The application of cold atmospheric plasma in medicine: The potential role of nitric oxide in plasma-induced effects

The use of non-thermal atmospheric pressure plasma (CAP) in medicine is promising and presents a new approach in the treatment of chronic wounds and skin infections. Many CAPs contain considerable amounts of nitric oxide (NO) and nitrogen dioxide (NO2), which induce acidification and nitrite/nitrate accumulation in treated tissues/liquids. Since many pathological conditions, such as impaired wound healing and microcirculation, are often related to restricted NO bioavailability, CAP sources may serve as NO delivery systems. Considering the striking similarities between the biological results obtained by CAP and NO treatment, it is quite possible that NO plays a crucial role in CAP-induced effects.In order to clarify possible connections, this paper will give a short introduction to NO physiology, as well as an overview of the literature concerning NO-based treatments and CAP with a focus on decontamination, and skin and wound healing.