Precision dermatology—a vibrant field where diversity, immunotherapy, and precision medicine intersect

Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. Successes in immunotherapy and the translational arena of melanoma extend to other key areas of dermatology, including vitiligo, melasma, albinism, and other pigmentary diseases. New research, published today in the Journal of Translational Medicine identifies challenges and advances in the treatment, diversity, and diagnosis of major skin disease.

Melanocytes protect the skin from genomic damage

Our skin is not only our largest organ and our primary contact interface with the world, it represents our individuality. The pigment in our skin is produced by melanocytes and absorbs dangerous UV radiation.

A life-threatening form of skin cancer, melanoma, arises, when melanocytes undergo cancerous transformation. They accumulate genomic damage at the body sites that were exposed to UV-intensive light, such as that from the sun.

Even though excellent efficacy and some complete remissions have been seen with a limited number of melanoma patients, many patients do not show responses of long duration upon treatment. Predicting tumor responses for each individual patient to targeted treatment and immunotherapy remains a major challenge and active field for research.

The color of our skin represents individuality and diversity

Precision dermatology accounts for differences between individuals for a healthy future of a diverse community.

On a campus like the University of California, Merced, which is dedicated to underserved minorities, one encounters an ethnically diverse young generation. Timely yet provocative questions in precision dermatology aim to account for the differences between individuals and address imminent needs in clinical care and laboratory research to ensure the healthy future of a diverse community.

Traditionally underserved ethnic populations such as Hispanics and African-Americans tend to suffer higher rates of cancer and age-related disease, for reasons that are not always clear. Variations in health, lifestyle, and socioeconomic risk factors across racial groups may account for some differences. Other differences are found in distinct molecular signatures due to pigmentation and metabolism.

Hispanics represent the largest and fastest-growing ethnic group in California. They are also 50% more likely to suffer from late-stage malignancies as white people of similar age. As such Hispanic families in the Central Valley of California are expected to bear a disproportionately large share of the nation’s substantial and ever-mounting burden of suffering due to cancer and environmental exposure to carcinogens.

When genetic mutations affect the production of the melanin pigment, people encounter partial or complete loss of pigmentation of their skin, eyes and hair. Albinism is a rare, genetically inherited condition that has unusually high prevalence in sub-Saharan Africa and some Native American groups. Patients are prone to sunburns and UV-dependent skin cancers, particularly in regions with a high UV index.

The idea of precision medicine has been quickly followed by the goal to improve personalized health and precision prevention of disease.

In less advanced societies, people with albinism may not have access to healthcare specialists, sunscreen, or protective clothes. Sadly, patients with albinism in Africa face a humanitarian crisis stemming from a lack of access to resources and an alarming increase in ritual assassinations of people with albinism. The united pigment cell community stands in solidarity and supports patients suffering from albinism, leaving a unique footprint in the field of pigment cell biology.

A new research perspective, now published in the Journal of Translational Medicine focuses on scientific societies and research progress around pigmented cells. The work identifies challenges and advances in the treatment, diversity, and diagnosis of major skin disease.

High-throughput profiles of individual patients will provide detailed information to improve therapy responses of future cancer patients.

From precision medicine to personalized health

DNA research has provided molecular insights into what carcinogens are connected to the formation of cancer, paving the way for the development of precision medicine. This has been quickly followed by the goal to improve personalized health and precision prevention of disease.

Primary prevention and early detection are powerful but underutilized strategies to reduce cancer incidence and mortality.

We are just starting to discover the wealth and breadth of the field in melanocyte and melanoma research. Lack of pigment production in albinism patients, patched loss of pigmentation called vitiligo, post-inflammatory- hyperpigmentation called melisma are on the frontlines of dermatology research.

Primary prevention and early detection are powerful but underutilized strategies to reduce cancer incidence and mortality. To systematically battle skin cancer mortality, the researchers propose a state-of-the-art pipeline to translate the most promising chemoprevention agents for high-risk patients into the clinic.

The significance of studying pigment cells is defined most dramatically by recent advances in melanoma immunotherapies that can be lifesaving, but also by the many diseases and conditions intersecting with the pigmentary system that remain in need of effective treatments.

Future efforts are focused on utilizing the established preclinical models to overcome drug adaptation as well as precision medicine profiling of cancer patients. Multi-omics data in combination with next generation sequencing will facilitate systems biology analyses that can identify master regulators and new drug targets in therapy-resistant cancers.

An international forum that embraces diversity

By bringing key stakeholders and experts in pigment cell and melanoma research together, the scientists have created an invaluable forum.

The International Federation of Pigment Cell Societies is the primary vehicle to promote worldwide scientific interchange for basic and clinical investigators who study pigment cell function in disease and development. A synergy of complementary approaches will yield the next breakthroughs and include genomics and systems biology, precision bench-to-bedside approaches, immunotherapy, technology-guided surgery, epidemiology, pigment biophysics, medicinal chemistry, and ancestry research.

By bringing key stakeholders and experts in pigment cell and melanoma research together, the scientists have created an invaluable forum to present data, to discuss ideas, to identify key areas of needed research and to set new research directions is essential to ensuring the future of this vibrant, diverse and unique research community.

A key realization is that successes in the translational arena of melanoma need to be duplicated in other key areas of pigment cell research, including vitiligo, melasma, albinism, and other pigmentary diseases.

View the latest posts on the On Medicine homepage

Comments

By commenting, you’re agreeing to follow our community guidelines.

Your email address will not be published. Required fields are marked *