Investigating the Role of Hair Follicles in the Altered Immune Status in Hidradenitis Suppurativa

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disorder characterized by painful boils in hair follicle-rich of the skin areas like the axillae and perineum. First described by Alfred Velpeau in 1839, HS was initially thought to stem from sweat gland inflammation. By the 1950s, the focus shifted to hair follicle occlusion as the core issue, linking HS to the "follicular occlusion triad." Globally, HS prevalence varies, with estimates up to 4.1%, being more common in women, especially in Western populations. The pathogenesis involves disruptions in the pilosebaceous unit, influenced by genetic factors, loss of hair follicle stem cell quiescence, DNA replication stress, and mechanical stress all leading to immune dysregulation and chronic inflammation. This project aims to investigate the Immunoglobulin G response in HS using western blotting and immunofluorescence techniques and by comparing serum from HS patients with those from individuals with other inflammatory skin disorders and healthy controls. While HS patients did not show the expected heightened reactivity to Pilosebaceous unit associated antigens, when compared with the control groups, the findings suggest that other factors, such as immunosuppressive treatments, and the histomorphology of scalp tissue may play a role in antibody-antigen interactions. Low intensity IgG reactivity was observed when hair follicle structures were targeted specifically. However, both western blot and immunofluorescence analysis of HS skin showed some evidence of IgG deposition in the HS tissue itself. These results also underscore the need for further research identifying other classes of immunoglobulins, and characterization of the IgG (e.g. IgA) subclasses between the different patient groups to gain a clearer understanding of the disease’s immunopathology.