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How Biomarkers Are Shaping the Future of Skin Disease Treatment

By Ella Cutter, Digital Marketing Manager, REPROCELL Europe
Skin punch biopsy procedure.

The Need for New Therapies to Treat Inflammatory Skin Conditions 

Inflammatory skin conditions are chronic disorders characterized by redness, swelling, irritation, and in some cases, severe discomfort, or pain.1 These conditions, such as atopic dermatitis (AD), psoriasis, and vitiligo, are not only physically burdensome but also significantly impact patients' quality of life. Globally, atopic dermatitis affects up to 2.6% of the general population2, while psoriasis has a prevalence of around 2-3%.3 The social and economic burden of these diseases is substantial, with patients often facing stigma, mental health challenges, and reduced productivity. 

Current treatment options for inflammatory skin conditions include topical therapies, systemic medications, and biologics. While these treatments have advanced significantly, many patients still experience partial or no response, relapses, or adverse effects. This unmet need highlights the urgency for innovative research to improve disease management and outcomes. 

Biomarkers have emerged as a promising approach in this field. These measurable biological indicators are helping researchers and clinicians better understand the underlying mechanisms of inflammatory skin conditions, paving the way for more targeted, effective therapies. They are revolutionizing dermatology by intertwining with precision medicine approaches to deliver highly targeted and individualized treatments. By leveraging insights from genetic, molecular and cellular markers, clinicians can tailor therapies to a patient’s unique disease profile, improving treatment efficacy and reducing the risk of adverse effects. This integration not only enhances our understanding of dermatological conditions but also drives the development of innovative, patient-centered therapeutic strategies.  

Role of Biomarkers in Dermatological Drug Development 

Biomarkers are defined as "a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes or pharmacologic responses to a therapeutic intervention," by Puntmann4. With the help of biomarkers, such as lipids, small molecules, nucleic acids and more5, drug development becomes more efficient. Specifically in the dermatological context, biomarkers contributed to the development of tailored treatments and personalised medicine. 

In atopic dermatitis, numerous biomarkers have been studied, including those from lesional and non-lesional skin, blood, and urine, for both baseline and post-treatment evaluation. Such studies show that levels of urine nitrate and malondialdehyde, for example, correlate with disease severity, whilst serum thymus and activation-regulated chemokine is currently the most reliable serum biomarker of the condition. Additional potential biomarkers include CTACK, sE-selectin, MDC, LDH, and IL-18. Evidence also suggests that using a panel of serum biomarkers is more effective for assessing disease severity than relying on a single marker.6

In psoriasis, several biomarkers have been investigated. Serum 8-hydroxy-2-deoxyguanosine (8-OHdG) shows promise for early disease diagnosis, while serum human beta-defensin (HBD-2), but not TL1A, is linked to disease activity. Plasma levels of TGF-beta1, TIMP-1, MMP-1, and IL-18 are associated with disease severity and treatment response. Studies suggest that combining these biomarkers offers greater value than analyzing them individually, as it determines the highest correlation with the Psoriasis Area and Severity Index (PASI) score. 7,8 

Biomarkers in dermatology provide precise insights into disease progression and treatment efficacy, enabling targeted and effective drug development. Skin biopsies (excision, punch, tape strips, shavings), in addition to blood sampling, can serve as critical tools for accessing these biomarkers, offering a direct, data-rich resource to evaluate drug safety, monitor patient responses, and refine therapeutic strategies in clinical trials.9 

Current Trends and Innovations in Dermatology Biomarker Research 

Localised and systemic skin diseases change the molecular composition of a person’s skin. It is often said that the skin serves as a window to the overall health of the body, as skin chemistry is represented by a breadth of disease biomarkers ranging from lipids and structural proteins to nucleic acids and small molecules. Biomarkers can provide a wealth of information about skin conditions and new technologies are expanding the numbers of biomarkers we can employ in trials and research studies.10“Molecular diagnostics identify gene, RNA, and protein variations that shed light on whether a specific person is predisposed to have a disease, whether they actually have a disease, or whether a treatment option is likely to be effective for a specific disease,” according to Raghavendra and Pullaiah.11 These innovations will allow more people to be correctly diagnosed and receive the best available treatment for them as individuals.

Recently, a study was published detailing circular RNA as a novel biomarker for skin diseases. Circular RNA is a newly discovered type of non-coding RNA, like micro-RNA that is gaining a lot of attention in RNA research. Unlike traditional RNA, which has open ends, circRNA forms a closed loop. This unique structure makes it more stable and resistant to degradation, allowing it to stay in cells longer and maintain consistent expression.12 Investigations have found that circRNAs can be abnormally found in skin disorders like psoriasis, melanoma and abnormal wound healing. Although this biomarker requires additional investigation for a comprehensive understanding, increasing research has demonstrated that numerous circRNAs are expressed abnormally in skin disorders and play a role in the onset and progression of skin diseases. This provides further evidence supporting the use of circRNAs as biomarkers for the diagnosis, prognosis, and treatment of skin conditions.13

As with drug development and personalised medicine, AI and molecular advances are expanding the horizons of biomarker discovery. AI-based methods indicate that more biomarkers can be found, and larger amounts of data can be processed and interpreted, although questions remain about the computing resources required to store and process such large volumes of data, as well as the need to balance privacy with the public good when sharing data that could build advanced AI models. Additionally, these programs can offer more accurate and personalised approaches to diagnoses and treatment of disease.14 Biomarkers can provide a more comprehensive analysis and understanding of disease progression and monitor changes in response to therapy in comparison to more traditional indicators.15 

