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Molinelli E, Gioacchini H, Sapigni C, Diotallevi F, Brisigotti V, Rizzetto G, Offidani A, Simonetti O. New Insight into the Molecular Pathomechanism and Immunomodulatory Treatments of Hidradenitis Suppurativa. Int J Mol Sci 2023; 24:ijms24098428. [PMID: 37176138 PMCID: PMC10179439 DOI: 10.3390/ijms24098428] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Hidradenitis suppurativa (HS) is an immune-mediated inflammatory disorder characterized by deep-seated nodules, abscesses, sinus tracts and scars localized in the intertriginous areas. It is accompanied by pain, malodourous secretion and a dramatically decreased quality of life. Although the pathogenesis has not been entirely elucidated, the primary event is follicular hyperkeratosis of the pilosebaceous apocrine unit. Since the registration of the tumor necrosis factor-alpha inhibitor Adalimumab in 2015, several cytokines have been implicated in the pathomechanism of HS and the research of novel therapeutic targets has been intensified. We provide an update on the inflammatory cytokines with a central role in HS pathogenesis and the most promising target molecules of future HS management.
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Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Helena Gioacchini
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Claudia Sapigni
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Federico Diotallevi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Giulio Rizzetto
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
| | - Oriana Simonetti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60126 Ancona, Italy
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Goldburg SR, Strober BE, Payette MJ. Hidradenitis suppurativa: Current and emerging treatments. J Am Acad Dermatol 2019; 82:1061-1082. [PMID: 31604100 DOI: 10.1016/j.jaad.2019.08.089] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 12/27/2022]
Abstract
The treatment of hidradenitis suppurativa (HS) has remained challenging because of the many knowledge gaps regarding etiology. However, recent studies into the pathogenesis of HS have enabled the investigation of newer therapies. The second article in this continuing medical education series reviews the evidence for established therapies for HS, including anti-inflammatories, antibiotics, and surgery. New and emerging therapies that specifically target cytokines involved in HS pathogenesis will be covered. The potential therapeutic roles of anticytokine therapies, including both the expanded application of existing molecules as well as the specific development of novel therapies for HS are discussed. With increased attention on HS and with numerous clinical trials currently underway, we hope that the variety of treatment options for HS will be expanded.
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Affiliation(s)
| | - Bruce E Strober
- Central Connecticut Dermatology Research, Cromwell, Connecticut; Yale University, New Haven, Connecticut
| | - Michael J Payette
- University of Connecticut School of Medicine, Farmington, Connecticut; Central Connecticut Dermatology Research, Cromwell, Connecticut; Dermatology Department, Farmington, Connecticut
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Mercurio L, Morelli M, Scarponi C, Eisenmesser EZ, Doti N, Pagnanelli G, Gubinelli E, Mazzanti C, Cavani A, Ruvo M, Dinarello CA, Albanesi C, Madonna S. IL-38 has an anti-inflammatory action in psoriasis and its expression correlates with disease severity and therapeutic response to anti-IL-17A treatment. Cell Death Dis 2018; 9:1104. [PMID: 30377293 PMCID: PMC6207563 DOI: 10.1038/s41419-018-1143-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/10/2018] [Accepted: 10/08/2018] [Indexed: 12/29/2022]
Abstract
IL-36 cytokines, a subgroup of IL-1 family, comprise IL-36α, IL-36β, and IL-36γ agonists, abundantly expressed in psoriatic skin, and IL-36RA and IL-38 antagonists. In psoriatic skin, IL-36 cytokines interfere with keratinocyte cornification programs and induce the release of antimicrobial peptides and chemokines active on neutrophils and Th17 lymphocytes. To date, the role of IL-38 antagonist in psoriasis remains to be defined. Here, we demonstrate that skin and circulating IL-38 levels are reduced in psoriatic patients and in other skin diseases characterized by neutrophilic infiltrate. In psoriasis, the balance of IL-36γ agonist/IL-38 antagonist serum levels is in favor of agonists and is closely associated with disease severity. Interestingly, IL-38 is upregulated by anti-IL-17A biological treatment and positively correlates with the therapeutic efficacy of secukinumab in psoriatic patients. The downregulation of IL-38 expression is strictly related to keratinocyte de-differentiation triggered by the inflammatory cytokines IL-36γ, IL-17, and IL-22. Finally, we demonstrate that administration of recombinant full-length IL-38 counteracts in vitro the biological processes induced by IL-36γ in human keratinocytes and endothelial cells and attenuates in vivo the severity of the psoriasiform phenotype induced by IMQ in mice. Such effects are achieved by restoring the physiological programs of keratinocyte proliferation and differentiation, and reducing the immune cell infiltrates.
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Affiliation(s)
- Laura Mercurio
- Laboratory of Experimental Immunology and Integrated Research Center for PSOriasis (CRI-PSO), Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, ROME, Italy
| | - Martina Morelli
- Laboratory of Experimental Immunology and Integrated Research Center for PSOriasis (CRI-PSO), Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, ROME, Italy
- Section of Dermatology, Department of Medicine, University of Verona, P.zza Stefani, 1, Verona, 37126, Italy
| | - Claudia Scarponi
- Laboratory of Experimental Immunology and Integrated Research Center for PSOriasis (CRI-PSO), Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, ROME, Italy
| | - Elan Z Eisenmesser
- Department of Biochemistry & Molecular Genetics, School of Medicine, University of Colorado Denver, Anschutz Campus, Aurora, 80045, CO, USA
| | - Nunzianna Doti
- Istituto di Biostrutture e Bioimmagini-CNR and CIRPEB, Via Mezzocannone, 16, Naples, 80134, Italy
| | - Gianluca Pagnanelli
- 1st Division of Dermatology and CRI-PSO, Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, Rome, 00167, Italy
| | - Emanuela Gubinelli
- CRI-PSO Istituto Dermopatico dell'Immacolata, IDI-IRCCS, via Monti di Creta, 104, Rome, 00167, Italy
| | - Cinzia Mazzanti
- 1st Division of Dermatology and CRI-PSO, Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, Rome, 00167, Italy
| | - Andrea Cavani
- INMP/NIHMP, via di S.Gallicano, 25, Rome, 00153, Italy
| | - Menotti Ruvo
- Istituto di Biostrutture e Bioimmagini-CNR and CIRPEB, Via Mezzocannone, 16, Naples, 80134, Italy
| | - Charles A Dinarello
- Department of Medicine, Radboud University Medical Center, 6525 HP, Nijmegen, The Netherlands
- Department of Medicine, School of Medicine, University of Colorado, Denver, Anschutz Campus, Aurora, CO, USA
| | - Cristina Albanesi
- Laboratory of Experimental Immunology and Integrated Research Center for PSOriasis (CRI-PSO), Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, ROME, Italy
| | - Stefania Madonna
- Laboratory of Experimental Immunology and Integrated Research Center for PSOriasis (CRI-PSO), Istituto Dermopatico dell'Immacolata IDI-IRCCS, via Monti di Creta, 104, ROME, Italy.
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