Hyper IgM syndrome type 2 presenting as intestinal lymphoid polyposis without recurrent infection

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Effects of adalimumab on T-helper-17 lymphocyte- and neutrophil-related inflammatory serum markers in patients with moderate-to-severe hidradenitis suppurativa.

BACKGROUND: T-helper (Th)-17 lymphocytes and neutrophils are the main sources of the proinflammatory cytokines involved in the pathogenesis of hidradenitis suppurativa (HS). OBJECTIVES: This study aims to evaluate the improvement of the inflammatory serum markers (ISM) levels in patients with moderate-to-severe HS who receive adalimumab. METHODS: Nineteen moderate-to-severe HS patients were prospectively recruited. Each of the patients received 40 mg of adalimumab weekly. The ISM levels and modified Hidradenitis Suppurativa Score (mHSS) scores were assessed at baseline and at week 36. Nineteen healthy volunteers (HC) constituted the control group. RESULTS: Before adalimumab treatment, the HS patients showed significantly increased levels of interleukin (IL)-6, IL-8, IL-10, IL-17A, soluble TNF receptor II (sTNF-RII), and C-reactive protein (CRP) as well as an increased erythrocyte sedimentation rate (ESR) (all P < .01). At week 36, the circulating levels of IL-1ß, IL-6, IL-8, IL-10, IL-17A, soluble TNF receptor I (sTNF-RI), sTNF-RII, and CRP, as well as the ESR (all P < .05), decreased significantly in the HS patients who received adalimumab. The decrease in levels of IL-6 (r = 0.65, P = .003), IL-8 (r = 0.52, P = .024), sTNF-RI (r = 0.55, P = .015), and CRP (r = 0.47, P < .040) and the ESR (r = 0.60, P < .006) were significantly well correlated with clinical improvements according to the mHSS. CONCLUSIONS: Adalimumab improves the ISM-based systemic inflammatory burden in patients with moderate-to-severe HS. IL-6, IL-8, sTNF-RI and CRP and the ESR may serve as novel biomarkers for a therapeutic response.

The Clinical Significance of Increased Serum Proinflammatory Cytokines, C-Reactive Protein, and Erythrocyte Sedimentation Rate in Patients with Hidradenitis Suppurativa.

OBJECTIVES: To assess inflammatory serum markers including serum proinflammatory cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) according to the clinical inflammatory activity of patients with hidradenitis suppurativa (HS). PATIENTS AND METHODS: Seventy-four patients with HS were studied based on the Hidradenitis Suppurativa-Physician Global Assessment (HS-PGA) score and Hurley staging system. Proinflammatory cytokines were measured using a multiplex cytokine assay. Twenty-two healthy volunteers were recruited. RESULTS: Serum interleukin- (IL-) 6, IL-23, soluble tumour necrosis factor alpha (TNF-α) receptor I (sTNF-RI), CRP, and ESR were different in the patients with HS compared with those in the healthy controls (P < 0.05). The levels of IL-1ß, IL-6, IL-8, IL-10, IL-12p70, IL-17A, sTNF-RII, CRP, and ESR were significantly elevated according to inflammatory activity based on HS-PGA scores (r > 0.25, P < 0.05). The levels of IL-6 (r = 0.53, P < 0.001), CRP (r = 0.54, P < 0.001), and ESR (r = 0.60, P < 0.001) were especially well correlated with clinical inflammatory activity based on HS-PGA scores. The levels of IL-6, IL-8, sTNF-RI, sTNF-RII, CRP, and ESR were significantly elevated according to Hurley staging system. CONCLUSIONS: Serum proinflammatory cytokines, CRP, and ESR are increased in relation to the clinical inflammatory activity of patients with HS compared with healthy controls. Serum IL-6, CRP, and ESR are effective biomarkers for evaluating the severity of HS.