Department of Hand Surgery, Plastic Surgery and Burns, Linkoping University Hospital, Linkoping, Sweden.
Scand J Med Sci Sports. 2014 Apr;24(2):363-8. doi: 10.1111/j.1600-0838.2012.01514.x. Epub 2012 Aug 12.
The pathogenesis of trigger finger has generally been ascribed to primary changes in the first annular ligament. In contrast, we recently found histological changes in the tendons, similar to the findings in Achilles tendinosis or tendinopathy. We therefore hypothesized that trigger finger tendons would show differences in gene expression in comparison to normal tendons in a pattern similar to what is published for Achilles tendinosis. We performed quantitative real-time polymerase chain reaction on biopsies from finger flexor tendons, 13 trigger fingers and 13 apparently healthy control tendons, to assess the expression of 10 genes which have been described to be differently expressed in tendinosis (collagen type 1a1, collagen 3a1, MMP-2, MMP-3, ADAMTS-5, TIMP-3, aggrecan, biglycan, decorin, and versican). In trigger finger tendons, collagen types 1a1 and 3a1, aggrecan and biglycan were all up-regulated, and MMP-3and TIMP-3 were down-regulated. These changes were statistically significant and have been previously described for Achilles tendinosis. The remaining four genes were not significantly altered. The changes in gene expression support the hypothesis that trigger finger is a form of tendinosis. Because trigger finger is a common condition, often treated surgically, it could provide opportunities for clinical research on tendinosis.
扳机指的发病机制通常归因于初级的屈指肌腱环的变化。相比之下，我们最近在肌腱中发现了与跟腱腱病或腱病相似的组织学变化。因此，我们假设与正常肌腱相比，扳机指的肌腱在基因表达上会存在差异，这种差异的模式类似于已发表的跟腱腱病的情况。我们对 13 例扳机指屈肌腱和 13 例看似健康的对照肌腱进行了活检，并进行了定量实时聚合酶链反应，以评估 10 种基因的表达情况，这些基因在腱病中被描述为表达不同（胶原 1a1、胶原 3a1、MMP-2、MMP-3、ADAMTS-5、TIMP-3、聚集蛋白聚糖、大蛋白聚糖、核心蛋白聚糖和 versican）。在扳机指的肌腱中，胶原 1a1 和 3a1、聚集蛋白聚糖和大蛋白聚糖均上调，而 MMP-3 和 TIMP-3 下调。这些变化具有统计学意义，并且以前在跟腱腱病中已有描述。其余四个基因没有明显改变。基因表达的变化支持扳机指是一种腱病的假说。由于扳机指是一种常见的疾病，通常需要手术治疗，因此它可以为腱病的临床研究提供机会。
