Handheld confocal Raman spectroscopy (CRS) for objective assessment of skin barrier function and stratification of severity in atopic dermatitis (AD) patients

Ho, Chris Jun Hui; Yew, Yik Weng; Dinish, U. S.; Kuan, Amanda Hui Yu; Wong, Melvin Kai Weng; Bi, Renzhe; Dev, Kapil; Li, Xiuting; Singh, Gurdial; Moothanchery, Mohesh; Perumal, Jayakumar; Thng, Steven Tien Guan; Olivo, Malini

doi:10.1016/j.jdermsci.2020.02.001

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…It may be difficult to express all skin barrier functions using TEWL and SCH measured with these devices, and a more precise instrument such as Raman spectroscopy may improve the accuracy of skin barrier function measurement. 4 In this study, the SCH of patients was significantly lower but not increased by dupilumab. Clinically, we also experience patients treated with dupilumab who have recovered from their dry skin condition.…”

Section: Dupilumab Probably Reduces Transepidermal Water Loss But Doementioning

confidence: 44%

Dupilumab probably reduces transepidermal water loss but does not increase stratum corneum hydration in atopic dermatitis

Furuhashi

Oda

Torii

et al. 2020

The Journal of Dermatology

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Dear Editor, Atopic dermatitis (AD) is a common and pruritic inflammatory skin disease, which has been widely treated by dupilumab. 1 It contributes to the treatment of adolescent AD patients with unmet high medical needs 2 and studies on the efficacy and safety in children as young as 6 years of age are in progress. 3 However, it is not yet known whether dupilumab restores skin barrier function in AD patients. Therefore, we investigated the extent to which skin barrier function was restored following treatment with dupilumab, using transepidermal water loss (TEWL) and stratum corneum hydration (SCH). A total of seven patients (aged 40.4 AE 15.8 years) and seven age-matched healthy volunteers (aged 35.4 AE 11.7 years) were enrolled in this study. Patients continued to use the same moisturizers

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Section: Dupilumab Probably Reduces Transepidermal Water Loss But Doementioning

confidence: 44%

Dupilumab probably reduces transepidermal water loss but does not increase stratum corneum hydration in atopic dermatitis

Furuhashi

Oda

Torii

et al. 2020

The Journal of Dermatology

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“…[141][142][143] A recent study used confocal Raman spectroscopy to quantify the amount of water, ceramide, and urocanic acid in the skin, and found reduced levels of these components in atopic skin and a decreased lipid-to-protein ratio, suggesting the potential use of this technique for the stratification of AD patients. 144 A promising non-invasive tool for detecting skin barrier function in vivo is represented by electrical impedance spectroscopy (EIS).…”

Section: Detection Of Skin Barrier Dysfunctionmentioning

confidence: 99%

“…Several studies have suggested that the confocal Raman spectroscopy is useful for the detection of FLG‐related AD skin barrier by assessing the reduction of natural moisturizing factors, which are driven from the breakdown of FLGs 141‐143 . A recent study used confocal Raman spectroscopy to quantify the amount of water, ceramide, and urocanic acid in the skin, and found reduced levels of these components in atopic skin and a decreased lipid‐to‐protein ratio, suggesting the potential use of this technique for the stratification of AD patients 144 …”

Section: Genetics and Epigenetics Of Epithelial Barrier Leakinessmentioning

confidence: 99%

Dysregulation of the epithelial barrier by environmental and other exogenous factors

et al. 2021

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The "epithelial barrier hypothesis" proposes that the exposure to various epithelial barrier-damaging agents linked to industrialization and urbanization underlies the increase in allergic diseases. The epithelial barrier constitutes the first line of physical, chemical, and immunological defense against environmental factors. Recent reports have shown that industrial products disrupt the epithelial barriers. Innate and adaptive immune responses play an important role in epithelial barrier damage. In addition, recent studies suggest that epithelial barrier dysfunction plays an essential role in the pathogenesis of the atopic march by allergen sensitization through the transcutaneous route. It is evident that external factors interact with the immune system, triggering a cascade of complex reactions that damage the epithelial barrier. Epigenetic and microbiome changes modulate the integrity of the epithelial barrier. Robust and simple measurements of the skin barrier dysfunction at the point-of-care are of significant value as a biomarker, as recently reported using electrical impedance spectroscopy to directly measure barrier defects. Understanding epithelial barrier dysfunction and its mechanism is key to developing novel strategies for the

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“…Verzeaux et al identified a modification of lipid organization and conformation in addition to the decrease in the lipid-to-protein ratio using ordinary partial least square (OPLS) regression in atopic skin [10]. Recently, Ho et al used a support vector machine (SVM) model to derive an Eczema Biochemical Index (EBI) to further stratify the severity of AD patients based on the skin constituents' content measured using a handheld CRM system [14].…”

Section: Introductionmentioning

confidence: 99%

Machine Learning Assisted Handheld Confocal Raman Micro-Spectroscopy for Identification of Clinically Relevant Atopic Eczema Biomarkers

Dev

et al. 2022

Sensors

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Atopic dermatitis (AD) is a common chronic inflammatory skin dermatosis condition due to skin barrier dysfunction that causes itchy, red, swollen, and cracked skin. Currently, AD severity clinical scores are subjected to intra- and inter-observer differences. There is a need for an objective scoring method that is sensitive to skin barrier differences. The aim of this study was to evaluate the relevant skin chemical biomarkers in AD patients. We used confocal Raman micro-spectroscopy and advanced machine learning methods as means to classify eczema patients and healthy controls with sufficient sensitivity and specificity. Raman spectra at different skin depths were acquired from subjects’ lower volar forearm location using an in-house developed handheld confocal Raman micro-spectroscopy system. The Raman spectra corresponding to the skin surface from all the subjects were further analyzed through partial least squares discriminant analysis, a binary classification model allowing the classification between eczema and healthy subjects with a sensitivity and specificity of 0.94 and 0.85, respectively, using stratified K-fold (K = 10) cross-validation. The variable importance in the projection score from the partial least squares discriminant analysis classification model further elucidated the role of important stratum corneum proteins and lipids in distinguishing two subject groups.

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Handheld confocal Raman spectroscopy (CRS) for objective assessment of skin barrier function and stratification of severity in atopic dermatitis (AD) patients

Cited by 11 publications

References 23 publications

Dupilumab probably reduces transepidermal water loss but does not increase stratum corneum hydration in atopic dermatitis

Dupilumab probably reduces transepidermal water loss but does not increase stratum corneum hydration in atopic dermatitis

Dysregulation of the epithelial barrier by environmental and other exogenous factors

Machine Learning Assisted Handheld Confocal Raman Micro-Spectroscopy for Identification of Clinically Relevant Atopic Eczema Biomarkers

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