Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Circulating cytokines in Patients with Hidradenitis Suppurativa: is there a Clue for new Therapeutic Options?
Pompei1, Orlando, Alvarez-Rodriguez1, Lorena, Blanco1, Ricardo, Villa2, Ignacio, Lopez-Hoyos1, Marcos, Lopez1, Marcos González, Fernandez-Llaca1, Hector
Hidradenitis suppurativa (HS) is a debilitating chronic disease with a pathogenesis that remains largely unknown. Most treatments remain empiric, are usually supportive and do not prevent the progression of the disease. More recently, treatment with TNF antagonists has shown promising results, that should be confirmed in well-designed clinical trials. As new treatment options for inflammatory conditions are rapidly appearing, the aim of the present study was to determine the cellular phenotype and the circulating cytokine profile in patients with HS.
Intracellular cytokine production was assessed in T cells (IFN-g, IL-2, IL-4, IL-10, IL-17) and monocytes (IL-1b, TNF-a, IL-6) by flow cytometry in 22 patients with active HS and 18 age- and sex-matched healthy controls (controls). Circulating cytokines (IL-12p70, IL-10, IL-8, IL-1b, TNF-a, IL-6) were measured by Cytometric Bead Array (CBA) in 26 patients with HS and 37 controls. Four HS patients were also assessed after treatment with TNF antagonists.
No significant differences between patients and controls were found for circulating levels of IL-12p70, IL-10, IL-8, IL-1b, and TNF-a. IL-6 was the only circulating cytokine significantly increased in patients with active disease (p=0.001). Using flow cytometry technology, we examined whether circulating monocytes were a major source of proinflammatory cytokines in patients with HS. The percentage of proinflammatory cytokine-producing cells ex vivo in patients with HS was similar to the percentage in controls. In vitro stimulation with LPS showed a clear response of circulating CD14+ cells, especially in controls. The percentage of IL-6, IL-1b and TNFa-producing cells after in vitro stimulation was significantly lower in patients with active HS. Compared to controls, HS patients were characterized by a decreased frequency of circulating CD3+IFNg+ex vivo (p=0.03). Disease control with treatment was followed by a further decrease of circulating CD3+IFNg+ (p=0.015). Patients with active HS showed a non-significant increased frequency of circulating Th17 (CD4+IL17+CCR6+ and CD4+IL17+IFN-) cells compared to controls. Disease control with treatment was also followed by a tendency to decrease circulating Th17 cells (p=0.06).
To the best of our knowledge, this is the first report that demonstrate an increase in serum levels of IL6 in patients with HS. We hypothesize that the increased levels of IL6 found in patients with HS are not the result of IL6 production by circulating monocytes, and it is reasonable to assume that the major production of this proinflammatory cytokine is located at the site of the inflammatory process or in other cell types that predominantly produce IL6.
To cite this abstract, please use the following information:
Pompei, Orlando, Alvarez-Rodriguez, Lorena, Blanco, Ricardo, Villa, Ignacio, Lopez-Hoyos, Marcos, Lopez, Marcos González, et al; Circulating cytokines in Patients with Hidradenitis Suppurativa: is there a Clue for new Therapeutic Options? [abstract]. Arthritis Rheum 2011;63 Suppl 10 :81