title: Compartmentalized Cytokine Responses in Hidradenitis Suppurativa.
abstract: BACKGROUND
  Favorable treatment outcomes with TNF blockade led us to explore cytokine responses in hidradenitis suppurativa (HS).
  
  
  METHODS
  Blood monocytes of 120 patients and 24 healthy volunteers were subtyped by flow cytometry. Isolated blood mononuclear cells (PBMCs) were stimulated for cytokine production; this was repeated in 13 severe patients during treatment with etanercept. Cytokines in pus were measured.
  
  
  RESULTS
  CD14brightCD16dim inflammatory monocytes and patrolling monocytes were increased in Hurley III patients. Cytokine production by stimulated PBMCs was low compared to controls but the cytokine gene copies did not differ, indicating post-translational inhibition. The low production of IL-17 was restored, when cells were incubated with adalimumab. In pus, high concentrations of pro-inflammatory cytokines were detected. Based on the patterns, six different cytokine profiles were discerned, which are potentially relevant for the choice of treatment. Clinical improvement with etanercept was predicted by increased production of IL-1β and IL-17 by PBMCs at week 8.
  
  
  CONCLUSIONS
  Findings indicate compartmentalized cytokine expression in HS; high in pus but suppressed in PBMCs. This is modulated through blockade of TNF.
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Kanni
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Tzanetakou
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Savva
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
authors.forename: Brigit
authors.initials: B
authors.lastname: Kersten
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Pistiki
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
authors.forename: Frank L
authors.initials: FL
authors.lastname: van de Veerdonk
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
authors.forename: Mihai G
authors.initials: MG
authors.lastname: Netea
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
authors.forename: Jos W
authors.initials: JW
authors.lastname: van der Meer
authors.affiliation: 4th Department of Internal Medicine, University of Athens, Medical School, Athens, Greece; Department of Internal Medicine, Radboud University Medical Center and Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism*; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D017497:Hidradenitis Suppurativa / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020381:Interleukin-17 / Q000378:metabolism; D053583:Interleukin-1beta / Q000235:genetics / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000378:metabolism; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology / Q000378:metabolism; D017452:Receptors, IgG / Q000378:metabolism; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000378:metabolism
chemical_list: D016207:Cytokines; C508717:IL17A protein, human; D007166:Immunosuppressive Agents; D020381:Interleukin-17; D053583:Interleukin-1beta; D018950:Lipopolysaccharide Receptors; D017452:Receptors, IgG; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept