Research Projects directed by our Mohs Surgeons include several prospective trials:
Research at the Center for Medical Mycology has been devoted to two main research areas:
A basic science area focusing on determination of virulence factors, including biofilm formation, responsible for the pathogenesis of Candida albicans
A clinical laboratory concentrating on development national standards for reference methods for anti-fungal susceptibility testing (including dermatophytes), and pre-clinical evaluation of anti-fungal
Research focused on psoriasis occurs in two venues:
Clinical Research and Outcomes stems primarily from the Murdough Family Center for Psoriasis, a Center established to enhance research and clinical care for psoriasis patients
The Center of Research Translation (CORT) an NIH (NIAMS) funded program project exploring basic and translational research including the use of photodynamic therapy to treat psoriasis and the development of cutting edge murine models for psoriasis
Research on dermatitis includes atopic dermatitis (Eczema), cutaneous hypersensitivity as a result of atopic dermatitis and allergic contact dermatitis. Several ongoing clinical studies are also underway in the Skin Study Center Core.
An area of extensive research focus within the Department is cutaneous T cell lymphoma (CTCL), several studies including the use of photodynamic therapy for CTCL have been, or are ongoing, in the Department including a currently enrolling clinical trial designed to assess the use of O6 Benzylguanine and topical carmustine in the treatment of refractory early stage (IA-IIA) CTCL
Several investigators have an interest in wound care and wound healing. Dr. Marie Tuttle heads a research area interested in defining mixed species fungal and bacterial non-healing (chronic) wounds. In collaboration with the UHCMC Dr. Tuttle is performing pyrosequencing of bacterial and fungal dna isolates from chronic wounds to describe the complex organismal make up of chronic skin wounds.
The majority of photodynamic therapy work centers on a photosensitizing compound developed at Case Western Reserve University silicon phthalocyanine 4 (Pc 4). This compound has been used as a photosensitizing agent for photodynamic therapy (PDT) treatment of CTCL as well as an ongoing clinical trial for psoriasis.
Several ongoing clinical trials in psoriasis treatment are currently enrolling at The Department of Dermatology Clinical Trials Unit. Information can be obtained here: http://www.uhcderm.com/clinical%20trials.html
The study of the immune system in the context of cutaneous biology in the Department of Dermatology includes basic research regarding T cell immunology (regulatory T cells, Th17 cells), macrophage/monocyte-T cell interactions, inflammation, innate and acquired immunity and tolerance. Translational projects include examination of the mechanism(s) of action for several biological therapeutics currently in use for dermatologic diseases including psoriasis, atopic dermatitis and cutaneous T cell lymphoma (CTCL).
Many aspects of cell biology are examined in cutaneous biology including studies of signal transduction pathways, examination of proteomic and metabolomic response of skin cells including keratinocytes, melanocytes and skin-derived immune cells, derivation of inflammatory cytokine response and apoptosis induction mechanisms including calcium flux and caspase induction.
The Department of Dermatology is complemented by cutting edge research performed in the Skin Cancer Research Institute. Studies of skin cancer include ongoing Phase I/II clinical trials, mechanism of action studies and basic research projects. Development of therapeutics is a complemented by collaborations in several departments including Biochemistry and Molecular Biology, Pharmacology and Biomedical Engineering.
The Faculty within the Department have created transgenic models of skin diseases including psoriasis, atopic dermatitis and alopecia. In addition, the Department has also established the ability to successfully transplant human skin (both healthy and diseased) and skin equivalents onto SCID, Rag-/- and Nude mice. Xenogenic transplants permit the design of experiments which could not be carried out in vivo, including the testing of novel therapeutic compounds. In addition, transplantation in the context of gain- or loss-of function mouse models allows for sophisticated read-outs beyond what could be achieved with in vitro experimentation.