Superficial treatment of mammalian cells using plasma needle E.Stoffels, I.E. Kieft, R.E.J. Sladek Department of Biomedical Engineering Eindhoven University of Technology PO Box 513, 5600 MB Eindhoven, The Netherlands e-mail: e.stoffels.adamowicz@tue.nl Abstract Interactions of a small-size, non-thermal helium plasma (plasma needle) with living cells in culture are studied. We have demonstrated the non-destructive character of our the plasma needle: under moderate conditions (low-power and low concentration of molecular species) plasma needle does not heat biological samples and does not induce cell death. Treatment of living cells is restricted to the cell exterior (membrane). As a result of Due to interactions of plasma radicals with cell adhesion molecules, cell attachment is temporarily interrupted; the loose cells can be removed, reattached or transferred. This effect may prove very useful in fine surgery, where a part of the tissue must be removed with high precision, without damage to the adjacent cells and without inflammatory reaction. Introduction Plasma processing of solid-state materials has more than twenty year long history. Numerous techniques of surface modification have been investigated and successfully implemented on the industrial scale: reactive ion etching of semiconductor/photoresist, deposition of amorphous silicon for solar cells, production of hard/protective/hydrophobic/decorative layers, etc. In all these applications, refined treatment is obtained performed using non-thermal gas discharge plasmas. A nonthermal plasma is the only medium which combines These media combine exceptional chemical activity with relatively mild, non-destructive character. All processes occur at room or slightly elevated temperature, so that treated surfaces do not undergo suffer any thermal damage. Thanks to the latter feature, plasma is suitable for treatment of heat-sensitive organic materials, like plastics and fabrics (wool [1]). Plasma application in life sciences is a recent trend, naturally born from the well-established and thriving solid-state processing technology. As expected in such a new development, many obstructions have been encountered. For example, most nonthermal discharges are generated under reduced pressures (< 1 mbar), which limits the choice of materials suitable for plasma processing, but not all organic materials can withstand such conditions. Nevertheless, low-pressure plasmas are being successfully used in biomedical engineering, e.g. for surface patterning to control cell adhesion [2] or spraying of bio-compatible materials to improve the performance of artificial implants [3]. Intermediate pressure (1- 10 mbar) and sub-atmospheric discharges have proven to be efficient in bacterial decontamination [4]. Many plasma-based devices have been constructed to sterilise (plastic) medical equipment; air filters have been equipped with corona-like discharges to destroy bacteria and spores in public areas [5]. Non-thermal plasmas at low pressures are undeniably of high value in surface biomedical technology. However, it is much more convenient to operate plasma devices at ambient pressure. Atmospheric plasmas are more flexible and less expensive in operation, because they do not require costly vacuum systems. Although obtaining non-thermal plasmas under atmospheric pressure is not an easy task, there are already several sources available [6-8]. Not all of them are directly applicable for treatment of vulnerable organic materials, but they can be used as light sources or sterilising, cleaning and etching media. We have developed an atmospheric plasma (the plasma needle), which operates at room temperature [9]. The physical principle of obtaining such a nonthermal source is maximisation of its surface to volume ratio: electron-induced heating in the volume becomes negligible, while energy losses through the plasma surface are relatively high. This situation is common in micro-plasmas, where the size of the glow is below 1 mm. Plasma needle is an example of such a small atmospheric glow. Its small size guarantees a low gas temperature, and in addition it allows for a high-precision local surface treatment. Measurements of temperature at the processed surface will be presented further in this paper. Thermal effects during treatment with the plasma needle will be discussed further in this paper. Plasma needle will in future be used as may become a refined surgical tool to dispose of pathological cells (cancer) and unwanted tissues (peeling, removal of scars), to fight bacterial infections (in vivo sterilisation of skin and dental cavities) and to improve wound healing by controlling cell adhesion. In contrast to mechanical, thermal or laser methods, plasma treatment will not cause severe injury and cell death (necrosis). Mechanical, thermal or laser methods, often used in surgery, always cause severe cell injury and death (necrosis). In the latter process cell membrane is damaged and the released cytoplasm induces an inflammatory reaction in the tissue. In contrast, necrosis can be avoided in plasma treatment, and cell removal without inflammation can be performed. In this study we investigate and classify the possible ways in which the plasma can affect mammalian cells. We use two model systems: the Chinese hamster ovarian cells (CHO-K1) and the human cells of lung carcinoma MR65. The CHO-K1 cells are basal type (fibroblasts), used