The Magnitude of mTORC1 Signalling May Predict the Response to Isotretinoin Treatment in Patients with Hidradenitis Suppurativa

Vita, Valerio De; Melnik, Bodo C.

doi:10.1159/000484408

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…In fact, the isotretinoin efficacy seems to be limited mainly to subgroups of patients with specific profiles 14 and the magnitude of mTORC1 signaling may be a predictor of the response to isotretinoin treatment. 15 …”

Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa with SAPHO syndrome maintained effectively with adalimumab, methotrexate, and intralesional corticosteroid injections

Crowley

O’Toole

Gooderham

2018

SAGE Open Medical Case Reports

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Introduction:Hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome are chronic, debilitating diseases involving apocrine gland-bearing skin inflammation and bone inflammation, respectively. Although both often present with multiple comorbidities, single patient co-presentation is rare.Methods/Results:This study reports the 8-year treatment course of a 40-year-old man with hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome, and reviews relevant literature. Initial oral and topical antibiotics had little effect. Intralesional corticosteroid injections were effective for localized inflammatory lesions but insufficient for hidradenitis suppurativa control. Adalimumab initiation and local excision of a persistent HS lesion led to stabilization. Adalimumab provided dramatic back pain improvement. Synovitis, acne, pustulosis, hyperostosis, osteitis was diagnosed; adalimumab continuation with subsequent methotrexate addition resulted in hidradenitis suppurativa-synovitis, acne, pustulosis, hyperostosis, osteitis control.Conclusions:Literature regarding comorbid hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome therapy is scarce but growing. Adalimumab, methotrexate, intralesional corticosteroid, and lifestyle changes successfully maintained a severe hidradenitis suppurativa–synovitis, acne, pustulosis, hyperostosis, osteitis–syndrome case. Further studies beyond a case-based review could yield more definitive treatment plans.

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Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa with SAPHO syndrome maintained effectively with adalimumab, methotrexate, and intralesional corticosteroid injections

Crowley

O’Toole

Gooderham

2018

SAGE Open Medical Case Reports

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“…According to Tsai et al, normal folic acid level, isotretinoin can have an inhibitory effect on homocysteine pathway (Tsai et al, ). Hence, isotretinoin has a dual effect on HS pathogenesis and associated cardiovascular comorbidities through suppression of (mTORC1) (De Vita & Melnik, ) and its effect on homocysteine, respectively.…”

Section: Indications Of Low‐dose Isotretinoin In Dermatologymentioning

confidence: 99%

“…Isotretinoin may also exert its anti-inflammatory effect through suppression of mTORC1 in a subgroup of isotretinoin-responsive patients (De Vita & Melnik, 2017). Others noted a plausible antiinflammatory role of isotretinoin through downregulation of inflammatory driving protein, S100a7a (Al-Sudany, Mohammed, & Alrifai, 2019).…”

Section: Introductionmentioning

confidence: 99%

Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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Isotretinoin is a first‐generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti‐inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date‐unlimited PubMed search, from inception till December 2019, using the following search terms: “low‐dose isotretinoin” and “dermatology,” “isotretinoin and safety,” “isotretinoin, off‐label uses,” “isotretinoin and male fertility,” “isotretinoin, iPLEDGE system,” aiming to deliver a therapeutic update relevant to clinical practice. All English‐language articles were considered with no limitation based on the articles' type. Low‐dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

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“…Metformin, a drug that reduces insulin resistance, has been identified as an mTORC1 inhibitor and attenuates psoriasis vulgaris and HS. 4 In summary, evidence suggests that HS and T2DM share a common pathogenic substrate, namely hyperactivated mTORC1 signaling. Funding sources: None.…”

mentioning

confidence: 95%

“…Notably, the differentiation of T helper 17 (T H 17) cells is controlled and promoted by mTORC1. 4 Substantial infiltration of T H 17 cells into lesional skin and increased IL-17 serum levels have been found in HS patients. 5 Evidence shows that interleukin (IL)-17 also plays a key role in insulin resistance and diabetes mellitus.…”

mentioning

confidence: 99%

Activated mTORC1 signaling: The common driving force of type 2 diabetes and hidradenitis suppurativa

Vita

Melnik

2018

Journal of the American Academy of Dermatology

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The Magnitude of mTORC1 Signalling May Predict the Response to Isotretinoin Treatment in Patients with Hidradenitis Suppurativa

Cited by 11 publications

References 26 publications

Hidradenitis suppurativa with SAPHO syndrome maintained effectively with adalimumab, methotrexate, and intralesional corticosteroid injections

Hidradenitis suppurativa with SAPHO syndrome maintained effectively with adalimumab, methotrexate, and intralesional corticosteroid injections

Low dose of isotretinoin: A comprehensive review

Activated mTORC1 signaling: The common driving force of type 2 diabetes and hidradenitis suppurativa

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