Augoff Katarzyna, Ratajczak Katarzyna, Gosk Jerzy, Tabola Renata, Rutowski Roman
Department of Gastrointestinal and General Surgery, Wroclaw Medical University, Wroclaw, Poland.
J Hand Surg Am. 2006 Dec;31(10):1635-9. doi: 10.1016/j.jhsa.2006.08.007.
Dupuytren's contracture is a fibroproliferative disorder of the hand characterized by an abnormal myofibroblast and fibroblast proliferation and extracellular matrix deposition leading to retraction and deformation of the palm. Recent studies have shown that molecules of extracellular matrix may coordinate morphogenesis, cell differentiation, and most importantly, fibrogenesis in tissue. Gelatinase A (MMP-2) is a member of the matrix metalloproteinase family of proteolytic enzymes that contribute to remodeling the extracellular matrix by degrading its components. The aim of this study was to determine the level of MMP-2 activation in the palmar fascia of patients with Dupuytren's contracture with reference to the clinical stages of disease progression and recurrence of the contracture after surgery.
The level of relative MMP-2 activation, expressed by the active to latent MMP-2 ratio, was investigated with use of zymography and computerized densitometry in 16 normal and 71 pathologic tissues characterizing different clinical stages of the disease progression.
We found that the level of MMP-2 activation was significantly elevated in the palmar fascias with Dupuytren's contracture compared with normal tissues. We did not find statistically significant differences between groups with different stages of the disease progression. We also did not find a relation between a high level of MMP-2 activation and the recurrence in the area of surgically treated Dupuytren's contracture.
The differences in MMP-2 activation between contractured and normal fascia suggest a participation of this enzyme in the promotion of Dupuytren's disease. We did not find a relationship, however, between the level of MMP-2 activation and the secondary contracture.
杜普伊特伦挛缩症是一种手部纤维增生性疾病，其特征是异常的肌成纤维细胞和成纤维细胞增殖以及细胞外基质沉积，导致手掌回缩和变形。最近的研究表明，细胞外基质分子可能协调组织中的形态发生、细胞分化，最重要的是纤维生成。明胶酶A（基质金属蛋白酶-2，MMP-2）是蛋白水解酶基质金属蛋白酶家族的成员，通过降解细胞外基质成分来促进其重塑。本研究的目的是参照疾病进展的临床阶段和手术后挛缩的复发情况，确定杜普伊特伦挛缩症患者掌腱膜中MMP-2的激活水平。
采用酶谱法和计算机密度测定法，对16份正常组织和71份代表疾病进展不同临床阶段的病理组织进行研究，以活性与潜伏性MMP-2比值表示相对MMP-2激活水平。
我们发现，与正常组织相比，杜普伊特伦挛缩症患者掌腱膜中的MMP-2激活水平显著升高。我们未发现疾病进展不同阶段的组间存在统计学显著差异。我们也未发现MMP-2激活水平高与手术治疗的杜普伊特伦挛缩症区域复发之间存在关联。
挛缩的和正常的掌腱膜之间MMP-2激活的差异表明该酶参与了杜普伊特伦病的进展。然而，我们未发现MMP-2激活水平与继发性挛缩之间存在关联。
