Dupuytren Award of the International Dupuytren Society

The difficulties The first surgical procedures for Dupuytren's disease were simple aponeurotomies.

The International Dupuytren Award

Portals proximal and/or distal to the distal interphalangeal joint flexion creases are used, some bilaterally.

These are presented to illustrate the diversity of even this subset of Dupuytren disease.

The second is found in hypertrophic scars, in fibromatoses and Dupuytren's disease.

Dupuytren diathesis by Natalie Gutierrez - issuu

During the past years, the Department of Plastic Surgery of the University Medical Centre Groningen initiated a large study on the genetic background of Dupuytren disease. This study was done in cooperation with medical centres in the Netherlands, England and Germany. Several genes were identified to be involved in Dupuytren disease, and we found that the Wnt signalling pathway plays an essential role in the disease pathology. This research project has been continued, focussing on cell biology processes, including the Wnt pathway, that form the origin of Dupuytren disease and associated fibromatoses. This leads to a better understanding of the pathology, and provides valuable information on possible starting points for future treatment options. Recently a new PhD project was started, focussing on genetic variants in Dupuytren’s Disease in general, and the functional implications of the NEDD4 locus more specifically.

– There have not been enough trials comparing treatments or outcomes in Dupuytren’s disease.

The main difference between the two pathological conditions is the greater amount of collagen in Dupuytren's tissue and the fact that tightly packed collagen bundles were never seen in knuckle pads.
Even in the presence of well-developed myofibroblasts, knuckle pads do not retract.

– Neither the DASH nor the URAM may be ideal questionnaires when measuring Dupuytren’s

Links and literature on Dupuytren surgery (fasciectomy)

In Australia a group of scientists, notably Swaminathan Iyer, PhD and colleagues from The University of Western Australia, the Fiona Wood Foundation and Royal Perth Hospital Burns Unit, and Pharmaxis Ltd are working on a LOX (lysyl oxidase) inhibitor, that has the potential to prevent crosslinking between collagen fibres (LOX promotes this crosslinking). The product has been tested in vitro, and now they are at a stage to start trials in Dupuytren specific settings, animal models and eventually in patients. It is hoped a topical application will be possible, also for burns and keloid patients.

Published on the Internet is the thesis of J ..

Dupuytren’s disease causes one or more fingers to curl into the palm due to the contracting and toughening of connective tissue under the skin of the palm. While surgery is commonly used to remove the contracted tissue, ultimately it can lead to hand deformity and impaired function, and not uncommonly it leads to amputation.

Reviews of side effects of Dupuytren surgery.

In the Biotechnology Research Centre of Al-Nahrein University in Baghdad, Dr Niyaf Alkadhem and colleagues have examined the effect of caffeine on Dupuytren’s fibroblasts. Since caffeine was proven to reduce fibrosis in rodents, they cultured fibroblasts in experimental models, and stimulated them with TGF-b to transform into myofibroblasts. Then some cultures were treated with caffeine which resulted in less proliferation and less alpha-smooth muscle actin than the untreated ones. However when the cells were grown under tension caffeine failed to have an effect on contraction. Therefore the conclusion was that caffeine affects cellular pathways relating to migration rather than contraction or tension generation. Treating existing fibrotic conditions with caffeine may prove challenging for this reason.

The project was completed and a thesis defended for PhD.

People suffering from Dupuytren’s disease could ultimately regain the function of their hands and quality of life, thanks to the work of the in New Zealand.

A Systems Approach to Understanding Dupuytren's …

Drs Latha Satish MSc, PhD and Dr Sandeep Kathju MD, PhD at the Department of Plastic Surgery, University of Pittsburgh, USA have been collaborating for many years now to understand the pathophysiology and the gene expression changes that contribute to the progression and/or recurrence of Dupuytren’s contracture. Our previous data examining the global gene expression patterns of DD-derived fibroblasts versus control carpal tunnel (CT)-derived fibroblasts confirms that there are numerous differences in their transcriptomes (mRNA expression) even in in vitro culture, indicating a stable intrinsically distinct disease pathology for DD-cells. Recently, for the first time, we have described an animal model for Dupuytren’s disease at the physiologically relevant orthotopic location. We also showed that gene expression differences seen between CT- and DD-derived fibroblasts persisted even in in-vivo. Using the animal model that we have developed which shows increased evidence of fibrosis in the forepaw that received the DD cells compared to CT cells we are currently pursuing with novel therapeutic interventions to diminish the DD-dependent fibrosis. We are also in the process of refining the animal model to recapitulate the disease completely. Our research is being funded by Private Donor Donation, Department of Plastic Surgery and the Pittsburgh Foundation.