Peripheral blood immunophenotyping in a predominantly African American cohort reveals a role for Type 2 immune dysregulation in hidradenitis suppurativa

Summary: Abstract Body: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease disproportionately affecting African American (AA) patients. HS is known to be a Th1 and Th17 inflammatory disease and treatments exist targeting these pathways, however the disease is known to have significant heterogeneity. We wanted to investigate the specific role of Type 2 immune responses in HS. We conducted a study including a cohort of primarily African American (AA) HS patients. We analyzed 28 patients with HS, of which 20 patients were African American and primarily Hurley Stage 3. Comprehensive immunophenotyping included whole blood flow cytometry, peripheral blood mononuclear cells (PBMC) cytometry by time-of-flight (CyTOF), and cytokine analysis using the Eve Cytokine Panel on serum samples. Cytokine analysis revealed elevated Th2 markers, including IL-4 (p<0.01) and IL-31 (p<0.05), in serum from HS patients. Whole blood flow cytometry demonstrated increased circulating basophils (p<0.0001), consistent with a Th2-skewed immune response. PBMC CyTOF analysis subsequently identified a marked increase in Th2 cells (p<0.05) (CD45+, CD4+, GATA3+). These findings suggest a dysregulated Th2 immune response in African American patients with HS. Our study indicates that African American patients with HS exhibit a heightened Th2 immune profile, as evidenced by increased Th2 cytokines, circulating basophils, and Th2 cell populations, suggesting a need for agents targeting broader immune axes in HS. Louis J. Born¹, Kavita Vats¹, Yagiz M. Akiska¹, Shahin Shahsavari¹, Davies Gage¹, Thomas Pritchard¹, Madan M. Kwatra^{2, 3}, Shawn Kwatra¹ 1. Department of Dermatology, University of Maryland Baltimore School of Medicine, Baltimore, MD, United States. 2. Department of Anesthesia, Duke University School of Medicine, Durham, NC, United States. 3. Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, United States. Minoritized Populations and Health Disparities Research