Title : Personalized and Precision Medicine (PPM) through the View of Biodesign-Inspired Translational & Data-Driven applications: An option for clinical dermatologists, skin care experts and consumers to realize the unique potential of getting Personal about skin and skin conditions to secure the human biosafety?
Abstract:
A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, personalized and precision medicine (PPM). Since traditional approaches based on clinical (including dermatological) symptoms and a few classic (canonical) indicators can only provide incomplete information on disease manifestations. So to achieve the implementation of PPM concept in clinical practice, it is necessary to create a fundamentally new strategy based upon the recognition of biomarkers, which are, in turn, an integral part of PPM and defined as indicators of normal or pathological biological processes. DermTech, a leader in PPM-driven dermatology, enabled by a non-invasive skin genomics platform, focused on non-invasive precision dermatology approaches. The DermTech Smart Sticker™ is used today for biomarker analysis of RNA, DNA, protein, and microbiome, and predict and track responses to therapeutic intervention.
PPM-driven dermatology uses individualized dermatologic disease-directed targeted therapy for the management of dermatoses, as well as for the assessment and therapy of cutaneous malignancies.
A well-known inflammatory condition is psoriasis with a background of polygenic inheritance. Some genetic markers have been applied in the disease prediction, clinical diagnosis, treatment, and new drug development, which could further explain the pathogenesis of psoriasis and promote the development of PPM-related tools to get the disease treated and cured. Genetic studies have identified >80 susceptibility loci for psoriasis and provided mechanistic insights into its pathogenesis. The American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF) joints official guidelines on the treatment of psoriasis with biologic agents reference the utility of biomarker use in efficient treatment.
In atopic dermatitis (AD), serum thymus and activation regulated chemokine (TARC) is considered to be the superior biomarker for assessing disease severity. Identifying patients by specific endophenotype of AD, along with their individual biomarkers, and using this information to treat them in a targeted fashion, may not only help more effectively treat patients with AD, but it may potentially help identify risk for this inflammatory disease in susceptible individuals (persons-at-risk) and help avoid the development of AD in the first place. The two most promising substance groups for preventive, prophylactic and therapeutic treaments are biodrugs and Janus kinase inhibitors. The latter including biologics and small molecules have created an unprecedented potential for PPM-driven dermatology and opened up the constructive discussion referring to the complex nature of AD.
Eczema poses a significant burden on both healthcare resources and patients’ quality of life. Modifying environmental risk factors or exposure plays a substantial role in managing the disease.
With the advances in hair research, the powerful tools of PPM-driven innovative technologies, we have the robust scientific data and tools to adapt the concept of PPM to the practice of trichiatry. And the trichiatrist must participate with the other medical disciplines in the diagnosis and treatment of all types of hair problems as they may relate to systemic disease. And thus the databases pertaining to the development and efficacy of PPM must be analyzed and be used to form the basis of PPM-based trichiatry.
PPM can be used in the treatment of skin cancer as current cutaneous melanoma therapy utilizes biomarkers for more effective diagnosis and treatment. With credible and systemic biomarker models, reliable and precise PPM-based diagnosis and assessment will be achieved! And patients would be more likely to be cured and have a higher quality of life. Multi-molecular biomarker panels integrating the information (predictor) into one predictive model significantly improve diagnostic accuracy and enhance the predictive power in skin carcinomas. In this context, there is a need to focus on tumor heterogeneity and homogeneity, whilst providing an understanding of biomarker discovery and application for PPM of oral squamous cell carcinoma.
Advances in computational and analytical approaches combined with the increasing amounts of healthcare data offer enormous potential for PPM-driven dermatology. The collection and integration of the diverse data sources can be facilitated through the use of digital health technology, whilst constructing the datasets and databanks. Overall, PPM- driven dermatology has the potential to provide a more comprehensive understanding of skin conditions at the individual level and improve patient outcomes.
