Frew John W, Hawkes Jason E, Krueger James G
Laboratory for Investigative Dermatology, Rockefeller University, New York, NY, 10065, USA.
F1000Res. 2018 Dec 13;7:1930. doi: 10.12688/f1000research.17267.1. eCollection 2018.
The pathogenesis of hidradenitis suppurativa (HS) remains unclear. In order to develop effective treatment strategies, a deeper understanding of pathophysiology is needed. This is impaired by multiple small studies with inconsistent methodologies and the impact of co-occurring pro-inflammatory conditions such as smoking and obesity. This systematic review aimed to collate all published reports of cytokine studies in tissue, blood, serum and exudate. It was registered with PROSPERO (Registration number CRD42018104664) performed in line with the PRISMA checklist. 19 studies were identified comprising 564 individual HS patients and 198 control patients examining 81 discrete cytokines. Methodology was highly varied and the quality of studies was generally low. There was a large degree of variance between the measured levels of cytokines. 78.2% of cytokines demonstrated heterogeneity by the chi-squared test for homogeneity and hence meta-analysis was not deemed appropriate. However, a strong and significant IL-17 signalling component was identified. Cytokines consistently elevated in lesional, peri-lesional and unaffected tissue are identified and discussed. Areas for further investigation include the role of dendritic cells in HS; the contribution of obesity, smoking, diabetes and the microbiome to cytokine profiles in HS; and examining the natural history of this disease through longitudinal measurements of cytokines over time.
化脓性汗腺炎（HS）的发病机制尚不清楚。为了制定有效的治疗策略，需要对其病理生理学有更深入的了解。然而，由于多项小型研究方法不一致，以及吸烟和肥胖等并发促炎状况的影响，这一目标受到了阻碍。本系统评价旨在整理所有已发表的关于组织、血液、血清和渗出液中细胞因子研究的报告。该研究在PROSPERO（注册号CRD42018104664）注册，并按照PRISMA清单进行。共纳入19项研究，包括564例HS患者个体和198例对照患者，检测了81种不同的细胞因子。研究方法差异很大，研究质量普遍较低。细胞因子的测量水平存在很大差异。78.2%的细胞因子经卡方同质性检验显示存在异质性，因此不适合进行荟萃分析。然而，研究确定了一个强大且显著的IL-17信号成分。本文还对病变组织、病变周围组织和未受影响组织中持续升高的细胞因子进行了鉴定和讨论。进一步研究的领域包括树突状细胞在HS中的作用；肥胖、吸烟、糖尿病和微生物群对HS中细胞因子谱的影响；以及通过对细胞因子进行长期测量来研究该疾病的自然病程。
