key: cord-1006748-0f9coqwd
authors: Lee, Jinkyung; Kwon, Ki Han
title: Development of customized inner beauty products and customized cosmetics apps according to the use of NRF2 through DTC genetic testing after the COVID‐19 pandemic
date: 2022-04-24
journal: J Cosmet Dermatol
DOI: 10.1111/jocd.14467
sha: ee7d39d1190d7cf36ae38a63a94008e1e3944615
doc_id: 1006748
cord_uid: 0f9coqwd

BACKGROUND: After the coronavirus disease‐19 (COVID‐19) pandemic, the definition of health continuity, well‐being, and well‐dying is also evolving. OBJECTIVES: This review is about the utilization of nuclear factor erythroid 2‐related factor 2 (NRF2) for customized inner beauty products and customized cosmetics through Direct‐To‐Consumer (DTC) genetic testing in the non‐face‐to‐face era that is evolving after the global pandemic. METHODS: In May 2021, we proposed a narrative review as a new report and commentary. It was written with reference to keywords such as “Covid DTC Genetic Test,” “Covid 4th industrial revolution,” “Covid NRF2,” and “Antioxidants.” This study was performed by searching on PubMed, Google Scholar, Scopus, and ResearchGate. A total of 432 papers were retrieved, of which 40 were successfully included in this study. RESULTS: With the rapid transition to a non‐face‐to‐face society after COVID‐19, the concept of DTC was born, which allows consumers to receive genetic testing directly without visiting a medical institution. Based on the 4th industrial revolution, a convergence medical device is needed to secure the function as an NRF2 regulator of antioxidants in customized inner beauty products and customized cosmetics. CONCLUSION: Therefore, let us look at the fact that a fusion medical device based on the 4th industrial revolution has emerged in the global DTC genetic test market, which is still insufficient to summarize important research results. This study is expected to be an important data for the development of antioxidants as NRF2 regulators in customized inner beauty products and customized cosmetics. As mobile use increases in the future, additional research focusing on app development is needed, and various follow‐up studies are also needed.

Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a global pandemic with unprecedented consequences. These coronaviruses are becoming an increasingly serious situation in our society due to their long incubation period and unpredictable high prevalence. Although effective vaccines are available, the epidemic is uncontrolled due to high mortality and rapid spread. 1 To minimize this risk of infection, additional general preventive and protective measures are needed to isolate and manage secondary or tertiary waves. So far, four vaccines have reported varying efficacy of approximately 62%-95%, and two of them (Pfizer/BioNTech Corp. and Moderna Corp.) are urgently approved for use by the FDA.

Additional access and distribution of these vaccines will save many lives in all countries. 2 If we look at the cases of severe acute respiratory syndrome (SARS) in the past, it was the first infectious disease of the 21st century, killing more than 700 people worldwide.

Again, no effective anti-SARS vaccine or drug has been found, despite the urgent need for adequate preparation against SARS outbreaks. Therefore, the characterization, familial classification, and kinetic mechanism of SARS coronavirus (SCV) helicase-nsP13 were studied. Potent inhibition of SARS helicase by the native flavonoids, myricetin, and scutellarein has revealed the identification of novel chemical inhibitors of nsP13. 3 Coronavirus disease-19 (COVID- 19) is a universal target in a variety of institutions, producing pathogenic effects. It has been shown to be a multifaceted, multisystem, multiorgan disorder with roles involved in oxidative stress and inflammatory processes. Accordingly, along with the development of treatment, there are research results that the use of health functional food or health functional food for the prevention or treatment of SARS-CoV-2 infection will be an effective treatment method in the field of alternative and auxiliary treatment. 4 In addition, the identification of myricetin and scutellarein, novel chemical inhibitors of SARS coronavirus helicase and nsP13 in the past, was conducted. A study result showed that selected natural flavonoids such as myricetin and scutellarein could act as SARS-CoV chemical inhibitors. 5 Nuclear factor erythroid 2-related factor 2 (NRF2) plays an important role in a redox-sensitive transcription factor that protects organisms from various types of electrophiles or oxidizing agents. NRF2 levels remain low in normal cells but rise very high in cancers that develop chemical or radiation resistance. NRF2 maintains redox balance and plays an important role in autophagy, apoptosis, cell cycle progression, and stem cell differentiation, which can be attributed to the presence of all multiple binding proteins, the results of the study have shown. 6 Meanwhile, in Korea, genetic analysis, which was used for disease treatment or paternity confirmation through early diagnosis, has recently been introduced to the cosmetic field through Direct-To-Consumer (DTC) gene analysis. DTC genetic testing (GT) allows consumers to receive genetic testing directly without people visiting various medical institutions such as hospitals, and it is called DTC. In August 2020, "My own health food recommendation and sales service" suitable for individual health conditions and lifestyles passed the Korean Chamber of Commerce and Industry and the government's sandbox and was able to enter the market. The Ministry of Trade, Industry and Energy and the Sandbox Support Center of the Korea Chamber of Commerce and Industry announced that they had held the "Industrial Convergence Regulatory Special Exception Review Committee" in writing and approved 11 sandbox projects (exemption from regulations for a certain period for new businesses, deferment of regulations). In addition, to foster innovative medical devices, VR/AR-based medical device items were newly established, and the new medical technology evaluation system was improved. Currently, there are no separate licensed items, but the establishment of separate licensed items for convergence medical devices such as VR (Virtual Reality) and AR (Augmented Reality)-based cognitive behavioral therapy software is in progress. 7, 8 Due to the circumstances of the times, the desire to live a healthy life has become common all over the world. People are getting more and more interested in a healthy life in the middle-aged and older people to be free from disease, to manage beautiful skin, and to prepare for an aging society. The focus is on the qualitative aspects of "how to live happily" and "how to live beautifully," rather than simply extending life in old age.