Biomarkers hold immense potential for shaping the future of dermatology research. Prognostic biomarkers are particularly vital for advancing the understanding of malignant conditions, while diagnostic biomarkers play a critical role in addressing autoimmune diseases. For inflammatory skin conditions, disease severity biomarkers are invaluable tools in guiding effective treatment strategies. However, the identification, validation, and integration of those various biomarker types present significant challenges, often necessitating collaborative efforts.16  

Biomarkers are revolutionizing dermatology by providing deeper insights into the mechanisms, diagnosis, and treatment of inflammatory skin conditions such as atopic dermatitis and psoriasis. This blog has explored their role in understanding disease progression, improving treatment precision, and driving innovation in drug development. From established markers like serum thymus and activation-regulated chemokine in atopic dermatitis, to emerging biomarkers such as circular RNAs, these tools are reshaping how we approach dermatological conditions. Looking ahead, advancements in technology, such as AI-driven analysis and molecular diagnostics, promise to expand biomarker discovery and application, enabling even more personalized and effective treatments.  

References: 

1. Brind’Amour, Katherine, and Rachael Ajmera. “Skin Disorders: Pictures, Causes, Symptoms, and Treatment.” Healthline, Healthline Media, 14 Feb. 2024, www.healthline.com/health/skin-disorders#permanent-disorders.

2. A study about how many people around the world have atopic dermatitis, British Journal of Dermatology, Volume 190, Issue 1, January 2024, Page e6, https://doi.org/10.1093/bjd/ljad462

3. “Get the Facts about Psoriasis and Psoriatic Arthritis.” The National Psoriasis Foundation: National Psoriasis Foundation, National Psoriasis Foundation, www.psoriasis.org/psoriasis-statistics/. Accessed 4 Feb. 2025.

4. Puntmann VO. How-to guide on biomarkers: biomarker definitions, validation and applications with examples from cardiovascular disease. Postgrad Med J. 2009 Oct;85(1008):538-45. doi: 10.1136/pgmj.2008.073759. PMID: 19789193.

5. Sumit Paliwal, Byeong Hee Hwang, Kenneth Y. Tsai, Samir Mitragotri, Diagnostic opportunities based on skin biomarkers, European Journal of Pharmaceutical Sciences, Volume 50, Issue 5, 2013, Pages 546-556, ISSN 0928-0987, https://doi.org/10.1016/j.ejps.2012.10.009.

6. Landeck, L., Kneip, C., Reischl, J. and Asadullah, K. (2016), Biomarkers and personalized medicine: current status and further perspectives with special focus on dermatology. Exp Dermatol, 25: 333-339. https://doi.org/10.1111/exd.12948

7. Flisiak, I., Zaniewski, P., & Chodynicka, B. (2008). Plasma TGF-β1, TIMP-1, MMP-1 and IL-18 as a combined biomarker of psoriasis activity. Biomarkers13(5), 549–556. https://doi.org/10.1080/13547500802033300

8. Landeck, L., Kneip, C., Reischl, J. and Asadullah, K. (2016), Biomarkers and personalized medicine: current status and further perspectives with special focus on dermatology. Exp Dermatol, 25: 333-339. https://doi.org/10.1111/exd.12948

9. Joanna Busquets, Francesco Del Galdo, Eugene Y. Kissin, Sergio A. Jimenez, Assessment of tissue fibrosis in skin biopsies from patients with systemic sclerosis employing confocal laser scanning microscopy: an objective outcome measure for clinical trials?, Rheumatology, Volume 49, Issue 6, June 2010, Pages 1069–1075, https://doi.org/10.1093/rheumatology/keq024

10. Sumit Paliwal, Byeong Hee Hwang, Kenneth Y. Tsai, Samir Mitragotri, Diagnostic opportunities based on skin biomarkers, European Journal of Pharmaceutical Sciences, Volume 50, Issue 5, 2013, Pages 546-556, ISSN 0928-0987, https://doi.org/10.1016/j.ejps.2012.10.009.

11. Raghavendra, P.B.., Pullaiah, T.. Advances in Cell and Molecular Diagnostics. Netherlands: Academic Press, 2018.

12. Zhao X, Zhong Y, Wang X, Shen J, An W. Advances in Circular RNA and Its Applications. Int J Med Sci. 2022 May 27;19(6):975-985. doi: 10.7150/ijms.71840. PMID: 35813288; PMCID: PMC9254372.

13. Xiaoting Wu, Yanwei Xiao, Jingxin Ma, Aoxue Wang, Circular RNA: A novel potential biomarker for skin diseases, Pharmacological Research, Volume 158, 2020, 104841, ISSN 1043-6618,https://doi.org/10.1016/j.phrs.2020.104841.

14. Seliverstov, P. V., Kutsenko, V. P., Gorelova, V. G., Magomedova, S. A., Akhmedov, S. R., & Nurmyradov, Y. N. (2024). Using artificial intelligence for biomarker analysis in clinical diagnostics. Molekulyarnaya Meditsina (Molecular Medicine), 22(5), 31-39. doi: 10.29296/24999490-2024-05-04

15. Raikar, G. (Vedant) S., Raikar, A. S., & Somnache, S. N. (2023). Advancements in artificial intelligence and machine learning in revolutionising biomarker discovery. In Brazilian Journal of Pharmaceutical Sciences (Vol. 59). FapUNIFESP (SciELO). https://doi.org/10.1590/s2175-97902023e23146

16. Landeck, L., Kneip, C., Reischl, J. and Asadullah, K. (2016), Biomarkers and personalized medicine: current status and further perspectives with special focus on dermatology. Exp Dermatol, 25: 333-339. https://doi.org/10.1111/exd.12948

 

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