Hidradenitis suppurativa (HS), also known as Verneuil's disease, is a chronic inflammatory dermatosis of the hair follicule located mainly in the skin folds (axillae, inguinal, submammary, etc.).
Currently, treatments are mainly limited to the use of broad-spectrum antibiotics in order to control outbreaks of hidradenitis suppurativa. Surgical treatment is the only curative treatment, but requires disfiguring removals with major scarring consequences.
Pathophysiologically, HS appears to be a primary abnormality of the pilosebaceous-apocrine unit, causing follicular occlusion, followed by the development of perifollicular cysts with commensal bacterial overgrowth, and finally rupture into the dermis causing an exaggerated inflammatory response. At present, few studies have examined the role of the regulatory immune system and its involvement in this disease.
We are also interested in analyzing the impact of new therapeutic strategies on hidradenitis suppurativa, and more particularly the impact of photodynamic therapy (PDT) which is a technique that has been used for a long time in dermatology, notably for the treatment of precancerous and cancerous lesions.
This technique has shown interesting results on inflammatory dermatoses such as acne.
This research consists in studying the immunomodulation of the immune response in HS and in evaluating a new therapeutic strategy based on PDT alone or in combination with antimicrobial peptides (PAMs).
Adult patients (≥18 years)
Carrier of moderate to severe (Hurley grade ≥2) hidradenitis suppurativa of classical or gluteal phenotype
Having an indication for surgical treatment (indication for excision)
Not receiving immunomodulatory treatments (corticotherapy, biotherapy, apremilast, retinoids) or immunosuppressive treatments (methotrexate, ciclosporin) in the 6 months before inclusion, excluding antibiotics
None
Subjects with hidradenitis suppurativa and subjects without hidradenitis suppurativa undergoing abdominoplasty
Case-control
Prospective
Blood tests
Biological/VaccineFor patients, it will be performed: * a collection of blood samples (3 tubes of 5 mL) according to the usual medical management, in order to search for cardiovascular comorbidities associated with HS, * A collection of 3 EDTA tubes and 2 additional dry tubes of 5 mL each according to the needs of the study.
exeresis
Procedure/SurgeryFor patients, it will be performed: \- 6 tissue samples from the total excision specimen: two samples from the acute inflammatory zone (nodule, abscess, fistula) of 1 cm3; two samples from the chronic lesion zone (scar) of 1 cm3 and two samples from the peri-lesion zone (in the margin) of 1 cm3 on fresh tissue.
abdominoplasty
Procedure/SurgeryFor the controls, 6 fresh skin samples of 1 cm3 each will be taken from the abdominoplasty operation: * four in the center, * two in the margin
Prevalence of different types of immune cell populations
Prevalence of cell populations will be determined by cytometry
Activation of lymphocytes
The activation state of circulating lymphocytes will be analyzed by flow cytometry using antibodies coupled to fluorochromes specifically targeting the following membrane markers: CD4, CD30, CD69, Anti-HLADR, CD152, CD197, CD25, CD8.
Prevalence of innate lymphoid cells
The prevalence of innate lymphoid cells will be determines by cytometry
Gene expression analysis
A microarray assay will be performed in order to determine the expression of genes of interest.
Size of exosomes
The size of exosomes will be measured by the Tunable resistive Pulse sensing method
Concentration of exosomes
The concentration of exosomes will be measured by the Tunable resistive Pulse sensing method
Quantification of antimicrobial peptides
Several antimicrobial peptides such as elafin/SHALP, dermcidin, S100A7/psoriasin, S100A8/calgranulin A, S100A9/calgranulin B, LL-37 (cathelicidin), h-βd1, h-βd2, h-βd3, h-βd4, ribonuclease 7, SLPI/ALP from HS patient serum versus blood baqs (control) as well as in supernatants of HS lesion tissue versus abdominoplasty tissue (control) cultured in microslices will be quantified by ELISA
Quantification of wound healing
Wound healing capacity We will evaluate the ability to restore wound healing in in vitro HS models (HaCaT NCSTN-/-line) versus the healthy model (HaCaT wild type) by performing wound healing and migration assays (IBIDI) with and without the addition of exogenous PAMs lacking in HS.
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