Antimicrobial peptides in hidradenitis suppurativa: a systematic review

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease of the hair follicle defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. HS is associated with microbial dysbiosis and immune dysregulation. In HS, an increasing number of studies have investigated antimicrobial peptides (AMPs). Objectives To provide an overview of the literature on AMPs in HS, and to discuss the potential role of AMPs in the pathogenesis of HS. Methods PubMed, Embase and the Cochrane Library were searched. The titles, abstracts and full texts of all articles were manually screened. Additionally, the reference lists of the included articles were screened and hand searched for relevant studies. Results The final literature sample comprised 18 retrospective and prospective studies (no reviews or commentaries) published between 2009 and 2020. Conclusions This review demonstrates the multitude of AMPs in HS. Although the methodology of the studies varied, the included studies indicate a consistent overexpression of human beta-defensin (hBD)-2, S100A7, S100A8 and S100A9 at both the mRNA and protein levels, and a decreased expression of hBD-1. Overall, the studies point to a dysregulation of AMPs in both lesional and nonlesional HS skin.

Automated summary

The review highlights the diversity of AMPs in HS, with consistent findings of dysregulation of AMPs in HS skin. The included studies demonstrate an overexpression of certain AMPs in HS, while others show a decreased expression.