Gradually, the definition of health and wellness in terms of beauty is evolving and being emphasized. Therefore, it is necessary to pay attention and support to the concept of various inner beauty and antioxidants of the middle-aged and elderly people related to immunity, and various studies that can be processed in combination are urgently needed. 9 Therefore, this study intends to investigate the use of NRF2 through DTC-GT after COVID-19. DTC is possible, meaning that consumers can receive genetic tests directly without visiting medical institutions as the society rapidly shifts to a non-face-to-face society after COVID-19. Based on this 4th industrial revolution, it is expected that these data will be a helpful major research on NRF2 and NRF2 regulators of antioxidants using customized inner beauty by introducing convergence medical devices. In addition, this study is intended to be helpful as a reference material for activation of sales of customized cosmetics and customized inner beauty in the future, the right to know individual genetic information, the still incomplete domestic DTC-GTmarket, and agile response to rapidly changing market conditions. 10

In May 2021, we proposed a narrative review as a new report and commentary. It was written with reference to keywords such as "Covid DTC Genetic Test", "Covid 4th industrial revolution," "Covid NRF2," and "Antioxidants." This study was performed by searching on PubMed, Google Scholar, Scopus, and ResearchGate.

A total of 432 papers were retrieved, of which 40 were successfully included in this study. As a result, the disease management mechanism of NRF2, primary NRF2 function proven by past disease cases, disease prevention management through DTC-GT, and health management through non-face-to-face application were presented in 4 tables.

The Using the Nrf2-Keap1 system as a key molecular target, some representative recognition has highlighted cytoprotective gene expression induced by chemopreventive phytochemicals. Representative recognition using the Nrf2-Keap1 system as a key molecular target has been reported to highlight cytoprotective gene expression.

Also, some of them are induced by chemopreventive phytochemicals. 13 Table 1 summarizes previous studies on antioxidants related to the central role of Nrf2.

In the past, SARS was caused by a novel coronavirus. Viral helicase, one of the components, has been studied in various ways for chemical SARS inhibitors. Characterization of the SARS coronavirus (SCV) helicase-nsP13, familial classification, and kinetic mechanism studies made novel findings in the potent inhibition of SARS helicase by natural flavonoids, myricetin, and scutellarein. A similar study also discussed novel chemical inhibitors of nsP13. 3 Myricetin and scutellarain were subjected to SARS coronavirus helicase, nsP13, fluorescence resonance energy transfer (FRET)-based double-stranded (ds) DNA unwinding to SARS coronavirus helicase, nsP13, and hepatitis C virus (HCV) helicase.

Results were obtained for a novel inhibitory effect on the activity of NS3h. These results demonstrate that none of the compounds inhibited the DNA unfolding activity or ATPase activity of human HCV helicase protein. However, myricetin and scutellarein inhibited the SARS-CoV helicase protein by affecting ATPase activity in vitro. In addition, the study results showed that it had no effect on the unwinding activity of nsP13. 5 confirmed that the NRF2 antioxidant gene expression pathway was suppressed. In addition, the NRF2 agonist 4-octyl-itaconate (4-OI) and the clinically approved dimethyl fumarate (DMF) induce cellular antivirals that potently inhibit the replication of SARS-CoV2 in cell lines. 15 Table 2 summarizes previous studies on the pivotal role of Nrf2 in the therapeutic approach of disease. [11]

2

Review of molecular mechanisms involved in the activation of the Nrf2-ARE signaling pathway by chemopreventive agents The discovery of multinuclear localization signals (NLS) and nuclear export signals (NES) in Nrf2 is also a consequence of the dynamic equilibrium of multivalent NLS and NES nuclearcytoplasmic translocations of transcription factors.

