Overview of the pathogenesis, diagnosis and treatment of Dupuytren's disease

Mandel, David R.; DeMarco, Paul J.

doi:10.2217/ijr.14.14

Cited by 4 publications

(5 citation statements)

References 44 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results from a newly examined population support existing evidence on the role of WNT signaling in the development of Dupuytren’s contracture. Major progress in this field could possibly provide therapeutic possibilities for an illness which currently has no etiological treatment options available [ 28 , 29 , 30 , 31 ]. However, SNPs discovered to date represent just a part of the whole mechanism of DC pathogenesis, leaving much to research further.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of WNT Signaling Pathway Gene Variants WNT7B rs6519955, SFRP4 rs17171229 and RSPO2 rs611744 in Patients with Dupuytren’s Contracture

Samulėnas

Smalinskienė

Rimdeika

et al. 2021

Genes

View full text Add to dashboard Cite

Dupuytren’s contracture (DC) represents a chronic fibroproliferative pathology of the palmar aponeurosis, which leads to flexion contractures of finger joints and hand disability. In recent decades, the WNT signaling pathway has been revealed to play a significant role in the manifestation and pathogenesis of DC. Our study aimed to evaluate the associations between Dupuytren’s contracture and WNT-related single-nucleotide polymorphisms: Wnt Family Member 7B (WNT7B) rs6519955 (G/T), Secreted Frizzled Related Protein 4 (SFRP4) rs17171229 (C/T) and R-spondin 2 (RSPO2) rs611744 (A/G). We enrolled 216 patients (113 DC cases and 103 healthy controls), and DNA samples were extracted from the peripheral blood. Genotyping of WNT7B rs6519955, SFRP4 rs17171229 and RSPO2 rs611744 was performed using the Real-Time PCR System 7900HT from Applied Biosystems. WNT7B rs6519955 genotype TT carriers were found to possess a higher prevalence of DC (OR = 3.516; CI = 1.624–7.610; p = 0.001), whereas RSPO2 rs611744 genotype GG appears to reduce the likelihood of the manifestation of DC nearly twofold (OR = 0.484, CI = 0.258–0.908, p = 0.024). In conclusion, SNPs WNT7B rs6519955 and RSPO2 rs611744 are associated with the development of Dupuytren’s contracture: WNT7B rs6519955 TT genotype increases the chances by 3.5-fold, and RSPO2 rs611744 genotype GG appears to attenuate the likelihood of the manifestation of DC nearly twofold. Findings of genotype distributions among DC patients and control groups suggest that SFRP4 rs17171229 is not significantly associated with development of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of WNT Signaling Pathway Gene Variants WNT7B rs6519955, SFRP4 rs17171229 and RSPO2 rs611744 in Patients with Dupuytren’s Contracture

Samulėnas

Smalinskienė

Rimdeika

et al. 2021

Genes

View full text Add to dashboard Cite

show abstract

“…Nodules tend to be composed mostly of myofibroblasts, and cords are made up of mostly fibroblasts. In addition to Dupuytren's contracture, these cells are also associated with other disorders, including hypertrophic scarring, Peyronie's disease, liver cirrhosis, cataract formation, pulmonary fibrosis, and valvular heart disease [1][2][3] .…”

Section: Pathophysiologymentioning

confidence: 99%

“…Obesity may offer some protection against developing Dupuytren's contracture. A small per-centage of patients may exhibit some degree of spontaneous regression 1,3,4 .…”

Section: Epidemiologymentioning

confidence: 99%

Dupuytren's Contracture: A Case Review

Hricz

2023

JBJS Journal of Orthopaedics for Physician Assistants

View full text Add to dashboard Cite

Dupuytren contracture is a contraction disorder of the hand related to an abnormal myofibroplastic process. An autoimmune response may trigger fibroblasts to proliferate along lines of tension within bands of the palmar fascia and other tissues within the hand resulting in fibrous cords and nodules of the hand. Risk factors include Scandinavian or Northern European descent, trauma, chronic use of vibrating tools, medical disorders such as diabetes, HIV, epilepsy, and vascular disease as well as a social history of smoking or alcoholism. The disorder is relatively painless, and patients tend to delay seeking care until the contracture has progressed to the point of causing some degree of disability or impacting their daily lives. Treatment options include surgical fasciectomy, collagenase injections, or needle fasciotomy followed by occupational therapy interventions such as splinting and stretching. Intervention is generally effective in improving symptoms and functionality; however, recurrence is still possible.

show abstract

“…Extra-palmar manifestations may involve the knuckles (Garrod's pads), feet (Ledderhose disease) and penis (Peyronie's disease). 2 The Dupuytren's diathesis predicts a more aggressive disease course 3 and is defined by disease onset in youth, the involvement of multiple rays including the radial digits and extra-palmar disease. 4 The precise disease aetiology is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…2 Known associations include male gender, advancing age, alcohol use, smoking, infection with HIV, diabetes mellitus, anti-epileptic medications and working with vibrating tools. 3,5 The pathogenesis of the disease also remains unknown. Several theories have been proposed including a perpetuating cycle of ischaemia, free radical production, tissue contracture and further ischaemia.…”

Section: Introductionmentioning

confidence: 99%

Using collagenase to treat Dupuytren’s disease: a hypothetical cost benefit analysis

Livingston¹,

Wagels²,

Heald³

2019

Australas J Plast Surg

View full text Add to dashboard Cite

Background: Collagenase, an enzyme produced by clostridium histolyticum (CCH), is a relatively new injection able to cleave collagen strands in vitro. While not yet available on the PBS, the side effect profile and risk of recurrence of collegenase injections are comparable to fasciectomy in appropriately selected patients. In this study, we aimed to demonstrate the safety and cost-effectiveness of collagenase for the treatment of Dupuytren’s disease. Method: Twenty-five patients at our hospital received collagenase injections for treatment of their Dupuytren’s disease. Data from this cohort was compared to a hypothetical group extrapolated from the literature. Results: Surgical treatment, excluding outpatient visits, costs on average AU$5852 per patient and collagenase costs AU$1176 per patient (gross cost difference AU$4676). Moderating this cost difference by the effect of complications using the incremental cost effectiveness ratio, the cost saving is AU$1137.71 per unit decrease in complications with collagenase treatment. Surgical fasciectomy has a lower risk of recurrence than collagenase but costs up to AU$543 more for patients for whom the condition does not recur within five years of treatment. In our cohort, 25 patients had 31 cords injected with collagenase. All but two patients achieved full range of motion of their affected joint and 20 per cent sustained minor skin tears requiring dressings. Conclusion: This analysis suggests that the investment of public health funds in the treatment of suitable patients with collagenase should produce a substantial cost saving without increasing the risk of complications.

show abstract

Overview of the pathogenesis, diagnosis and treatment of Dupuytren's disease

Cited by 4 publications

References 44 publications

Evaluation of WNT Signaling Pathway Gene Variants WNT7B rs6519955, SFRP4 rs17171229 and RSPO2 rs611744 in Patients with Dupuytren’s Contracture

Evaluation of WNT Signaling Pathway Gene Variants WNT7B rs6519955, SFRP4 rs17171229 and RSPO2 rs611744 in Patients with Dupuytren’s Contracture

Dupuytren's Contracture: A Case Review

Using collagenase to treat Dupuytren’s disease: a hypothetical cost benefit analysis

Contact Info

Product

Resources

About