[CCoE Notice] Dissertation Announcement: Harshdeep Singh Chawla, "Multi-functional Optical Coherence Tomography Assesses Skin Involvement in Systemic Sclerosis"

[Greenwell, Stephen J]

[Dissertation Defense Announcement at the Cullen College of Engineering]Multi-functional Optical Coherence Tomography
Assesses Skin Involvement in Systemic Sclerosis
Harshdeep Singh Chawla
April 21, 2025; 2 p.m. to 5 p.m. (CST)
Location: Room 350 Health 1

Committee Chair:
Kirill V. Larin, Ph.D.

Committee Members:
Shervin Assassi, MD,  MS | Chandra Mohan, Ph.D. | Jerome Schultz, Ph.D. | David Mayerich, Ph.D.
Abstract

Systemic sclerosis (SSc), or scleroderma, is a chronic autoimmune disorder characterized by fibrosis of skin and internal organs. Early diagnosis and classification are critical for evaluating disease progression. Although considered rare, the five-year survival rate post-diagnosis is 77.9%, which decreases to 55.5% after ten years, with a median survival of approximately 11 years.

Diagnosis of SSc involves clinical evaluations, laboratory tests, and imaging techniques. The 2013 ACR/EULAR criteria offer a standardized method for evaluating skin thickening, fibrosis lesions, telangiectasias, nailfold capillary abnormalities, pulmonary involvement, Raynaud's phenomenon, and SSc-specific autoantibodies. One major pathological outcome of SSc is skin involvement, where significant fibrosis in the skin leads to thickening of the dermis, obliteration of skin appendages like hair follicles and sweat glands, atrophy of the epidermis, and vascular rarefaction, ultimately resulting in tissue hypoxia and impaired skin function.

To this end, the modified Rodnan skin score (mRSS) is the standard for measuring the severity of skin involvement in SSc. This assessment uses manual palpation over 17 body regions, with scores ranging from 0 (normal) to 3 (severely affected), resulting in an overall skin score. However, mRSS is subject to inter-observer variability and can be influenced by factors like skin elasticity, particularly in early SSc stages. Therefore, establishing an objective tool for skin involvement assessment in SSc is essential for improving prognostic accuracy, monitoring disease progression, evaluating treatment effectiveness, and facilitating the development of effective therapies.

Optical coherence tomography (OCT) is a noninvasive, label-free imaging modality that can examine morphological, biomechanical, and vascular changes in the skin of SSc patients. It has an optimal depth (1-2 mm) and resolution (5-15 μm) for characterizing skin fibrosis. OCT quantitatively measures tissue parameters, making it ideal for detecting SSc-related changes in skin. OCT performs morphological imaging, but mechanical assessment of skin can be performed with its elastographic functional extension, optical coherence elastography (OCE), while OCT angiography (OCTA) maps microvasculature affected by SSc.

This dissertation discusses the use of multifunctional OCT (i.e., OCT, OCE, and OCTA) to assess skin involvement in a diverse cohort of SSc patients and matched healthy controls. A multifunctional OCT system was built, and its reliability and operational performance were tested in a murine model of SSc-like fibrosis. The study's results confirmed that multifunctional OCT could detect alterations in murine skin's mechanical properties, morphology, and vascular characteristics. The system was then converted to a clinic-friendly mobile format for SSc patient imaging at UTHealth. Data was collected from 55 patients and 20 healthy controls, and the results show strong discrimination of the SSc patients from the healthy subjects but a low-to-moderate correlation with histopathology and qPCR measurements.
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