Cold atmospheric plasma (CAP), a type of non-thermal plasma (NTP), is considered the fourth state of matter, an ionized gas that stores most of its energy in highly energetic electrons while maintaining an overall ambient temperature. CAP has proven to be a powerful tool with remarkable antibacterial, antifungal, antiviral, antiparasitic and immunomodulatory effects, whose popularity and wide range of applications have expanded rapidly across multiple disciplines in recent years.

The antibacterial effects of CAP have been demonstrated against clinically important bacteria, including those identified by the WHO as critical in the development of antibiotic resistance (the ESKAPE group and others), and their more resistant biofilm forms. CAP antiviral properties, research of which has greatly enhanced during the COVID-19 pandemic, include virus inactivation of SARS-CoV-2, influenza A, and even a highly resistant adenovirus. Moreover, recent studies highlighted the antiparasitic potential of CAP, demonstrating its efficacy against protozoan parasites such as Leishmania major and Acanthamoeba castellanii, as well as helminths, including Schistosoma mansoni, underscoring its broad-spectrum biocidal capabilities. In addition to these antimicrobials and antiparasitic effects, CAP can also modulate inflammation by enhancing the recruitment and activation of innate immune cells at infection sites. This immunomodulatory property contributes to tissue regeneration, angiogenesis or anti-tumor immune responses, and is an important factor in understanding the therapeutic effects of CAP, not only in overcoming antibiotic resistance.

The effectiveness of CAP is strongly influenced by the settings of the generating devices. Key factors include the type of discharge, applied voltage and current, frequency, gas composition and flow rate, exposure duration, and the distance between the plasma source and target surface. These parameters determine the amounts and ratios of generated reactive oxygen and nitrogen species (RONS), ultraviolet radiation, and charged particles, which collectively drive pathogen inactivation through mechanisms such as membrane disruption, oxidative damage to proteins and DNA, and induction of programmed cell death. Understanding the interplay between device settings and biological effects is essential for optimizing CAP applications.

Beyond pathogen inactivation, CAP has demonstrated compatibility with sensitive materials and surfaces, with their minimal mechanical or chemical alterations, enabling safe use of CAP in diverse settings, including medicine, food safety, agriculture, and material science. These properties highlight that full CAP exploitation needs a multidisciplinary approach that integrates physics, chemistry, biology, engineering, and clinical sciences.

In this Research Topic, we aim to collect precisely multidisciplinary articles that bridge these disciplines and focus on the following sub-themes:

• CAP–microbiome interaction mechanisms
• CAP activity against multidrug-resistant bacteria, clinically relevant fungi, viruses, helminths and protozoa
• CAP device optimization for enhanced antimicrobial activity
• CAP reactive species interaction with microbiological environments
• CAP-driven modulation of inflammation, tissue repair, innate and adaptive defense mechanisms
• CAP in oncology and immunotherapy¨
• CAP regulation of gene expression and cell signalling
• Interactions between CAP-derived species and biomolecules (lipids, proteins, nucleic acids)
• CAP-assisted drug delivery and combination with chemotherapeutic agents
• CAP-assisted seed sterilization and plant growth promotion
• CAP food decontamination and shelf-life extension
• CAP surface modification and sterilization of sensitive materials
• CAP safety, biocompatibility, and regulatory aspects
• CAP devices scale-up for industrial application
• Plasma activated water and saline inhibitory activity
• CAP application for wound healing
• CAP device miniaturisation for application in subcutaneous and internal structures.

For this Research Topic, we welcome the following article types: Methods, Mini Review, Original Research, Perspective, Review, Systematic Review.
By leveraging knowledge from across fields, we seek to bring CAP to the forefront of interest of the global scientific community and the wider professional public, fostering further innovation and implementation to various areas of application.

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Expanding Multidisciplinary Potential of Cold Atmospheric Plasma Beyond Antimicrobial Resistance