Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
Acta Orthop. 2013 Aug;84(4):420-5. doi: 10.3109/17453674.2013.814011. Epub 2013 Jul 3.
Dupuytren's disease (DD) is a benign fibroproliferative process that affects the palmar fascia. The pathology of DD shows similarities with wound healing and tumor growth; hypoxia and angiogenesis play important roles in both. We investigated the role of angiogenic proteins in DD.
The expression of vascular endothelial growth factor (VEGF), its receptors vascular endothelial growth factor receptor 1 (VEGFR1) and vascular endothelial growth factor receptor 2 (VEGFR2), hypoxia-inducible factor alfa (HIF-1α), and alfa-smooth muscle actin (α-SMA) were analyzed immunohistochemically in fragments of excised Dupuytren's tissue from 32 patients. We compared these values to values for expression in a control group.
15 of 32 samples could be attributed to the involutional phase (α-SMA positive), whereas 17 samples were considered to be cords at the residual phase (α-SMA negative). In the involutional phase, the HIF-1α and VEGFR2 expression was statistically significantly higher than in the residual phase and in the controls.
Both the VEGFR2 receptor and HIF-1α were expressed in α-SMA positive myofibroblast-rich nodules with characteristics of DD in the active involutional phase. Thus, hypoxia and (subsequently) angiogenesis may have a role in the pathophysiology of DD.
掌腱膜挛缩症（Dupuytren 病，DD）是一种良性纤维增生性疾病，影响掌筋膜。DD 的病理学与创伤愈合和肿瘤生长具有相似性；缺氧和血管生成在这两者中都起着重要作用。我们研究了血管生成蛋白在 DD 中的作用。
我们通过免疫组化分析了 32 名接受手术的 DD 患者的掌腱膜挛缩症组织中血管内皮生长因子（VEGF）、其受体血管内皮生长因子受体 1（VEGFR1）和血管内皮生长因子受体 2（VEGFR2）、缺氧诱导因子 alfa（HIF-1α）和α-平滑肌肌动蛋白（α-SMA）的表达，并将这些值与对照组进行了比较。
32 个样本中有 15 个可归因于退行期（α-SMA 阳性），而 17 个样本被认为是残余期的索状（α-SMA 阴性）。在退行期，HIF-1α 和 VEGFR2 的表达明显高于残余期和对照组。
在活跃的退行性阶段，具有 DD 特征的 α-SMA 阳性肌成纤维细胞丰富的结节中均表达了 VEGFR2 受体和 HIF-1α。因此，缺氧和（随后的）血管生成可能在 DD 的病理生理学中起作用。
