Gut Microbiome Perturbations in Patients with Hidradenitis Suppurativa: A Case Series

Kam, Sarah A.; Collard, Marianne; Lam, Jimmy; Alani, Rhoda M.

doi:10.1016/j.jid.2020.04.017

Cited by 23 publications

(31 citation statements)

References 17 publications

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“…99 In a small pilot study, Kam and colleagues sampled the gut microbiome from three HS patients and three healthy controls. 100 A significant decrease in α-diversity (a measure of the differences within a community) and significant decrease in the abundance of Firmicutes were noted in HS patients compared with controls. 100 In a separate study by Lam and colleagues, the gut microbiome was investigated in a larger patient cohort, including 17 HS patients and 20 healthy controls.…”

Section: The Gut Microbiome Of Hsmentioning

confidence: 98%

“…100 A significant decrease in α-diversity (a measure of the differences within a community) and significant decrease in the abundance of Firmicutes were noted in HS patients compared with controls. 100 In a separate study by Lam and colleagues, the gut microbiome was investigated in a larger patient cohort, including 17 HS patients and 20 healthy controls. 101 In contrast to Kam et al, this study did not find any alterations in α-diversity or Firmicutes abundance in HS patients.…”

Section: The Gut Microbiome Of Hsmentioning

confidence: 98%

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Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Schell

Schneider

Nelson

2021

Experimental Dermatology

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Hidradenitis suppurativa (HS) is a chronic multifaceted, potentially scarring, inflammatory skin disease affecting the pilosebaceous units (PSU) of the axilla, inframammary folds, groin and buttocks. Clinical features include painful inflammatory nodules, abscesses and draining sinus tracts that produce a purulent, foul-smelling discharge. The estimated prevalence of HS is 0.2-0.6% globally, but the prevalence varies by geographic location: 0.5-1.3% in Europe, 0.7-1.2% in the United States and 0.01%-2.2% in the Asia-Pacific region. 1,2 Common comorbidities and behaviours associated with HS include diabetes, pulmonary disease, metabolic syndrome, obesity, polycystic ovary syndrome, inflammatory bowel disease, smoking and mechanical stress on skin. 1,3-5 HS negatively impacts patients' quality of life and causes significant economic burden on patients and the healthcare system. [6][7][8][9][10] The pathogenesis of HS is not fully understood. However, evidence supports the hypothesis that hair follicle occlusion leads to follicle rupture and an aberrant immune response to follicular and bacterial debris, triggering a cycle of damage and chronic inflammation. 7,[11][12][13][14] Factors involved in HS pathogenesis include genetics, hormones, local environmental factors (eg sweating, skin friction), abnormal host responses to skin bacteria and impaired wound healing. [15][16][17][18] Approximately 30% of patients have a family history of HS, and of these, about 10% of these familial cases have an inactivating mutation in the γ-secretase enzyme complex. 19,20 These γ-secretase mutations are relatively uncommon in sporadic cases of HS (~6%). 21 γ-secretase activity in the skin

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Section: The Gut Microbiome Of Hsmentioning

confidence: 98%

Section: The Gut Microbiome Of Hsmentioning

confidence: 98%

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Schell

Schneider

Nelson

2021

Experimental Dermatology

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“…Only two studies were identified which investigated the gastrointestinal microbiome in HS. [40]. However, this study was very small, with only three participants each in the HS and control groups.…”

Section: The Main Findingsmentioning

confidence: 88%

The Microbiome in Hidradenitis Suppurativa: A Review

Wark

Cains

2020

Dermatol Ther (Heidelb)

