Angiotensin Receptor Autoantibodies in Dupuytren Disease: A Biomarker Study.

BACKGROUND

Dupuytren disease (DD) is a fibroproliferative disorder characterized by excess collagen deposition in the digitopalmar fascia resulting in disabling flexion contractures. The angiotensin II type 1 receptor (AT1R) pathway has previously been shown to be upregulated in a variety of other fibrotic disorders. We explored the potential association between DD and activating autoantibodies (AAb) against the profibrotic AT1R or counterregulatory antifibrotic angiotensin II type 2 receptor (AT2R). Patients with DD and controls were recruited from a single hand clinic. Demographic and clinical data and total flexion deformity angle of each digit were recorded. Serum levels of AT1R-AAb and AT2R-AAb were measured by enzyme-linked immunosorbent assay. No differences were noted in serum AT1R-AAb levels between control and DD patients. In women with DD, circulating AT2R-AAb were significantly lower than in control women (7.61 ± 3.0 U/mL vs 13.5 ± 3.1 U/mL, respectively). AT2R-AAb observed values tended to be lower in women with higher Tubiana severity scores. In contrast, AT2R-AAb levels were not different between control or DD male subjects. These early findings suggest angiotensin II signaling differences may contribute to sex differences in DD and that an AT2R agonist may be particularly beneficial in treating women with DD.

LEVEL OF EVIDENCE

Diagnostic, Level II.