Evaluation of levels of LRG1 (Leucine-rich α-2-glycoprotein 1), IL-1ß, IL-6, IL-17A, TNF-alpha, and hs-CRP in serum samples of patients with Hidradenitis Suppurativa.

Project no. 31867 · Status: Kapanmış (Yayın bekleniyor) · 2023

Summary

Hidradenitis Suppurativa (HS) is a chronic, quality-of-life-impairing, inflammatory disease characterized clinically by painful nodules, abscesses, sinus tracts, and draining fistulas that primarily occur in areas rich in apocrine glands, such as the axillary, inguinal, and gluteal regions. The primary disorder in the pathophysiology of HS is obstruction of the folliculopilosebaceous unit, follicular rupture, and eventually the activation of innate and adaptive immune responses. Pro-inflammatory cytokines like Interleukin (IL)-1β and Tumor Necrosis Factor-α (TNF-α), mediators such as IL-17 mediated by activated T helper (Th)1 and Th17 cells, as well as neutrophils, macrophages, and plasma cells, play a role in this process. This inflammatory vicious cycle results in pain, purulent discharge, tissue destruction, and scar formation. Leucine-rich α2-glycoprotein 1 (LRG1) has recently gained prominence as an acute- phase protein shown to have elevated levels in various inflammatory diseases, including rheumatoid arthritis, ulcerative colitis, and psoriasis. Through IL-6-mediated expression, it plays a role in Th17 differentiation in naïve Th cells and contributes to angiogenetic and fibrotic processes via TGF-β). In this study, LRG1 levels, which have not been previously studied in HS patients, and some inflammatory markers previously shown to be associated with HS [IL-6, IL-1β, IL- 17A, TNF-α, and high-sensitivity C-reactive protein (hs-CRP)] were compared with a control group and according to disease severity.MATERIALS AND METHODSThe study included volunteer HS patients (n=40) diagnosed based on well-defined clinical criteria and age- and gender-matched healthy controls (n=40) who presented to the Dermatology and Venereology Department of Ege University Medical Faculty between July 2023 and August 2024. Subjects with known tumoral diseases, active infections, those receiving systemic therapy, or having undergone surgical procedures within the last month were excluded. The patients' family history, age of disease onset, smoking status, comorbidities, and body mass index (BMI) were recorded. Disease severity was assessed using the Hidradenitis Suppurativa Physician Global Assessment (HS-PGA) and Hurley staging systems. Blood samples (5 milliliters) were collected under sterile conditions, and the sera were separated promptly and stored at -80°C in the Biochemistry Department of Ege University. The samples were later analyzed using ELISA kits.RESULTSAmong the HS patients included in the study, 67.5% were male and 32.5% were female, with an average age of 34.63 ± 10.67 years (median 34). Both groups had similar age and gender distributions. Of the patients, 85% were smokers, and their average BMI was 30.06 ± 5.98 (median 29.5). HS patients had a statistically significant higher smoking history and BMI compared to healthy controls (p<0.05). Serum levels of IL-6, IL-1β, IL-17A, TNF-α, and hs-CRP were found to be significantly elevated in the patient group compared to healthy controls (p<0.05). However, the mean serum LRG1 levels were similar between the patient and control groups, showing no statistical significance (p>0.05). No correlation was found between LRG1 levels and IL-6, IL-1β, IL-17A, TNF-α, or hs-CRP. A positive correlation was observed between hs-CRP levels and IL-6, IL-1β, IL-17A, and TNF-α (p<0.05). When evaluated by disease severity, no association was found between LRG1, IL-6, IL-1β, IL-17A, TNF-α, and hs-CRP levels according to HS-PGA and Hurley staging (p>0.05). Additionally, no significant relationship was observed between smoking history, gender, and BMI levels with serum LRG1, IL-6, IL-17A, IL-1β, TNF-α, and hs-CRP levels (p>0.05).CONCLUSIONOur study results support the role of IL-6, IL-1β, IL-17A, and TNF-α in the pathogenesis of HS. Elevated serum levels of IL-6, IL-1β, IL-17A, and TNF-α, even in patients with mild HS, suggest that the inflammatory process is evident early in the disease, indicating that targeting these inflammatory molecules could be effective in preventing disease progression at an early stage. The finding that LRG1 levels were similar between HS patients and healthy controls suggests that LRG1 may have limited potential as a biomarker for HS.

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