What is the role of toll-like receptors in the pathophysiology of hidradenitis suppurativa (HS)?

Updated: Nov 20, 2020
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Toll-like receptors play an integral role in the innate immune response to bacteria. A highly increased expression of toll-like receptor 2 (TLR2) by CD68+ macrophages and CD209+ dendritic cells in acne inverse skin lesions was found. [38]

Apart from Toll-like receptor 2 activating microbial products as an important trigger factor in the chronic inflammatory process, the inflammatory reactions leading to hidradenitis suppurativa are only poorly understood, but they show many similarities with other inflammatory reactions such as with psoriasis; proinflammatory cytokines interleukin (IL)‒12 and IL-23 are mediators in autoimmune tissue destruction and are abundantly expressed by macrophages in hidradenitis suppurativa; IL-23 has been shown to be involved in the induction of a T-helper cell subset named Th17; antimicrobial peptides beta-defensin 2, Psoriasin, and cathelicidin are highly up-regulated in lesions of psoriasis and in hidradenitis suppurativa, which may at least in part, explain the clinical finding that hidradenitis suppurativa patients only rarely have skin infections. [1]

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