Immunological pathways in Hidradenitis Suppurativa and potential therapeutic targets. (360G-Wellcome-217652_Z_19_Z)

Hidradenitis Suppurativa (HS) is a chronic skin condition consisting of abscesses, boils and sometimes scarring in the groin, armpits and under the breasts. It has a severe impact on quality of life. There is dysregulation of the immune system. There is only 1 licensed treatment for moderate to severe HS, adalimumab, a TNF-α inhibitor. It is effective in 50% of patients. This project aims to improve the understanding of the role of the immune system in HS. We will compare the immune profiles in patients skin and fluid collected from their skin, before and after treatment with adalimumab, to try to identify differences in patients who respond and those who don't. We will compare HS immune profiles to patients with psoriasis, atopic eczema and healthy controls. We will also look at targeting IL-17 and IL-23 as potential therapeutic options. A final part of the study will look at the use of metformin to treat HS. Approximately 50% of HS patients have metabolic syndrome. Metformin is a useful treatment for HS but little is know about how or why it works. We will look at its effect on HS, metabolic markers, inflammatory markers, as well as skin and blood cytokines.