Compartmentalized Cytokine Responses in Hidradenitis Suppurativa |
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| Authors: | Theodora Kanni Vassiliki Tzanetakou Athina Savva Brigit Kersten Aikaterini Pistiki Frank L van de Veerdonk Mihai G Netea Jos W van der Meer Evangelos J Giamarellos-Bourboulis |
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| Institution: | 1. 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.; 2. Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.; Laikon Hospital, GREECE, |
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| Abstract: | BackgroundFavorable treatment outcomes with TNF blockade led us to explore cytokine responses in hidradenitis suppurativa (HS).MethodsBlood monocytes of 120 patients and 24 healthy volunteers were subtyped by flow cytometry. Isolated blood mononuclear cells (PBMCs) were stimulated for cytokine production; this was repeated in 13 severe patients during treatment with etanercept. Cytokines in pus were measured.ResultsCD14brightCD16dim inflammatory monocytes and patrolling monocytes were increased in Hurley III patients. Cytokine production by stimulated PBMCs was low compared to controls but the cytokine gene copies did not differ, indicating post-translational inhibition. The low production of IL-17 was restored, when cells were incubated with adalimumab. In pus, high concentrations of pro-inflammatory cytokines were detected. Based on the patterns, six different cytokine profiles were discerned, which are potentially relevant for the choice of treatment. Clinical improvement with etanercept was predicted by increased production of IL-1β and IL-17 by PBMCs at week 8.ConclusionsFindings indicate compartmentalized cytokine expression in HS; high in pus but suppressed in PBMCs. This is modulated through blockade of TNF. |
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