The dermatology clinical research market is expanding rapidly on a global scale. Better health care for people is the promise of the expanding national and international research initiatives. More multicenter studies are being conducted worldwide by sponsors because of the need for innovative treatment solutions for conditions such as pigmentary disorders, acne, dermatitis, inflammatory skin diseases, alopecia and hair disorders, melanoma in skin of color.
In this article, we will give an outline of recent advancement including AI and personalised medicine in clinical research in dermatology. We will also discuss how recent trends would shape the future of dermatological care for patients worldwide.
Clinical research is the foundation of treatment innovation.Trials are conducted to evaluate the safety, effectiveness and efficacy of the new drug or treatment, which confirms they meet the highest standard to include in the treatment mainstream.
In recent years, aesthetic dermatology has gained more attention due to people's obsession with and interest in improving their appearance. Mainly, non-invasive procedures to enhance texture, tone and skin appearance. To provide more safer, effective treatment options to patients, dermatologists are using clinical trials to standardise the treatments like Botox, fillers, laser and light therapy in acne, facial enlarged pores, unwanted hair removal, alopecia, etc in skin of colour.
AI technology and machine learning is a game- changer in the healthcare sector. In dermatology, AI is transforming everything from skin condition detection to the treatment planning. Computer identification of skin conditions aids in step wise diagnosis, including image acquisition, image pre-processing, image segmentation, feature extraction, and classification of lesions. Now, automated image-based skin lesion detection is available for melanoma, pigmentary skin lesions, non-melanocytic skin malignancies, psoriasis, skin rashes, onychomycosis, etc.
Imaging technology and software are available to identify acne and rosacea which helps in lesion counting, percentage of papules, nodules, comedones and pustules. In autoimmune disorders like vitiligo, psoriasis, psoriatic arthritis, etc machine learning is helping in patient identification, diagnosis, disease subtype, disease progression, risk prediction, treatment, outcome and management.
In the near future, it is expected that in clinical set-up, AI-assisted treatment will become more common which will work alongside dermatologists to provide best quality of care and patient outcome.
Exosomes are extracellular vesicles created by all cells and carry molecules such as nucleic acid, lipids, proteins and metabolites. Both in vitro and in vivo studies confirm that exosomes have a role in wound healing, scar repair, preventing skin aging, regulation of skin pigmentation, hair growth, chronic inflammatory dermatoses, atopic dermatitis and skin tumors. Although the exosome-based regenerative therapies are still in very early stages of research and development, they show promise as safe and effective treatment alternatives to traditional approaches. In future, exosome-based cell engineering, gene editing and protein encapsulation within the exosomes is the target of research to maximise the exosomes benefits. However, clinical trials are needed for a specific cutaneous condition using exosomes to validate its efficacy in humans.
Nanoparticles are nano sized (10-9) particles. Nanoparticles directly deliver the drug to the affected skin area. It also helps in deep penetration, prolonged stability and regulated release of an active ingredient. Nanoparticles such as silver and gold are incorporated into the skin formulations for their effective antibacterial, antifungal, antiaging and moisturizing properties. The cosmetic industries are using a variety of nanoparticles and nanocarriers to provide innovative solutions for topical skin care, addressing issues like inflammation, aging and hydration. To increase the efficacy and transport of the chemicals in skin care treatments, specialized nanocarriers and hybrid nanoparticles including retinoid, peptide, antioxidant, and hyaluronic acid are being investigated.
Gene therapy is a technique that modifies a person's genes. It is a promising therapy for genetic and inherited skin disease, vaccination, cancer, immunomodulation, as well as healing of some refractory ulcers. The integration of genes of interest into a vector to modify the targeted cell is a complex procedure. Challenges include, vector effectiveness, durability, safety, and avoiding genomic integration and immune reactions. The research is still ongoing and to make gene therapy clinically available, future research work should focus on both vector design and delivery technique.
Dermatology research is directed towards personalized treatment, particularly for autoimmune disorders like hidradenitis suppurativa, psoriasis, atopic dermatitis, alopecia areata, vitiligo and chronic spontaneous urticaria to develop customized immunotherapies by targeting genetic predisposition. Biomarkers are used for diagnosis, prognosis and therapy monitoring.
Future research is focused on integration of nanotechnology for targeted delivery system and AI technology for decoding the biomarker pattern. Including wearable technology with multi-omics data, real-time biomarker monitoring can be made possible, improving patient outcomes and treatment regimens. This could revolutionize holistic care in dermatology
The future of clinical trials in dermatology is brimming with potential. Future skin care would be shaped by the integration of exosomes, nanoparticles, AI, machine learning, and gene therapy for various chronic, persistent, and inherited dermatological problems. The development would enable customized dermatology and address each patient's needs. Human clinical trials are the most crucial part of the research to validate the new medicine. We hope to see more clinical trials in the field of dermatology.