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-1 beta, 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.