Enabling precision monitoring of psoriasis treatment by optoacoustic mesoscopy

Author:

Hindelang Benedikt123ORCID,Nau Teresa123,Englert Ludwig23ORCID,Berezhnoi Andrei23,Lauffer Felix1ORCID,Darsow Ulf1,Biedermann Tilo1ORCID,Eyerich Kilian1ORCID,Aguirre Juan23ORCID,Ntziachristos Vasilis234ORCID

Affiliation:

1. Department of Dermatology and Allergy, Technical University of Munich, 81675 Munich, Germany.

2. Chair of Biological Imaging, Technical University of Munich, 81675 Munich, Germany.

3. Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764, Neuherberg, Germany.

4. Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich, 81675 Munich, Germany.

Abstract

Psoriasis is a widespread inflammatory skin disease affecting about 2% of the general population. Recently, treatments that specifically target key proinflammatory cytokines driving the disease have been developed to complement conventional therapies with unspecific antiproliferative or anti-inflammatory effects. Efficient monitoring of treatment efficacy in the context of precision medicine and the assessment of new therapeutics require accurate noninvasive readouts of disease progression. However, characterization of psoriasis treatment remains subjective based on visual and palpatory clinical assessment of features observed on the skin surface. We hypothesized that optoacoustic (photoacoustic) mesoscopy could offer label-free assessment of inflammation biomarkers, extracted from three-dimensional (3D) high-resolution images of the human skin, not attainable by other noninvasive methods. We developed a second-generation ultra-broadband optoacoustic mesoscopy system, featuring sub–10-μm resolution and advanced motion correction technology, and performed 80 longitudinal measurements of 20 psoriatic skin plaques in humans under conventional inpatient treatment or receiving biologics with concomitant topical corticosteroid treatment. Optoacoustic image analysis revealed inflammatory and morphological skin features that indicated treatment efficacy with sensitivity, accuracy, and precision that was not possible using clinical metrics. We identify 3D imaging biomarkers that reveal responses to treatment and offer the potential to facilitate disease and treatment characterization. Our findings suggest that optoacoustic mesoscopy may offer a method of choice for yielding both qualitative and quantitative evaluations of skin treatments that are inaccessible by other methods, potentially enabling optimized therapies and precision medicine in dermatology.

Publisher

American Association for the Advancement of Science (AAAS)

Subject

General Medicine

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