# Restoring Immune Balance in Hiddradenitis Suppurativa

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $709,450

## Abstract

Project Summary/Abstract
Hidradenitis Suppurativa (HS) is a chronic debilitating inflammatory skin disease. Despite its high prevalence and
morbidity, HS is understudied, and there is currently no uniformly effective treatment for this condition. Elucidation of
disease pathogenesis, target identification and evaluation of novel treatments has been limited by the lack of
comprehensive studies examining the immunology of this disease. This is compounded further by the fact that there are
currently no animal models that accurately recapitulate the findings seen in HS skin. We have assembled a multi-
disciplinary team of investigators at UCSF to better understand the immunopathogenesis of HS at both the cellular and
molecular levels. This is centered around the recently established 'UCSF Hidradenitis Suppurativa Center of Excellence'
(HSCE), a clinic dedicated entirely to providing first-rate care for HS patients and performing translational studies in this
disease. With the HSCE, my laboratory has made significant advances in our understanding of the immunology of HS,
including new observations of defects in the regulatory T cell (Treg) compartment. Tregs normally reside around hair
follicles and regulate both neutrophilic inflammation and dermal fibrosis, two pathologic hallmarks of HS skin. Our
preliminary results suggest that Tregs are both quantitatively and qualitatively defective in skin of HS patients. We
hypothesize that dysfunctional Treg-mediated control of Th17 immune responses plays a central role in the
pathogenesis of HS and that correcting this imbalance will effectively ameliorate inflammation and restore tissue
immune homeostasis. Experiments outlined in this proposal will functionally dissect the cellular and molecular
mechanisms controlling the Treg/Th17 balance in HS skin. We have developed an innovative ex vivo immune cell assay
using HS skin. In addition, we have begun to establish a humanized mouse model of HS that recapitulates the
inflammatory infiltrate observed in diseased skin of these patients. In these newly established model systems, we will
utilize a novel molecule that preferentially binds to the high affinity IL-2 receptor to functionally determine if selective
Treg augmentation attenuates inflammation in HS skin. In addition, we have recently discovered two cell surface
receptors preferentially expressed on Tregs in human skin, CD27 and OX40, that play a major role in inhibiting Th17
differentiation in these cells. In separate experiments, we will determine whether inhibiting Th17 differentiation in Tregs
via signaling through CD27 and/or OX40 restores immune balance in HS. The experiments outlined in this proposal
represent a conceptually and technically innovative, comprehensive, and multidisciplinary approach to elucidate how
functional manipulation of the Treg/Th17 differentiation axis influences inflammation in HS skin. The Th17 pathway in
human skin has primarily been studied in psoriasis and several therapeu...

## Key facts

- **NIH application ID:** 9962173
- **Project number:** 1R01AR075864-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Michael David Rosenblum
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $709,450
- **Award type:** 1
- **Project period:** 2020-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9962173

## Citation

> US National Institutes of Health, RePORTER application 9962173, Restoring Immune Balance in Hiddradenitis Suppurativa (1R01AR075864-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9962173. Licensed CC0.

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