (TGF-β) activity, and delayed matrix remodeling.
• Non-thermal atmospheric pressure plasma (NTAPP) therapy is a potential non-pharmacologic treatment for these complex wounds.

Purpose of the Study:

• To compare the efficacy of reactive nitrogen-dominant (nitrogen plasma) and reactive oxygen-dominant (argon plasma) exposures in a diabetic wound model.
• To investigate the impact of plasma gas chemistry on angiogenesis and matrix remodeling in diabetic wound repair.

Main Methods:

• Streptozotocin-induced diabetic rats were treated with nitrogen or argon gas using a universal plasma jet.
• Wound closure rates, re-epithelialization, collagen deposition, angiogenesis (cluster of differentiation 31 staining), and TGF-β expression were evaluated.

Main Results:

• Nitrogen plasma treatment accelerated wound area reduction and achieved 90% closure by day 19, compared to day 24 for argon plasma and over 30 days for controls.
• Nitrogen plasma induced an early angiogenic response (CD31 peak on day 6) and promoted collagen maturation and normalized TGF-β expression.
• Argon plasma, while beneficial, showed a less pronounced effect on these healing parameters.

Conclusions:

• Plasma gas chemistry influences diabetic wound healing trajectories, with nitrogen plasma demonstrating superior outcomes.
• Mechanistic differences in regulating angiogenesis and matrix remodeling exist between nitrogen and argon plasma treatments.
• Plasma therapy holds potential as an adjunct treatment for difficult-to-heal diabetic wounds.