as a first model to identify general cell responses, while MR65, being human epithelial cells, bring us closer to the intended medical application (skin treatment). We have established that plasma treatment causes no necrosis, but a sophisticated cell response: temporary interruption of cell adhesion. Experiment The plasma needle Plasma needle is a radio-frequency (rf) glow generated at the tip of a sharp tungsten needle (length 5 cm, thickness 0.3 mm) contained in a metal/plastic plasma box. The discharge is generated using a Hewlett Packard 33120A waveform generator in combination with an Amplifier Research 75AP250RF amplifier and a home-built -type matching network. The excitation frequency is about 13 MHz and peak-topeak RF voltage is from 200 to 400 V. Plasma power is determined using Amplifier Research PM 2002 power meter connected to an Amplifier Research dual directional coupler. A schematic view of the setup is shown in Figure 1. Basically, this is a unipolar configuration, where (remote) chamber walls serve as a grounded electrode. Similar to other atmospheric glows, the plasma operates most readily in helium. However, this is not a hindrance: for the safety of treated tissues it is favourable to use an inert gas as an ambient atmosphere and allow only small amounts of active species (e.g. air). Helium supply into the plasma box is controlled by a Brooks series 5850E mass flow controller. The box is not vacuum tight; under typical operating conditions (He flow of 2 slm) the air content in the plasma due to leakage from outside atmosphere is 0.5 to 1%. The plasma box is supplied with two external manipulators: one to move the stage on which treated samples are placed, and another one to adjust the distance between the needle and the sample surface. Diagnostics In this multi-disciplinary research we combine physical methods to characterise the plasma with standard assays from cell biology to recognise the condition of the treated cells. In the past we performed optical emission spectroscopy to determine various temperatures in the plasma (vibrational, rotational and electronexcitation [9]). Here we present temperature measurements using a common NiCr-Ni thermocouple, fixed to the moving stage. No influence of the rf noise on the thermocouple read-out has been observed. Chinese Hamster Ovarian (CHO-K1) and MR65 cells are cultured in flasks containing appropriate cell culture medium, and incubated at 37 oC. The exact protocol is given elsewhere [10]. To prepare samples for plasma treatment, the cells are transferred onto sterilized object glasses (26 x 10 x 1 mm) and placed in multiwell dishes. Healthy cells proliferate once every 24 hours and form a twodimensional layer on the glass sample (see Figure 2). We typically wait for two or three days before exposing them to the plasma. This is in order to obtain an optimum confluence (the percentage of the cell-covered area on the glass sample), which is about 80%. Just before treatment, samples are washed with Phosphate Buffered Saline (PBS) and placed on the moving stage. To prevent drying out of the cells, samples are covered with a film of PBS (2 droplets or 0.08 ml; the resulting thickness of the PBS layer is about 0.3 mm). Plasma needle is brought at a distance of 2 mm to the sample. Typical treatment time is 30 seconds, during which the sample is moved by the manipulated stage over a typical distance of 1 cm. This produces a typical "track" of plasma-treated cells, which can be easily recognised under the microscope. The track is typically 0.5 mm wide. Individual cells on this track are irradiated for about 1-2 seconds. In order to establish the condition of cells after treatment, appropriate fluorescent staining is applied. For observation, a confocal laser scanning microscope (CLSM) is used. The CLSM is equipped with an argon ion laser (488 nm), which excites the fluorescent probes applied to the cells. The resulting fluorescent radiation is focused on the pinhole (see Figure 3) in front of the detector supplied with an appropriate colour filter. Note that in this configuration the fluorescent light collected by the detector originates mainly from the focal spot of the laser; light emitted from other areas is greatly suppressed. In biophysics confocal microscopy is a standard technique, allowing for three-dimensional imaging with a spatial resolution of 0.2 m. Typically we use two fluorescent probes: Cell Tracker Green (CTG) and Propidium Iodide (PI). CTG is absorbed by all cells, but only living cells transform it into fluorescent species. This probe is used to verify cell viability: in living cells the whole cytoplasm displays green fluorescence. PI penetrates only necrotic cells (with damaged membranes) and binds to the DNA and RNA. So-called dual staining (CTG+PI) is applied about 1 hour after plasma treatment, in order to distinguish between dead and living cells. Results and discussion Plasma appearance and interactions with surfaces In the unipolar configuration, when grounded objects are remote, the plasma appears exclusively at the tip of the rf-powered needle. Dependent on the conditions, the glow can assume various shapes; some examples are shown in Figure 4. This is a spatially self-constricted plasma. The size of the glow is determined by the power input and the composition of the ambient gas. The peak-to-peak rf voltage at the breakdown is about 200 V; the plasma