Bedside assessment of multiphoton tomography

The application of multiphoton microscopy in the field of biomedical research and advanced diagnostics promises unique insights into the pathophysiology of skin diseases. Recently, various studies on drug delivery and skin cancer have been successfully completed. With the aim of gaining deeper understanding of the linkage between cellular structure and physiological processes, non-invasive multiphoton-based intravital tomography (MPT) and fluorescence lifetime imaging (FLIM) were combined within the scope of inflammatory skin and chronic wounds in clinical application.
The optical biopsies generated via MPT were morphologically analysed and aligned with classical skin histology. Because of its subcellular resolution, MPT provided evidence of a redistribution of mitochondria in keratinocytes indicating an altered cellular metabolism. Morphometric algorithms reliably showed a perinuclear accumulation in lesional skin in contrast to an even distribution in healthy skin. MPT-FLIM confirms these observations showing a metabolic shift in lesions. Moreover, detection of the onset and progression of inflammatory processes could be achieved.
In conclusion, the change in the distribution of mitochondria and the verification of an altered cellular metabolism facilitate a better understanding of the processes of wound healing and inflammatory skin diseases envisioning future clinical areas of MPT-FLIM application.