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Hidradenitis suppurativa: A folliculotropic disease of innate immune barrier dysfunction?
Author(s) -
Johnston Daniel G.W.,
Kirby Brian,
Tobin Desmond J.
Publication year - 2021
Publication title -
experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.108
H-Index - 96
eISSN - 1600-0625
pISSN - 0906-6705
DOI - 10.1111/exd.14451
Subject(s) - hidradenitis suppurativa , innate immune system , immune system , hair follicle , immunology , microbiome , inflammation , immunity , medicine , disease , biology , microbiology and biotechnology , bioinformatics , pathology
Abstract The innate immune system of human skin consists of a multi‐layered barrier consisting of cells and soluble effector molecules charged with maintaining homeostasis and responding to insults and infections. It has become increasingly clear that these barrier layers become compromised in skin diseases, especially in disorders of an (auto)inflammatory nature. In the case of hidradenitis suppurativa, great strides have been made in recent years in characterizing the underlying breakdown in homeostatic innate immunity, including an increasing understanding of the central role of the hair follicle in this process. This breakdown appears to occur at multiple levels: the pilosebaceous unit, associated epithelium, the cutaneous microbiome, alteration of immune cell function and local molecular events such as complement activation. This review seeks to summarize, contextualize and analyse critically our current understanding of how these innate immune barriers become dysregulated in the early stage(s) of hidradenitis suppurativa, and to speculate on where potential hidradenitis suppurativa research could be most fruitful.