appears as a faint point-like glow. At about 350 V it starts to expand in volume, spreading along the exposed part of the powered wire. In presence of electron attaching species (oxygen due to air leakage) the glow shrinks into a narrow flame. The breakdown voltage increases to about 400 V for 10% air contamination; the plasma becomes sensitive for arcing and instabilities. Previous measurements have shown that both high power level and presence of (electronegative) molecular species result in considerable heating of the gas, even up to 600 K [9]. For the treatment of living cells we apply power levels not higher than 0.2 W and we limit air concentration to less than 1% of the ambient atmosphere. When the plasma needle is brought close enough to a (grounded) object, it switches into a bipolar mode, where the glow spreads towards the surface (see Figure 4c). The threshold distance is dependent on the power level; for 0.2 W it is about 2 mm. In this way the plasma is able to interact with the living objects, placed on the grounded sample holder. In order to verify that the objects (cells) do not suffer thermal damage, we have measured the surface temperature by means of a thermocouple attached to the sample holder. Two configurations are tested: a dry thermocouple (metal surface) and a thermocouple immersed in PBS (liquid surface). The PBS film is very thin; the distance between the thermocouple bead and the plasma needle is in both cases the same. Temperature measurements in PBS are relevant for cell treatment and also for in vivo plasma operation. This is because living cells and tissues are vulnerable to desiccation, so they must be covered by a film of ionic solution. The steady-state temperature as a function of the distance between the surface and the needle is shown in Figure 5. It is evident that the thermal effect is directly related to the plasma power. At low power levels the temperature increase is minor and thus tolerable for in vivo treatment. Cell treatment Normally, cultured cells form a single layer on the substrate. This kind of twodimensional tissue tends to fill the whole available surface. When the substrate is fully occupied (100% confluence), cell proliferation is reduced and eventually the cells die. Therefore the unfixed (living) samples cannot be cultured longer than about 4 days. Formation of a sheet consisting of elongated cells results from cell-cell and cellbottom interactions by means of trans-membrane proteins, called cell adhesion molecules (CAM). Here, two kinds CAMs are active: cadherins, which bind neighbouring cells to each other, and integrins, which attach the cells to the substrate surface. Treatment of CHO-K1 and MR65 cells is performed under mild conditions: plasma power not exceeding 0.1 W and exposure time of about 1 second. Applying higher power levels results in necrosis of the cells, which are at the nearest distance to the plasma source. Typical necrotic cells stained with PI are shown in Figure 6. The cells seem to retain their internal structure (nuclei, etc.) but their membranes are leaking. We suppose that the membranes are etched by active radical species from the plasma. In pursuit of fine, non-destructive plasma treatment, inducing cell necrosis should be avoided. The most striking effect of plasma treatment is the interruption of cell interactions. Typical treated areas in CHO-K1 and in MR65 cell samples are shown in Figure 7. When the cells are detached from each other, they assume a round shape (optimal surface to volume ratio). Cell detachment after exposure to plasma seems to be a general feature, which takes place for various cell types. The viability of the detached cells has been confirmed using CTG+PI. Rounded cells display intense green fluorescence; on the same sample no necrotic cells can be found. Later on, the rounded cells have been fixed (devitalised) using buffered 4% formaldehyde, and stained with PI in order to visualise possible modifications to the cell interior (e.g. to the DNA in the nuclei). However, no remarkable changes have been observed. This shows that plasma action is restricted to the cell exterior. The unfixed rounded cells restore cell contact within 4 hours; after 24 hours the sample is confluent, just like any non-treated sample. At somewhat longer plasma exposure, the cells not only detach from each other, but also lose contact with the substrate and float in the PBS. This results in the formation of typical “voids” on the sample surface (Figure 8). The fully detached cells can be taken up in the medium and transferred onto another substrate. Also in this case, CHO-K1 as well as MR65 cells are viable and tend to reconstruct a layer within a few hours. We expect that this kind of cell behaviour is induced by plasma particles, which can penetrate under water. A “suspected” class of species are the reactive nitrogen and reactive oxygen species (RNS/ROS). These reactive species include oxygen atoms (O), oxygen negative ions (O2-), ozone (O3), hydroxyl radicals (OH), nitric oxide radicals (NO) and hydrogen peroxide (H2O2). The observation that the effect of detachment becomes more pronounced with increasing air contamination, but is fully eliminated when the plasma is applied through a layer of glass (e.g. when the samples are put upside down on the stage), indicates that ROS/RNS play a role in cell detachment. Since the radicals can propagate under liquid only to a