Association of Hidradenitis Suppurativa With T Helper 1/T Helper 17 Phenotypes A Semantic Map Analysis

IMPORTANCE In spite of progress in understanding the mechanisms underlying hidradenitis suppurativa (HS) as an inflammatory skin disease, there is still a demand for an overview on immunopathogenesis of HS. OBJECTIVE To demonstrate the importance of the type 1/type 17 immune response in lesional HS skin by drawing a semantic connectivity map. DESIGN, SETTING, AND PARTICIPANTS Single-center case series of 24 patients with HS. Association of HS with T helper 1/T helper 17 (T(H)1/T(H)17) phenotype was assessed using semantic map analysis. MAIN OUTCOMES AND MEASURES Association of HS with T(H)1/T(H)17 phenotype. RESULTS The analysis was performed on 24 lesional HS biopsy samples from untreated patients with HS (16 [67%] female; median age, 36.5 years [range, 21-51 years]) with a mean (SD) Hurley stage of 2.29 (0.62) and 9 punch biopsy samples from healthy controls (6 [67%] female; median age, 43 years [range, 23-66 years]). The map shows a clustering of all T(H)1/T(H)17-associated cytokines (interleukin 17 [IL-17], interferon., IL-12, IL-23, IL-32, IL-1 beta, tumor necrosis factor) around overall lesional inflammation. Tumor necrosis factor, IL-12, and IL-17 are even directly connected via interferon.. In contrast, IL-13, a T(H)2-associated cytokine, was inversely correlated with the presence of T(H)1/T(H)17-associated cytokines, further highlighting the importance of the T(H)1/T(H)17 cytokines in HS pathogenesis. CONCLUSIONS AND RELEVANCE These findings suggest that HS may be a T(H)1/T(H)17-driven inflammatory skin disease.