Johnston Daniel G W, Kirby Brian, Tobin Desmond J
The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin 4, Ireland.
Charles Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland.
Exp Dermatol. 2021 Oct;30(10):1554-1568. doi: 10.1111/exd.14451. Epub 2021 Aug 27.
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.
人类皮肤的固有免疫系统由多层屏障组成，该屏障由细胞和可溶性效应分子构成，负责维持体内平衡并应对损伤和感染。越来越清楚的是，这些屏障层在皮肤疾病中会受到损害，尤其是在具有（自身）炎症性质的疾病中。就化脓性汗腺炎而言，近年来在确定稳态固有免疫的潜在破坏方面取得了长足进展，包括对毛囊在这一过程中的核心作用有了越来越深入的了解。这种破坏似乎发生在多个层面：皮脂腺单位、相关上皮组织、皮肤微生物群、免疫细胞功能的改变以及局部分子事件，如补体激活。本综述旨在总结、梳理并批判性地分析我们目前对化脓性汗腺炎早期这些固有免疫屏障如何失调的理解，并推测化脓性汗腺炎潜在研究最可能取得丰硕成果的方向。