limited extent, their densities will rapidly decrease with increasing penetration depth. This situation is schematically depicted in Figure 9. Based on strong density gradients, it can be explained that loss of cell-cell intraction is easier to attain than the total detachment from the substrate. Since the cells are viable, the damaged CAMs are reconstructed within a few hours, which is a typical time scale for protein synthesis in healthy cells. In the near future we will apply a fluorescent probe to detect ROS in (biological) liquids. This will allow to determine the concentration gradients and also penetration of active oxygen species into the cell interior. Conclusions Plasma interactions with living cells do not necessarily cause cell death. In fact, we have found a non-destructive plasma treatment which can be considered as “surface processing” of cells. We observe loss of cell contact, and cell detachment from the substrate, possibly due to plasma-induced damage of cell adhesion molecules: cadherins and integrins. Such a situation is temporary; a full restoration of cell interactions is completed within a few hours. This remarkable plasma-cell interaction allows ample time to manipulate the detached cells: they can be removed, rearranged or transferred onto other samples. Since the treated cells do not seem to be harmed, we suppose that cell detachment is the finest and least destructive action of the plasma. The final aim of this research is achieving controlled tissue modification with a high precision. The plasma effect on cell adhesion is potentially applicable in refined cell removal. Since the cells that detach during interaction with the plasma are alive (not necrotic), no inflammatory reaction in the tissue is expected. Besides simple cell removal (e.g. disposing of pathological cells), plasma treatment offers a possibility to aid wound healing, by making cells move into the injured area. Due to its mild and refined action, plasma may prove advantageous in various therapies, where minimum damage is of high importance. References [1] Radetić M, Jocić D, Jovančić P, Trajković R, Petrović Z Lj 2000 Textile Chemist and Colorist & American Dyestuff Reporter 32 55 [2] Ohl A, Schröder K, Keller D, Meyer-Plath A, Bienert H, Husen B, Rune G M 1999 J. Mater. Sci. Mater. Med. 10 747 [3] Heimann R B, Vu T A 1997 J. Thermal Spray Technol. 6 145 [4] Moisan M, Barbeau J, Moreau S, Pelletier J, Tabrizian M, Yahia L’H 2001 Int. J. Pharm. 226 1 [5] Birmingham J G, Hammerstrom D J 2000 IEEE Trans. Plasma Sci. 28 51 [6] Park J, Henins I, Herrmann H W, Selwyn G S 2001 J. Appl. Phys. 89 20 [7] Laroussi M 2002 IEEE Trans. Plasma Sci. 30 1409 [8] Moselhy M, Shi W, Stark R H, Schoenbach K H 2001 Appl. Phys. Lett. 79 1240 [9] Stoffels E, Flikweert A J, Stoffels W W, Kroesen G M W 2002 Plasma Sources Sci. Technol. 11 383 [10] Kieft I E, Broers J L V, Caubet-Hillotou V, Ramaekers F C S, Slaaf D W, Stoffels E 2003 Bioelectromagnetics, submitted Figure captions Figure 1: A scheme of the experimental setup. The details of the plasma box: a – stage manipulators, b – the needle (rf electrode), c – the sample, d – the thermocouple head. Figure 2: A culture of healthy CHO-K1 cells. The cells are stained with cell tracker green and visualised by the confocal fluorescence microscope. Average length of a cell is 30 m. Figure 3: A scheme of a confocal microscope. The sample is placed on the stage (bottom of the picture) and irradiated by a laser. The induced fluorescence/scattering is led through a system of two lenses and finally detected by the photomultiplier (for more details see http://www.zeiss.com). Figure 4: Various shapes of the plasma glow: (a) 1 mm monopolar glow in helium at 250 V (about 0.1 W), (b) expanded glow at 400 V (about 1 W), (c) bipolar discharge created between the needle and a moist organic tissue. Figure 5: Surface temperature determined by a thermocouple as a function of distance of the needle to the surface, for various conditions: dry thermocouple: circles - 0.3 W plasma in helium, squares - 0.15 W in helium, triangles - 0.15 W in helium with 3% air; thermocouple immersed in PBS: diamonds - 0.15 W in helium. Figure 6: Necrotic (dead) CHO-K1 cells after treatment at 1 W. The cell membranes are damaged; the nuclei display bright red fluorescence after PI staining. Figure 7: Plasma-treated (0.1 W) samples of CHO-K1 cells (left) and MR65 (right). CHO-K1 are stained with CTG; the green fluorescence confirms their viability. MR65 are observed under a usual phase-contrast microscope (without staining). Figure 8: Overview of the treated area on a CHO-K1 sample: the typical void (0.5 mm in diameter) is formed due to local detachment of the cells from the sample. Partially detached (rounded) cells are visible at the edge of the void. Figure 9: A scheme depicting the possible scenario of plasma-cell interactions leading to cell detachment. Figure 1. Stoffels et al. function generator rf amplifier dual coupler Power meter He bottle a flow controller b c a d matching network Figure 2. Stoffels et al. Figure 3. Stoffels et al. Figure 4. Stoffels et al. a c b Figure 5. Stoffels et al. temperature 30 0.3 W 28 26 24 0.15 W 22 1 3 5 7 distance to needle (mm) 9 Figure 6. Stoffels et al. Figure 7. Stoffels et al. Figure 8. Stoffels et al. Figure 9. Stoffels et al. cadherin integrin plasma helium solution radical density gradient fully detached cell attached cells