Bisson M A, McGrouther D A, Mudera V, Grobbelaar A O
The Raft Institute of Plastic Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK.
J Hand Surg Br. 2003 Aug;28(4):351-6. doi: 10.1016/s0266-7681(03)00135-9.
Mechanisms behind the onset and progression of Dupuytren's disease are poorly understood. Both myofibroblasts and transforming growth factor beta 1 (TGF-beta(1)) have been implicated. We studied fibroblast cultures derived from nodules or cords of Dupuytren's contracture tissue to determine the proportion of myofibroblasts present in comparison with flexor retinaculum fibroblast cultures. We identified myofibroblasts by immunohistochemical staining for alpha-SMA. We then investigated the effects of TGF-beta(1) stimulation on these fibroblasts. Basal myofibroblast/fibroblast proportions were 9.7% in nodule cell cultures, 2.7% in cord cell cultures and only 1.3% in flexor retinaculum cell cultures. Nodule and cord myofibroblast proportions increased to 25.4% and 24.2%, respectively, in response to TGF-beta(1) treatment. Flexor retinaculum cell cultures showed no response to TGF-beta(1) stimulation. Fibroblasts cultured from specific regions of Dupuytren's tissue retain myofibroblast features in culture. TGF-beta(1) stimulation causes an increased myofibroblast phenotype to similar levels in both nodule and cord, suggesting that previously quiescent cord fibroblasts can be reactivated to become myofibroblasts by TGF-beta(1). This could be an underlying reason for high recurrence rates seen after surgery or progression following injury.
掌腱膜挛缩症发病及进展背后的机制尚不清楚。肌成纤维细胞和转化生长因子β1(TGF-β(1))都与之有关。我们研究了取自掌腱膜挛缩组织结节或条索的成纤维细胞培养物,以确定与屈肌支持带成纤维细胞培养物相比,其中肌成纤维细胞的比例。我们通过α-SMA免疫组织化学染色鉴定肌成纤维细胞。然后我们研究了TGF-β(1)刺激对这些成纤维细胞的影响。在结节细胞培养物中,基础肌成纤维细胞/成纤维细胞比例为9.7%,在条索细胞培养物中为2.7%,而在屈肌支持带细胞培养物中仅为1.3%。在TGF-β(1)处理后,结节和条索的肌成纤维细胞比例分别增加到25.4%和24.2%。屈肌支持带细胞培养物对TGF-β(1)刺激无反应。从掌腱膜组织特定区域培养的成纤维细胞在培养中保留了肌成纤维细胞特征。TGF-β(1)刺激使结节和条索中的肌成纤维细胞表型增加到相似水平,这表明先前静止的条索成纤维细胞可被TGF-β(1)重新激活成为肌成纤维细胞。这可能是手术后高复发率或损伤后病情进展的一个潜在原因。