Multi-band optical coherence tomography platform for the development of novel atopic dermatitis treatments.

用于开发新型特应性皮炎治疗的多波段光学相干断层扫描平台。

基本信息

批准号：
EP/S025944/1
负责人：
Stephen Matcher
金额：
$ 129.71万
依托单位：
University of Sheffield
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2019
资助国家：
英国
起止时间：
2019 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FS025944%2F1
关键词：
Multi band optical coherence tomography

项目摘要

Atopic dermatitis (AD - also known as eczema) is a skin disease that is greatly underestimated both in its prevalence and in its negative effects both on sufferers. The physical sensation of trying to sleep whilst experiencing a severe eczema "flare" has been likened to putting on a wet-suit that is stuffed with stinging nettles, zipping it up and then lying down to try to sleep. AD first affects the very young, with symptoms often appearing in the first 6 months of life and persisting through school years. Having open, weeping sores on the skin can cause children to have serious emotional problems at school and the lack of sleep from severe nighttime itching leaves children exhausted, unable to concentrate and thus unable to keep up. In severe attempted suicide is not uncommon, even in children under 10 years of age. The burden on carers is similar to that from children who need e.g. to be fed through a tube at home. Yet AD is a very common condition, affecting up to 30% of children in the UK and up to 10% of all adults. The UK has one of the highest rates of AD in the world and the disease is the commonest reason for consulting a GP about a skin complaint. AD is a "disease of the modern world": rates of AD have increased dramatically since the 1940's, suggesting that an increase in external irritants is a major factor. AD belongs with asthma and hay fever in being primarily an "allergic" reaction. The financial burden of AD on the health service arises because it is the first step along the "atopic march", where a child with AD very often progresses on to one of these other conditions. Despite its potential severity and high prevalence, AD has been neglected as a priority for developing treatments. The most commonly prescribed treatments (moisturizing creams and steroid creams) are over 50 years old. Steroid creams are very effective for calming inflammation and itching but come with serious problems. Sufferers can become dependent on them (steroid addiction) but at the same time they gradually damage the skin ("skin thinning"). Many carers suffer from "steroid phobia" and under-treat children; this causes AD flares to be poorly controlled which then requires even more steroid cream to be used later. The last 5 years has seen this regretable situation begin to completely transform however. New treatments are being brought to market which control inflammation and itching with potentially far fewer side-effects than steroid creams. The companies developing these treatments urgently require objective tools that can assess the skin before, during and after use so that they can reliably measure how well the treatments suppress AD flares and avoid causing skin damage. During a previous EPSRC project we applied an emerging imaging tool, optical coherence tomography (OCT), to AD patients and normal volunteers and found it to be potentially an ideal tool for this purpose. Such was the interest in our work from major drug companies that we are actively collaborating with them to use existing OCT techniques to evaluate 3 new types of AD treatment. At the same time at Sheffield we have a unique collaboration between dermatologists and OCT engineers who can see even greater potential for more advanced OCT techniques to be applied. This HIPS project is a unique partnership between clinicians, engineers and drug companies which will develop cutting edge OCT tools and assess their effectiveness in assessing new AD treatments. The potential impact in healthcare is enormous because of the huge demand for these new treatments. If successful we will develop an advanced OCT scanner that can immediately be used to help in the clinical evaluation of new and emerging treatments for this highly distressing disease.

特应性皮炎（AD - 也称为湿疹）是一种皮肤病，其患病率及其对患者的负面影响都被大大低估了。在经历严重的湿疹“发作”时试图入睡的身体感觉就像穿上塞满荨麻的潜水衣，拉上拉链，然后躺下试图睡觉。 AD 首先影响幼儿，症状通常出现在生命的前 6 个月，并持续整个学年。皮肤上的开放性流脓性溃疡可能会导致儿童在学校出现严重的情绪问题，而夜间严重瘙痒导致的睡眠不足会导致儿童精疲力竭、无法集中注意力，从而无法跟上进度。在严重的情况下，自杀未遂的情况并不少见，即使对于 10 岁以下的儿童也是如此。照顾者的负担与需要照顾的儿童的负担类似。在家通过管子喂食。然而 AD 是一种非常常见的疾病，影响着英国多达 30% 的儿童和多达 10% 的成年人。英国是世界上AD发病率最高的国家之一，这种疾病是就皮肤问题咨询全科医生的最常见原因。 AD 是一种“现代世界的疾病”：自 20 世纪 40 年代以来，AD 的发病率急剧上升，这表明外部刺激物的增加是一个主要因素。 AD 与哮喘和花粉症一样，主要是一种“过敏”反应。 AD 对卫生服务造成的经济负担之所以出现，是因为它是“特应性征程”的第一步，患有 AD 的儿童经常会发展为其中一种其他病症。尽管 AD 具有潜在的严重性和高患病率，但作为开发治疗方法的优先事项，AD 一直被忽视。最常用的治疗方法（保湿霜和类固醇霜）已有 50 多年的历史。类固醇霜对于镇静炎症和瘙痒非常有效，但也会带来严重的问题。患者可能会变得依赖它们（类固醇成瘾），但同时它们会逐渐损害皮肤（“皮肤变薄”）。许多护理人员患有“类固醇恐惧症”并且对儿童治疗不足；这会导致 AD 耀斑控制不佳，随后需要使用更多的类固醇霜。然而，过去五年这种令人遗憾的情况开始彻底转变。新的治疗方法正在上市，可以控制炎症和瘙痒，而且副作用可能比类固醇乳膏少得多。开发这些治疗方法的公司迫切需要能够在使用前、使用期间和使用后评估皮肤的客观工具，以便他们能够可靠地测量治疗方法抑制 AD 耀斑并避免造成皮肤损伤的效果。在之前的 EPSRC 项目中，我们对 AD 患者和正常志愿者应用了一种新兴的成像工具光学相干断层扫描 (OCT)，并发现它可能是实现此目的的理想工具。主要制药公司对我们的工作很感兴趣，因此我们正在积极与他们合作，利用现有的 OCT 技术来评估 3 种新型 AD 治疗方法。与此同时，在谢菲尔德，我们在皮肤科医生和 OCT 工程师之间进行了独特的合作，他们可以看到应用更先进的 OCT 技术的更大潜力。该 HIPS 项目是临床医生、工程师和制药公司之间的独特合作伙伴关系，将开发尖端的 OCT 工具并评估其在评估新的 AD 治疗方面的有效性。由于对这些新疗法的巨大需求，对医疗保健的潜在影响是巨大的。如果成功，我们将开发一种先进的 OCT 扫描仪，可立即用于帮助对这种高度痛苦的疾病的新兴疗法进行临床评估。