Pathological findings in subsynovial connective tissue in idiopathic carpal tunnel syndrome

Donato, Giuseppe; Galasso, Olimpio; Valentino, Paola; Conforti, Francesco; Zuccalà, Valeria; Russo, Emanuele; Maltese, Lorenza; Perrotta, Ida; Tripepi, Sandro; Amorosi, Andrea

doi:10.5414/npp28129

Cited by 41 publications

(57 citation statements)

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“…In our study, we have also not seen inflammation. However, within the subsynovial connective tissue play an important role on the development of idiopathic CTS (6,7,30). These histopathological changes might increase the volume and pressure in the carpal tunnel that result in ischemia and reperfusion of the tenosynovium (30).…”

Section: █ Resultsmentioning

confidence: 99%

“…There are many studies on the pathophysiological, biochemical, electrophysiological and clinical aspects of CTS (6,7,24,28,30). The most popular theories on the pathogenesis of CTS are mechanical compression, microvascular insufficiency and vibration theories (1).…”

Section: █ Resultsmentioning

confidence: 99%

“…Increased pressure within the carpal tunnel causes disruption of the blood supply of median nerve under ligamentum carpi transversum (6,13). Increased When the anatomical structure of this region is examined, the groove of the palmar side is covered by the flexor retinaculum to form the carpal tunnel.…”

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confidence: 99%

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Comparative histopathologic evaluation of diabetic, hypothyroid and idiopathic carpal tunnel syndrome

Taşer

Deger²,

Deger³

2016

Turkish Neurosurgery

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Section: █ Resultsmentioning

confidence: 99%

Section: █ Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Comparative histopathologic evaluation of diabetic, hypothyroid and idiopathic carpal tunnel syndrome

Taşer

Deger²,

Deger³

2016

Turkish Neurosurgery

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“…Tenosynovial tissues were flash frozen and stored at À80˚C until mRNA isolation and immunohistochemical examination were performed as described below. We extracted mRNA and used quantitative real-time polymerase chain reaction (PCR) to compare the expression levels of genes encoding Wnt1,2,3,4, 5a, 5b,6, 7a, 7b, 8a, 8b, 9a, 9b, 10a, 10b,11,and 16 between the groups. Expression of genes encoding cell proliferation factors, such as estrogen-responsive finger protein (Efp), epidermal growth factor receptor (EGFR), heparin binding-epidermal growth factor-like growth factor (HB-EGF), insulin-like growth factor-1…”

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confidence: 99%

“…3 Increased expression of cell proliferation factors, such as vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF), in synovial cells is a feature of ICTS. 6,7 However, the mechanism by which the expression of these factors increases remains unknown.…”

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confidence: 99%

Enhanced expression of Wnt9a in the flexor tenosynovium in idiopathic carpal tunnel syndrome

Yamanaka

Menuki

Zenke

et al. 2015

Journal Orthopaedic Research

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This study aimed to clarify the association between abnormal Wnt signaling and the cause of idiopathic carpal tunnel syndrome (ICTS) and whether an association exists between Wnt signaling and cell proliferation in the flexor tenosynovium. The subjects included nine patients with ICTS; the controls were nine patients with distal radius fractures without any symptoms of carpal tunnel syndrome. We extracted mRNA from the flexor tenosynovium and compared the expression levels of genes encoding 17 types of Wnt in both subjects and controls via quantitative real-time polymerase chain reaction (PCR). Expression levels of factors involved in cell proliferation, such as estrogen-responsive finger protein, epidermal growth factor receptor, heparin binding-epidermal growth factor-like growth factor, insulin-like growth factor-1, and vascular endothelial growth factor (VEGF) were also measured using quantitative real-time PCR. In addition, we compared the Wnt and MIB-1 protein expression levels to clarify the effect of Wnt on cell proliferation. Quantitative real-time PCR revealed significantly greater expression of the gene encoding Wnt9a in subjects with ICTS than in controls and also revealed a positive correlation between the expression of genes encoding Wnt9a and VEGF in subjects with ICTS. Quantitative evaluation using immunohistochemical staining also indicated more marked Wnt9a expression in subjects than in controls. However, there was no relationship between the expression of Wnt9a and the cell proliferation index MIB-1. These results indicate that Wnt9a expression is enhanced in ICTS and that Wnt9a may be involved in VEGF expression in ICTS. Keywords: idiopathic carpal tunnel syndrome; Wnt signal; vascular endothelial growth factor; MIB-1; flexor tensynovium Carpal tunnel syndrome (CTS) has the highest incidence among all entrapment syndromes, with an overall prevalence of approximately 3.8%. 1 The majority of CTS cases are idiopathic. 2 Although the exact pathological mechanism of idiopathic CTS (ICTS) remains unknown, some characteristic features of ICTS have been revealed. For example, ICTS is associated with fibroblast proliferation and collagen fiber overgrowth. Furthermore, median nerve compression and restricted range of motion consequent to these characteristics may be among the causative factors associated with ICTS. 3,4 In addition, few inflammatory changes have been observed in the flexor tenosynovium in ICTS 5 ; instead, blood vessel wall destruction and angiogenesis accompanied by a degree of edema may be detected. 3 Increased expression of cell proliferation factors, such as vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF), in synovial cells is a feature of ICTS. 6,7 However, the mechanism by which the expression of these factors increases remains unknown.Wnt signaling controls initial cell development, morphogenesis, and organogenesis as well as postnatal cell proliferation, differentiation, and activity, and 19 types of Wnt ligands have been identifie...

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Collagen gel contraction as a measure of fibroblast function in carpal tunnel syndrome

Yang

Thoreson

Gingery

et al. 2014

J Biomedical Materials Res

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Non-inflammatory subsynovial connective tissue (SSCT) fibrosis with nerve compression is a prominent feature of carpal tunnel syndrome (CTS). Studies have shown that SSCT matrix synthesis and material property changes in CTS are associated with increased activity of transforming growth factor β (TGF-β1). This study’s aims were to 1) investigate the ability of SSCT fibroblasts from CTS patients and unaffected individuals to contract a collagen gel ring and 2) determine how the addition of TGF-β1 affects this ability. SSCT fibroblasts from 3 normal cadavers and 3 age-matched female patients who had undergone surgery for CTS were used. Results showed patient cell seeded gels had a significantly higher contraction rate (p<0.001) than control cells and fully contracted gel rings possessed a significantly higher tensile strength (p=0.003) and stiffness (p<0.001). Furthermore, TGF-β1 significantly intensified contraction rate (p<0.001), tensile strength (p<0.001) and stiffness (p<0.001). In conclusion, SSCT cells from normal donors and CTS patients contract collagen gel rings differently, and this ability is affected by TGF-β1 treatment. This cell-seeded collagen gel model may be useful for developing methods of stopping or eliminating the effect of TGF-β1 effects on the SSCT fibroblasts and surrounding matrix, which might aid identification of medical treatments of CTS.

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Pathological findings in subsynovial connective tissue in idiopathic carpal tunnel syndrome

Cited by 41 publications

References 0 publications

Comparative histopathologic evaluation of diabetic, hypothyroid and idiopathic carpal tunnel syndrome

Comparative histopathologic evaluation of diabetic, hypothyroid and idiopathic carpal tunnel syndrome

Enhanced expression of Wnt9a in the flexor tenosynovium in idiopathic carpal tunnel syndrome

Collagen gel contraction as a measure of fibroblast function in carpal tunnel syndrome

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