Laboratory of Investigative Dermatology, Rockefeller University, New York, New York.
Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, Weill Cornell Medical School, New York, New York.
Exp Dermatol. 2021 Oct;30(10):1388-1397. doi: 10.1111/exd.14141. Epub 2020 Aug 11.
Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin disease with still largely unknown pathogenesis. While infectious organisms have been identified in lesions of the disease since the 1980s, questions remain over the role that bacteria and microbiome play. Recent studies using 16S ribosomal RNA gene sequencing and larger culture-based studies have begun to paint a clearer picture of the microbial world of HS. With this systematic review, we summarize all the work that has been done to date in HS bacteriology, analyse potential pitfalls and limitations of the current studies, and address future directions of investigation. This systematic review attempted to collate and analyse all bacteriology studies done to date. This review was prospectively registered with PROSPERO (1670769) performed in line with the PRISMA checklist. Twenty two studies were identified comprising 862 individual HS patients for culture studies and 206 HS patients for 16S rRNA gene sequencing studies. Methodology tended to be varied, with different sampling, culturing and sequencing methods as well as amount of analysis and stratification of patients. Bacteria identified as elevated in HS lesions in sequencing studies as well as grown from HS lesions in culture studies are identified and discussed. These primarily included the anerobic Gram-negative bacilli Prevotella, Porphyromonas and Fusibacterium, the Gram-positive bacilli Corynebacterium, and the Gram-positive cocci Staphylococcus, Streptococcus and Parvimonas. Potential interactions, as well as work in other disease models with related bacteria are also discussed. Areas of further investigation include in vitro studies of interactions between bacteria and keratinocytes, gut and oral microbiome studies and deep sequencing studies for virulence and phage factors.
化脓性汗腺炎（HS），也称为反向痤疮，是一种慢性炎症性皮肤病，其发病机制在很大程度上仍不清楚。虽然自 20 世纪 80 年代以来，在疾病的病变中已经确定了感染性生物体，但关于细菌和微生物组的作用仍存在疑问。最近使用 16S 核糖体 RNA 基因测序和更大的基于培养的研究的研究开始更清楚地描绘 HS 的微生物世界。通过这项系统评价，我们总结了迄今为止在 HS 细菌学方面所做的所有工作，分析了当前研究的潜在陷阱和局限性，并探讨了未来的研究方向。这项系统评价试图整理和分析迄今为止所有的细菌学研究。本综述前瞻性地在 PROSPERO（1670769）中进行了注册，符合 PRISMA 清单的要求。共确定了 22 项研究，包括 862 名单独进行培养研究的 HS 患者和 206 名进行 16S rRNA 基因测序研究的 HS 患者。方法学往往多种多样，包括不同的采样、培养和测序方法以及对患者的分析和分层的数量。在测序研究中发现 HS 病变中升高的细菌以及从 HS 病变中培养的细菌被鉴定并讨论。这些细菌主要包括厌氧革兰氏阴性杆菌普雷沃氏菌、卟啉单胞菌和梭杆菌、革兰氏阳性杆菌棒状杆菌，以及革兰氏阳性球菌葡萄球菌、链球菌和小单胞菌。还讨论了潜在的相互作用，以及与相关细菌的其他疾病模型中的工作。进一步的研究领域包括细菌与角质形成细胞、肠道和口腔微生物组之间的相互作用的体外研究，以及毒力和噬菌体因素的深度测序研究。