[12]

3

Nrf2 as a master redox switch in turning on the cellular signaling involved in the induction of cytoprotective genes by some chemopreventive phytochemicals Cytoprotective gene expression induced by some representative dietary chemopreventive phytochemicals using the Nrf2-Keap1 system as key molecular targets.

[13]

4

Proc Natl Acad Sci USA a new popularity among consumers. 16 The recent increase in public interest in genetics and genomics is driving the rapid growth of the DTC-GT. As yet, regulatory issues have limited true DTC-GTs that can be used without a physician's order. The future paradigm, however, has gradually shifted to a consumer-oriented GT model, in which patients research their own testing options and request specific genetic testing from healthcare providers. 17 of respondents thought that participation of a genetic counselor would improve DTC-GT, only 31.2% "agree" or "strongly agree".

Confirmation of these findings suggests that most respondents are more likely to accept DTC-GT if genetic counseling is part of the process. However, most counselors conclude that it is inconvenient to provide these services. 20 Table 3 summarizes disease prevention management through DTC -GT.

The global economy is now in serious trouble due to COVID-19.

In this context of the times, the non-face-to-face era is expanding. Effective consumption promotion in the future is seen as an confirmed. 26 Table 4 summarizes health management through nonface-to-face applications. 

Since the online market of DTC-GT is expected to grow, it is important to remain aware of a possible impact.

Despite many complex questions and challenges, this market represents an opportunity for the genetics community to address unmet needs.

Specialists remain the best group to assist patients with DTC-GT, however, primary care providers may still provide accurate interpretation of test results when specialists are unavailable.

If genetic counseling was part of the process, most respondents would be more receptive to the DTC-GT, but the majority of counselors felt uncomfortable providing this service. After the COVID−19 pandemic, it was confirmed for the first time that the consumption of customized inner beauty formulations and the use of customized cosmetics would be more effective. 

The virus causes COVID-19, a disease characterized by shortness of breath, fever, and pneumonia, which can be fatal to people's bodies. SARS-CoV-2 has similar characteristics to past human coronaviruses. It has the same genomic similarity. So, just like coronavirus, 38 The use and scope of DTC-GT, also known as consumer-led direct genetic testing, are increasing.

As a result, consumers can receive genetic counseling to understand the consequences and determine their impact on health care.

Recently, these studies have been multifaceted. In these studies, people who requested genetic counseling after receiving DTC-GT results were interviewed, and their motivations, expectations, and experiences were explored. As a result, it was reported that DTC-GT results could be valid and potentially impactful in health care. They wanted a more thorough explanation in "lay terminology" that combined the results with family and personal health records and "game plans." Consumers reported concerns about clinic visits for DTC-GT genetic counseling sessions. 39 It is very meaningful to propose the most suitable genetic test kit product, from test application to actual sample collection and return. Genetic test kit products developed based on user experience will be able to utilize basic data for efficient and popular personal genetic testing in the future. It is also expected to help form a new medical culture and improve public health care. 40 A randomized trial study of personal health records from Behavioral Health Homes mobile tested whether the application improved the quality of health care for individuals receiving care in these settings. Severe mental illness was found across two behavioral health centers to receive either a mobile personal health record application or routine care, and 311 participants with one or more cardiac metabolic risk factors were enrolled. The secure mobile personal health record (mPHR) app provided intervention group participants key information on diagnostics, medications, and laboratory test values and enabled them to track health goals. The use of the mPHR app showed statistically significant results for the quality of care in individuals with severe psychiatric disorders and comorbid cardiac metabolic disorders. However, it has been clinically reported to be associated with a moderate differential benefit. 41 In addition, during the COVID-19 pandemic, research on DTC-GT for customized cosmetics underlined the evolution of DTC-GT since then. As a result, it was confirmed for the first time that the consumption of customized inner beauty formulations and the use of customized cosmetics would be more effective. Based on the above meaningful research results, it has been announced that it is necessary to study the combined effect of customized inner beauty products and customized cosmetics in the global DTC-GT market. 10

Therefore, this study is also evolving the definition of health sustainability, well-being, and well-dying after the global COVID-19 pandemic. Accordingly, we considered the use of NRF2 through DTC -GT in the non-face-to-face era. To summarize the above important research results, it is necessary to introduce convergence medical devices based on the 4th industrial revolution in the still insufficient global DTC-GT market. It is hoped that this study will serve as key data to help develop the potential of antioxidants as NRF2 modulators in customized inner beauty products and customized cosmetics. Due to the increase in mobile usage in the future, it is judged that additional and various follow-up studies on app development are needed.

The authors of this manuscript do not have any conflicts of interest to disclose.

The conducted literature review did not require the agreement of the bioethics committee.

Jinkyung Lee and Ki Han Kwon involved in conception or design of the work, interpretation, drafted the article, and critically revised of the article. All authors finally approved the version to be published.

The findings of this study are available from the corresponding author upon reasonable request.

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