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Introduction: Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disease. It is characterised by the development of abscesses and nodules in intertriginous anatomical sites. Whilst it is now recognised as an autoinflammatory condition rather than an infective disease, bacteria are implicated in disease pathogenesis. Methods: We performed a search of the literature from inception to 12 August 2020 using the search terms ''hidradenitis suppurativa'', ''Verneuil's disease'', ''acne inversa'', ''microbiome'', ''bacteriology'' and ''microbiology''. Studies were included if they assessed the cutaneous, gut or oral bacteria, bacteriology or microbiome in hidradenitis suppurativa. Results: Twenty-one studies examining the cutaneous microbiome and two studies examining the gastrointestinal microbiome in HS were identified. No studies examining the oral microbiome in HS were identified. A total of 972 patients and 46 healthy controls were included across studies examining the cutaneous microbiome. A total of 100 patients and 36 controls were included across both gut microbiome studies. Coagulase-negative Staphylococcus, anaerobes such as Porphyromonas and Prevotella, and Staphylococcus aureus species were commonly encountered organisms across the included cutaneous microbiome studies. The studies examining the gut microbiome were limited, with one small study demonstrating an alteration in the gut microbiome composition compared to controls. The other study found no alteration to the gut microbiome in patients with HS compared to those with inflammatory bowel disease (IBD) and HS, and IBD and/or psoriasis. Conclusion: Research should be undertaken into the oral microbiome in HS. Further research should be undertaken examining the cutaneous and gut microbiome in HS, and its relationship with documented co-morbidities. Additionally, metagenomics-focused studies may help identify the relationship between microorganisms and host, and this may shed light on new pathways of disease pathogenesis. This may help identify potential future therapeutic targets.

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“…1 Furthermore, the gut-skin axis and in particular the link between the gut microbiome (and its metabolic output) and inflammatory cutaneous diseases like HS is becoming increasingly apparent, and warrants study in the context of HS. 162,163 For instance, reduced short chain fatty acid (SCFA) output from the gut microbiome has long been linked with IBD and associated inflammation, and can be directly mapped to immunological effects on T-cell polarization and macrophage function. [164][165][166] Aside from bacteria, other microorganisms which form part of the skin microbiome have also been linked with complications in HS.…”

Section: The S K In Microb I Ome " Barrier " In Hsmentioning

confidence: 99%

Hidradenitis suppurativa: A folliculotropic disease of innate immune barrier dysfunction?

Johnston

Kirby

Tobin

2021

Experimental Dermatology

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Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease affecting the axillae, perineum and inframammary regions, among other body sites. Accumulating evidence indicates a hair follicle (HF) focus to this disease, as it is characterized by an early occlusion, followed by rupture of the HF and more generalized skin inflammation. 1 HS is part of the follicular occlusion tetrad of disorders (HS, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus).It results in painful local nodules and abscesses that can develop into pus-filled malodorous sinus tracts, also known as tunnels, that may result in extensive scarring. 2,3 In addition to cutaneous inflammation, patients with moderate-to-severe HS have evidence of systemic inflammation, as measured by C-reactive protein (CRP) and highsensitivity CRP. 1,4-8 Thus, it is unsurprising that HS is associated with significant psychosocial morbidity and profoundly impaired patient quality of life, when compared to other inflammatory skin diseases such as psoriasis. [9][10][11][12] Aside from the obvious pain and discomfort of HS lesions, patients commonly experience mood disorders (eg depression), altered body image, stigmatization, social isolation and sexual dysfunction. 9,[12][13][14][15][16] Approximately 35% of HS cases in northwestern European cohorts display a positive family history which suggests a genetic component. 17 This is less in some Asian populations at approximately 5% of patients. 18,19 Environmental factors,

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Gut Microbiome Perturbations in Patients with Hidradenitis Suppurativa: A Case Series

Abstract: JZ, et al. Exome sequencing of desmoplastic melanoma identifies recurrent NFKBIE promoter mutations and diverse activating mutations in the MAPK pathway. Nat Genet 2015;47:1194e9.

Cited by 23 publications

References 17 publications

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

The Microbiome in Hidradenitis Suppurativa: A Review

Hidradenitis suppurativa: A folliculotropic disease of innate immune barrier dysfunction?

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