Murrell G A
Division of Orthopedic surgery, Duke University NC, Durham.
Ann Chir Main Memb Super. 1992;11(5):355-61. doi: 10.1016/s0753-9053(05)80270-4.
At a cellular level, the major phenomenon in Dupuytren's contracture is an increase in proliferating fibroblasts, rather than an alteration in the type of fibroblasts. The collagen and glycosaminoglycan changes observed in the tissues of Dupuytren's contracture are likely to be secondary to changes in fibroblast density. Oxygen free radicals released from narrowed microvessels and from the fibroblasts themselves may play a role in stimulating fibroblast proliferation. Messina's experiments with continuous distraction and the success of limited fasciotomy indicate a role for physical forces in the pathogenesis of Dupuytren's contracture. The mechanism whereby physical events stimulate biochemical changes are undetermined, but preliminary investigations suggest that electrical fields and ion channels may be important. The future of Dupuytren's contracture rests with the delineation of these chemical and physical processes and their application and rigorous testing in the clinical setting.
在细胞水平上，杜普伊特伦挛缩症的主要现象是增殖性成纤维细胞增多，而非成纤维细胞类型的改变。在杜普伊特伦挛缩症组织中观察到的胶原蛋白和糖胺聚糖变化可能继发于成纤维细胞密度的改变。狭窄微血管和成纤维细胞自身释放的氧自由基可能在刺激成纤维细胞增殖中起作用。梅西纳关于持续牵引的实验以及有限筋膜切开术的成功表明物理力在杜普伊特伦挛缩症发病机制中起作用。物理事件刺激生化变化的机制尚不确定，但初步研究表明电场和离子通道可能很重要。杜普伊特伦挛缩症的未来取决于对这些化学和物理过程的描绘及其在临床环境中的应用和严格测试。
