The microbiome of tunnels in hidradenitis suppurativa patients

Abstract

Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels and scarring involving the intertriginous regions. Recent next‐generation sequencing (NGS) studies suggest genera such as Prevotella spp., Peptoniphilus spp. and Porphyromonas spp. are associated with chronic and early HS lesions. However, a systematic investigation of the bacterial microbiome in HS tunnels remains unexplored using NGS. Objective We aimed to investigate the bacterial composition of the luminal white gelatinous material found in HS tunnels using NGS. Methods An exploratory study of patients with diagnosis of HS (n = 32) with tunnels. The tunnels were present either in the groin (n = 17) or in the axilla (n = 15). During deroofing of the tunnels, a sterile E‐swab was taken of the luminal gelatinous material. The samples were investigated using NGS targeting 16S ribosomal RNA. Results The skin microbiome was characterized in 32 HS patients. Overall, five microbiome types were identified: Porphyromonas spp. (type I), Corynebacterium spp., (type II), Staphylococcus spp. (type III), Prevotella spp. (type IV) and Acinetobacter spp (type V). Porphyromonas spp. (type I) and Prevotella spp. (IV) were the most frequent genera found the tunnels. Conclusion This study points to a potential association between the presence of certain anaerobic bacteria (Porphyromonas spp., Prevotella spp.) and HS tunnels. It may be speculated that these two genera are associated with the pathogenesis in HS either as drivers or as biomarkers.

The Role of the Cutaneous Microbiome in Hidradenitis Suppurativa—Light at the End of the Microbiological Tunnel

“…Bacterial diversity was increased in HS skin when compared to healthy controls, at least in terms of the inguinal region. Consistent with Ring et al [61], there was an abundance of Prevotella and Porphyromonas, which may underpin an association between these bacteria and disease severity. As the authors themselves acknowledged, the cross-sectional nature of the study and relatively small number of participants should be borne in mind before extrapolating the results to the wider HS population.…”

“…Moreover, the composition of the HS microbiota varied with clinical severity, with Prevotella and Porphyromonas associated with lesions. Consistent with the early metagenomic studies [59,60], recent studies have confirmed the association between Prevotella and Porphyromonas and HS, particularly in HS tunnels [61].…”

Integrating complement into the molecular pathogenesis of Hidradenitis Suppurativa

“…Peptinophillus species as strongly associated with disease activity, [39] particularly in the setting of dermal tunnels in HS. [40,41] Porphyromonas has also been implicated as an activator of both complement and the Th17 axis in chronic periodontitis, a mucosal disease featuring biofilm formation similar to HS. [42,43] These pathogens-derived proteases can also cleave cell-surface receptors such as CD14, resulting in impaired clearance of apoptotic cells and promotion of chronic inflammation.…”

Clinical, microbiological, immunological and imaging characteristics of tunnels and fistulas in hidradenitis suppurativa and Crohn’s disease

“…not previously reported in microbiological HS studies using traditional culturing . Only one study has systematically investigated the luminal microbiome of HS tunnels using NGS . Overall, five microbiome types were identified among 32 HS tunnels: Porphyromonas spp.…”

“…[10,11] Only one study has systematically investigated the luminal microbiome of HS tunnels using NGS. [12] Overall, five microbiome types were identified What is already known about this topic?…”