Simon Francis Thomsen, et al. – Bispebjerg Hospital, Department of Dermato-Venereology: Current and Future Research Activities
Our laboratory studies focus on defining new treatment targets and understanding the mechanisms of action of known therapies, such as psoralen plus ultraviolet A( PUVA), interferons and proteasome inhibitors. We have discovered that receptor NOTCH1 is aberrantly expressed in cutaneous lymphoma and that this molecule provides a promising treatment target( 6). Our current interests focus on genetic heterogeneity and clonal evolution of cutaneous lymphomas and employ techniques of next-generation sequencing and bioinformatics pipelines developed in house specifically for this purpose.
Laser dermatology
Lasers and light-based therapies are gaining increasing impact in dermatology with new, effective and selective treatments to large groups of patients. Experimental use of lasers in dermatology is a cornerstone of the department’ s research and is consolidated in an international, multidisciplinary research setting, pursuing to develop new treatments for patients with dermatological diseases, such as non-melanoma skin cancer, inflammatory acne, scars, and vascular lesions.
Laser-assisted drug delivery is a dedicated research area that was developed in collaboration with Harvard Medical
School. The concept takes advantage of fractional laser channels to deliver topically applied drugs and provides the unique opportunity to directly target diseased tissue( 7). By combining pharmacolo gical and energy-based research, intensified topical treatments have been developed and translated into clinical benefit for high-risk patients, including organ transplant patients, with severe field cancerization and premalignant lesions. Further research initiatives aim at delivering anti-cancerous agents directly into tumour tissue, while monitoring tumour response with imaging techniques; thus having the perspective to develop a new, non-surgical treatment concept to patients with non-melanoma skin cancer.
Our research activities cover a wide field from experimental laboratory experiments, in vivo murine and pig trials, early phase, proof of concept clinical trials, to larger, multicentre clinical trials. Scientific collaborators include national and international experts in dermatological laser techniques, skin cancer, pharmacy, non-invasive fluorescence analyses, optical coherence tomography( OCT) and re-scan confocal microscopy( RCM) imaging techniques( Fig. 2), chemical imaging with mass spectroscopy and analytical chemistry.
Skin barrier function, contact dermatitis and atopic dermatitis
Research on skin barrier function has comprised experimental studies with focus on contact dermatitis, including standardized irritation models and assessment with bioengineering methods. Results from these have led to clinical studies, and intervention trials focusing on patients with hand eczema, and results have had direct clinical impact with respect to patient education and prevention of hand eczema. We have proposed a new classification of hand eczema( 8), and a future goal is that all patients with hand eczema should be guided and treated depending on the specific sub-diagnosis of the eczema; a step forward in the direction of personalized medicine.
Fig. 2. Confocal microscope.
Another disease related to skin barrier function is atopic dermatitis, where colonization with Staphylococcus aureus is known as a major factor for severity and initiation of flares. Our studies investigating bacteria at the strain level( primarily S. aureus) in lesional and non-lesional atopic dermatitis skin have indicated a relationship between bacterial clonal lineage, genetic biomarkers and skin barrier function( 9). This association between specific bacteria and skin barrier impairment is new and interesting, and more studies directed at the skin microbiome in atopic dermatitis are ongoing. The antibiotic resistance pattern for S. aureus in patients with atopic dermatitis is being followed, since this is important for the individual patient as well as for society. A new minimal invasive method, using tape-strips for sampling of stratum corneum has proven
10 Dermato-Venereology in the Nordic Countries
Forum for Nord Derm Ven 2018, Vol. 23, No. 1