The pharmacology of antibiotic therapy in hidradenitis suppurativa

Marasca, Claudio; Tranchini, Paolo; Marino, Vincenzo; Annunziata, Maria Carmela; Napolitano, Maddalena; Fattore, Davide; Fabbrocini, Gabriella

doi:10.1080/17512433.2020.1762571

Cited by 16 publications

(25 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The pharmacology, mechanism of action and effectiveness of common HS antibiotic therapies were recently reviewed by Marasca and colleagues. 32 None of these antibiotics have been directly assessed for their impact on the HS skin microbiome, yet information on their impact on the human microbial communities is available. 214 In short, antibiotics decrease microbial diversity and overall burden and, in doing so, likely remove the microbial stimulus for host immune activation.…”

Section: The Impac T Of Antib I Oti C S On the S K In Microb I Omementioning

confidence: 99%

“…30,31 Further evidence to support a bacterial contribution to HS pathology is twofold: (a) the increased expression of many antimicrobial peptides (AMPs) and microbe-activated immune signalling pathways in HS skin lesions and (b) the partial efficacy of combination of antibiotic therapies with broad-spectrum antibacterial activity in HS patients. 3,32,33 Over the last 50 years or so, more than 200 publications have documented microbial dysbiosis in HS skin, yet many unanswered questions remain about the exact role of bacteria and bacterial metabolites in HS pathophysiology and symptoms.…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

Schell

Schneider

Nelson

2021

Experimental Dermatology

View full text Add to dashboard Cite

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

show abstract

Section: The Impac T Of Antib I Oti C S On the S K In Microb I Omementioning

confidence: 99%

mentioning

confidence: 99%

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

Schell

Schneider

Nelson

2021

Experimental Dermatology

View full text Add to dashboard Cite

show abstract

“…The role of microbes in the pathogenesis of HS is still discussed. High levels of antimicrobial peptides including β-defensin-2, S100 proteins, lipocalin-2, and LL37/cathelicidin in HS skin [ 89 ] and the efficacy of antibiotics have suggested a strong microbial influence in disease activity [ 150 ]. However, it is unclear whether bacteria are initiating- and/or promoting-factors in the progression of HS or if sinus/tunnel formation provides a favorable habitat for biofilm-producing bacteria.…”

Section: Resultsmentioning

confidence: 99%

“…The presence of microorganisms in HS has led to the condition being considered an infectious disorder. This is reinforced by the current guidelines for therapy focusing on the use of antibiotics [ 150 , 164 ].…”

Section: Resultsmentioning

confidence: 99%

Cytokine Pathways and Investigational Target Therapies in Hidradenitis Suppurativa

Duca

Morelli

Bennardo

et al. 2020

IJMS

View full text Add to dashboard Cite

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting areas with a high density of apocrine glands and characterized by subcutaneous nodules that may evolve into fistulas with pus secretion. Methods: The aim of this review is to investigate all current knowledge on cytokine regulation in the pathogenesis of HS. A systematic literature research using the words “cytokine”, “interleukin”, “pathway”, and “hidradenitis suppurativa” was performed in PubMed/Medline and Scopus/Embase databases. A search of the clinicaltrials.gov website for interventional recruiting and completed trials including the term “hidradenitis suppurativa” was also performed up to August 2020. We will discuss the pathogenetic role of various cytokines in HS and potential therapeutic targets for this debilitating disease. Results: The pathophysiology underlying this complex condition has not been clearly defined. An upregulation of various cytokines, such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, IL-17, IL-23, and other molecules seems to be related to this inflammatory condition. Various cells, such as lymphocytes T Helper 1 and 17 and keratinocytes seem to be involved in the genesis of this condition. Conclusions: Several future studies and clinical trials are necessary in order to have new knowledge about HS and to properly treat this complex condition.

show abstract

“…Systemic antibiotics (e.g., tetracyclines, clindamycin, rifampicin) are considered first-line therapy according to guidelines and expert opinions, although HS is not primarily an infectious disease, and none of them are approved by the Federal Drug Agency (FDA) or the European Medicines Agency (EMA) for the treatment of HS [1,63,95,99]. Their mode of action is believed to be immunomodulatory by reducing NFκB activation, resulting in diminished production of pro-inflammatory cytokines [12]. Combined with surgery, optimized antibiotic treatments may be promising in severe HS [100].…”

Section: From Conventional Therapies To Molecular Treatmentsmentioning

confidence: 99%

Hidradenitis Suppurativa: Where We Are and Where We Are Going

Scala

Cacciapuoti

Garzorz‐Stark

et al. 2021

Cells

Self Cite

View full text Add to dashboard Cite

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. It is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture and immune responses. Innate pro-inflammatory cytokines (e.g., IL-1β, and TNF-α); mediators of activated T helper (Th)1 and Th17 cells (e.g., IFN-γ, and IL-17); and effector mechanisms of neutrophilic granulocytes, macrophages, and plasma cells are involved. On the other hand, HS lesions contain anti-inflammatory mediators (e.g., IL-10) and show limited activity of Th22 cells. The inflammatory vicious circle finally results in pain, purulence, tissue destruction, and scarring. HS pathogenesis is still enigmatic, and a valid animal model for HS is currently not available. All these aspects represent a challenge for the development of therapeutic approaches, which are urgently needed for this debilitating disease. Available treatments are limited, mostly off-label, and surgical interventions are often required to achieve remission. In this paper, we provide an overview of the current knowledge surrounding HS, including the diagnosis, pathogenesis, treatments, and existing translational studies.

show abstract

The pharmacology of antibiotic therapy in hidradenitis suppurativa

Cited by 16 publications

References 76 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

Cytokine Pathways and Investigational Target Therapies in Hidradenitis Suppurativa

Hidradenitis Suppurativa: Where We Are and Where We Are Going

Contact Info

Product

Resources

About