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HomeScience Translational MedicineVol. 14, No. 644Enabling precision monitoring
of psoriasis treatment by optoacoustic mesoscopy
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ENABLING PRECISION MONITORING OF PSORIASIS TREATMENT BY OPTOACOUSTIC MESOSCOPY

Benedikt Hindelang https://orcid.org/0000-0003-4350-0518Teresa NauLudwig Englert
https://orcid.org/0000-0002-5937-0853Andrei BerezhnoiFelix Lauffer
https://orcid.org/0000-0002-1992-2836Ulf DarsowTilo Biedermann
https://orcid.org/0000-0002-5352-5105Kilian Eyerich
https://orcid.org/0000-0003-0094-2674Juan Aguirre
https://orcid.org/0000-0002-8636-6278
bioimaging.translatum@tum.deand [...]Vasilis Ntziachristos
https://orcid.org/0000-0002-9988-0233 bioimaging.translatum@tum.de +1 authors
Authors Info & Affiliations
Science Translational Medicine
11 May 2022
Vol 14, Issue 644
DOI: 10.1126/scitranslmed.abm8059

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 * More than skin-deep
 * Abstract
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 * REFERENCES AND NOTES


MORE THAN SKIN-DEEP

Monitoring inflammatory skin diseases such as psoriasis is a subjective process
that relies on clinical scores calculated from skin appearance. Here, Hindelang
et al. developed ultra-broadband raster-scan optoacoustic mesoscopy (UB-RSOM), a
type of noninvasive, label-free imaging that yields three-dimensional images of
the skin including its microvasculature. Using the UB-RSOM system, the authors
longitudinally monitored patients with psoriasis undergoing conventional
treatment or biological treatment. They detected quantifiable changes in
microvascular morphology in response to treatment, which were not detectable
looking at surface skin and which correlated with dermatology life quality
index. UB-RSOM could help monitor and optimize treatments for inflammatory skin
conditions.


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.


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INFORMATION & AUTHORS

InformationAuthors


INFORMATION

PUBLISHED IN

Science Translational Medicine
Volume 14 | Issue 644
May 2022

COPYRIGHT

Copyright © 2022 The Authors, some rights reserved; exclusive licensee American
Association for the Advancement of Science. No claim to original U.S. Government
Works.
https://www.sciencemag.org/about/science-licenses-journal-article-reuse
This is an article distributed under the terms of the Science Journals Default
License.

SUBMISSION HISTORY

Received: 13 October 2021
Accepted: 19 April 2022

PERMISSIONS

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Request Permissions

ACKNOWLEDGMENTS

We would like to thank R. J. Wilson for editing the manuscript.
Funding: This project was funded by the German Society of Dermatology (DDG,
German Psoriasis Price to J.A.), the European Commission (“INNODERM” no. 687866
and “WINTHER” no. 871763 to V.N.), and the German Research Foundation (DFG,
435874434/A2 to T.B.).
Author contributions: Conceptualization: J.A., V.N., and B.H. Methodology: J.A.
and B.H. Data curation: B.H., J.A., T.N., A.B., and L.E. Investigation: J.A. and
B.H. Visualization: J.A. and A.B. Funding acquisition: J.A., V.N., and T.B.
Project administration: J.A., V.N., U.D., and T.B. Supervision: J.A., V.N.,
U.D., T.B., K.E., and F.L. Writing—original draft: J.A., B.H., and V.N.
Competing interests: J.A. is co-inventor of the patent applications EP2946721A1
and EP3654828A1 held by the Helmholtz Zentrum München that covers aspects of
RSOM. V.N. has financial interests in iThera Medical GmbH. All other authors
declare that they have no competing interests.
Data and materials availability: All data associated with this study are present
in the paper or the Supplementary Materials. Reasonable requests will be granted
with permission of the Klinik und Poliklinik für Dermatologie und Allergologie
am Biederstein, Munich, Germany. Figures in blue and green colormaps are
available for the colorblind reader.


AUTHORS

AFFILIATIONSEXPAND ALL

Benedikt Hindelang https://orcid.org/0000-0003-4350-0518
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Roles: Conceptualization, Data curation, Formal analysis, Investigation,
Methodology, Resources, Validation, Visualization, Writing - original draft, and
Writing - review & editing.
View all articles by this author
Teresa Nau
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Roles: Investigation, Resources, Validation, Visualization, and Writing - review
& editing.
View all articles by this author
Ludwig Englert https://orcid.org/0000-0002-5937-0853
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Roles: Formal analysis and Resources.
View all articles by this author
Andrei Berezhnoi
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Roles: Formal analysis, Investigation, Resources, Software, and Writing - review
& editing.
View all articles by this author
Felix Lauffer https://orcid.org/0000-0002-1992-2836
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Roles: Resources, Validation, and Writing - review & editing.
View all articles by this author
Ulf Darsow
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Roles: Conceptualization, Methodology, Project administration, Resources,
Supervision, Validation, and Writing - review & editing.
View all articles by this author
Tilo Biedermann https://orcid.org/0000-0002-5352-5105
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Roles: Conceptualization, Funding acquisition, Project administration,
Resources, and Supervision.
View all articles by this author
Kilian Eyerich https://orcid.org/0000-0003-0094-2674
Department of Dermatology and Allergy, Technical University of Munich, 81675
Munich, Germany.
Roles: Conceptualization, Methodology, and Writing - review & editing.
View all articles by this author
Juan Aguirre* https://orcid.org/0000-0002-8636-6278 bioimaging.translatum@tum.de
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Roles: Conceptualization, Data curation, Formal analysis, Funding acquisition,
Investigation, Methodology, Project administration, Resources, Software,
Supervision, Validation, Visualization, Writing - original draft, and Writing -
review & editing.
View all articles by this author
Vasilis Ntziachristos* https://orcid.org/0000-0002-9988-0233
bioimaging.translatum@tum.de
Chair of Biological Imaging, Technical University of Munich, 81675 Munich,
Germany.
Institute of Biological and Medical Imaging, Helmholtz Zentrum Munich, 85764,
Neuherberg, Germany.
Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical
University of Munich, 81675 Munich, Germany.
Roles: Conceptualization, Funding acquisition, Project administration,
Resources, Supervision, Visualization, Writing - original draft, and Writing -
review & editing.
View all articles by this author

FUNDING INFORMATION

Deutsche Forschungsgemeinschaft: 435874434/A2
Author Please
European Commission INNODERM VN: 687866
European Commission WINTHER VN: 871763
German Society of Dermatology German Psoriasis Price JA: Psoriasis Prize

NOTES

*
Corresponding author. Email: bioimaging.translatum@tum.de (V.N.);
juanaguir@gmail.com (J.A.)


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