Advances in hidradenitis suppurativa
Transcript: What are the biggest unknowns in HS pathophysiology?
Martina Porter
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The pathophysiology of HS, I think is still quite difficult. There's a few things that we know for certain, like this is a disease of hair follicles, and they tend to get included from some process that causes hyperkeratosis, and then they get very inflamed, and I think we're still trying to understand exactly what that inflammation is and if it's T-cell-driven, or B-cell-driven, or a combination, and we've found out a lot in the last five years and some of it has been because we've tried so many different therapies and some are more effective than others, and this has help elucidate some of the pathways.
But even as we start to understand the disease, HS is a little bit different than some of our other classic inflammatory skin disorders because there is a significant amount of disfiguration and scarring that occurs over time, and patients are much more likely to progress and have long-term effects, I think of having the disease. And I think it'll be interesting to see, when we think of the pathophysiology, are there different inciting events in onset and initiation of disease, and then in sort of long term, long-standing disease?
And are these patients inflammatory profiles similar at, you know, zero to one year or two years, or two to 10 years, or 10 years and beyond? Because what we've found even in some of our trials is that patients who have longer-standing disease are more refractory to treatment, and it is sort of independent of disease severity.
So it'd be interesting to see, I think, if there's actually changes in the pathophysiology over time as well. But I think the more trials we do and the more we are really studying the disease, the more I expect to hopefully find answers.
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