Title : Personalized and precision dermatology through the view of biodesign-inspired translational & data-driven applications: Revolutionary skin treatments for every concern in clinical dermatology integrating skin care experts and consumers
Abstract:
A new systems approach to diseased states and wellness result in a new branch in the healthcare, namely, Personalized and Precision Medicine (PPM). In this sense, PPM demonstrates an integration of Fundamental & Clinical Science, Design-driven Bioengineering & Translational ART, & IT-related support, illustrating application of the unique OMICS tools processed, mined and integrated via IT algorithms. The pace of innovation in Personalized & Precision Dermatology is thus becoming fast including:
- Diagnostic Tools and Therapeutic Innovations: progression in creating targeted and smart medicines, treatments like gene therapy, immunotherapy and stem cell applications, developing theranostics and advancements in molecular imaging methods
- Regenerative Medicine and Tissue Engineering: creating bioartificial organs and cutaneous tissues for transplantation, using scaffolds and biocompatible skin materials to support cell growth and tissue development
- Healthcare IT and Systems: development of software and IT network systems for patient management, Electronic Health Records (EHRs), and mobile health applications.
In this context, the innovative design and advanced biointerface-related and biodesign-driven engineering have promoted the development of various smart medicines, unique therapeutic protocols and nanocarriers for optimizing diagnostic procedures and drug delivery to monitor, to treat and to manage cutaneous diseases. The latter dictates that skin tissue engineering is considered as an interdisciplinary field of design-driven biotech that comprises applying principles of life sciences and nanobiomaterials to restore, maintain, and enhance tissue function.
For instance, cellular therapy and targeted immunotherapy are key components of skin tissue and immune cell engineering, leveraging the ability of stem cells to differentiate into targeted skin cell types, on one hand and into immune cells, on the other one, respectively.
Another example is protein engineering through the view of biodesign, offering significant promise for applications in tissue engineering, regenerative dermatology and plastic surgery.
Currently, there are many kinds of precise biomaterials used in clinical dermatology and their applications are diverse. Meanwhile, with the rise of 3D- and 4D-printing technology, the macroscopically more precise and personalized bio-scaffolding materials with microporous structure (synthetic ones) have made good progress, which is thought to bring new development to biomaterials to be used in dermatology- and cosmetology-related practice. The printing products have been applied to the repair of skin, ear and nasal cartilage, maxillofacial bone, i.e., in the field of plastic surgery, and show good therapeutic effect. As a result, nanocosmetics and plastic nanosurgery can be referred now to as a new category of cosmetic products based on nanocarriers made by micro/nanoemulsions or by nanobiopolymers.
In light of the above-mentioned, advanced therapies including: (i) Nucleic acid therapies (ncRNA), (ii) targeted immunotherapies; (iii) suicide gene therapies, and (iv) gene therapy using tumor suppressor genes, have lately gained immense attention in the field of dermatooncology, in particular, in cutaneous melanoma treatment.
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 promote the development of PPM-guided tools to get the disease treated and cured. The American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF) joints official guidelines on the upgraded treatment of psoriasis with bioagents reference the utility of biomarker use in efficient treatment.
In Atopic Dermatitis (AD), chemokines are becoming the superior biomarker for assessing disease severity. Identifying patients by specific endophenotype of AD 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 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, we are gaining tools to adapt the concept of PPM to the practice of trichiatry.
For reference: targeted therapies have revolutionized the treatment of chronic skin diseases, offering new options for patients unresponsive to standard treatments. For instance, therapeutic mAbs and Janus Kinase Inhibitors (JAKis), have emerged as essential tools in the treatment of cutaneous diseases. Those therapies modulate the immune system through specific signaling pathways, providing effective alternatives to traditional systemic immunosuppressive agents. In this context, genetic markers of the principally new generations have been proven to be linked with specific skin conditions like psoriasis, eczema, and certain types of skin cancers, allowing dermatologists to accurately pinpoint underlying causes of skin concerns and create personalized treatment plans that target those specific genetic components.
In this context, PPM-guided protocols are used in the treatment of skin cancer as current cutaneous melanoma therapy utilizes biomarkers for more effective diagnosis and treatment. Multi-molecular biomarker panels integrating the information into one predictive model significantly improve diagnostic accuracy and enhance the predictive power in skin carcinomas. There is a need to focus on tumor heterogeneity and homogeneity, whilst providing an understanding of biomarker and target discovery and application for PPM of oral squamous cell carcinoma.
At PPM-guided dermatology, exceptional and precision care is offered for common and complex skin problems, and provide a broad range of services for patients and pre-illness persons-at-risk. Following the above-mentioned, the triple play of Biodesign, Customized Medication and Bioinformatics are becoming vital for Precision Aesthetic and Personalized Dermatology. Simultaneously, health care IT and Bioinformatics do offer a set of potential solutions to surmount the potential barriers. Technologies such as Artificial Intelligence (AI), blockchain, machine learning, Augmented Reality (AR), and high-resolution imaging are powerful tools that are pushing the boundaries of what we can offer patients in dermatology. In this context, PPM-guided dermatology can harness full-scale potential of PPM-guided translational genomics and bioinformatics, advancing both the quality and accessibility of patient care. Therefore, cutting-edge technologies, innovative treatment modalities, and a growing emphasis on holistic approaches to skin health are at the forefront of current advancements in integrative dermatology. Staying abreast of these trends and incorporating them into practice will be essential for the profiled experts aiming to provide the highest standard of care.
