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. 1992 May;74(3):156–161.

An insight into Dupuytren's contracture.

G A Murrell 1
PMCID: PMC2497584  PMID: 1616255

Abstract

Dupuytren's contracture is a deforming, fibrotic condition of the palmar fascia which has confounded clinicians and scientists since the early descriptions by Guillaume Dupuytren in 1831. It predominantly affects elderly, male caucasians, has a hereditary predisposition and has strong associations with diabetes, alcohol consumption, cigarette smoking and HIV infection. The major morphological features are an increase in fibroblasts, particularly around narrowed fibroblasts; a finding consistent with localised ischaemia. During ischaemia, adenosine triphosphate (ATP) is converted to hypoxanthine and xanthine, and endothelial xanthine dehydrogenase to xanthine oxidase (alcohol also mediates this change, a finding of particular relevance given the association of Dupuytren's contracture with alcohol intake). Xanthine oxidase catalyses the oxidation of hypoxanthine to xanthine and uric acid with the release of superoxide free radicals (O2-), hydrogen peroxide (H2O2) and hydroxyl radicals (OH.). These free radicals are highly reactive, with half-lives in the order of milliseconds and are toxic in high concentrations. A potential for free radical generation in Dupuytren's contracture was elicited by finding a sixfold increase in hypoxanthine concentrations in Dupuytren's contracture compared with control palmar fascia. In vitro studies affirmed the toxic effects of oxygen free radicals to Dupuytren's contracture fibroblasts, but also showed that, at lower concentrations (concentrations similar to those likely to occur in Dupuytren's contracture), free radicals had a stimulatory effect on fibroblast proliferation. Cultured fibroblasts were found to release their own O2-. These endogenously released free radicals were also found to be important in fibroblast proliferation.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. An H. S., Southworth S. R., Jackson W. T., Russ B. Cigarette smoking and Dupuytren's contracture of the hand. J Hand Surg Am. 1988 Nov;13(6):872–874. doi: 10.1016/0363-5023(88)90262-6. [DOI] [PubMed] [Google Scholar]
  2. Arafa M., Steingold R. F., Noble J. The incidence of Dupuytren's disease in patients with rheumatoid arthritis. J Hand Surg Br. 1984 Jun;9(2):165–166. [PubMed] [Google Scholar]
  3. Attali P., Ink O., Pelletier G., Vernier C., Jean F., Moulton L., Etienne J. P. Dupuytren's contracture, alcohol consumption, and chronic liver disease. Arch Intern Med. 1987 Jun;147(6):1065–1067. [PubMed] [Google Scholar]
  4. Babior B. M., Curnutte J. T., Kipnes R. S. Biological defense mechanisms. Evidence for the participation of superoxide in bacterial killing by xanthine oxidase. J Lab Clin Med. 1975 Feb;85(2):235–244. [PubMed] [Google Scholar]
  5. Bazin S., Le Lous M., Duance V. C., Sims T. J., Bailey A. J., Gabbiani G., D'Andiran G., Pizzolato G., Browski A., Nicoletis C. Biochemistry and histology of the connective tissue of Dupuytren's disease lesions. Eur J Clin Invest. 1980 Feb;10(1):9–16. doi: 10.1111/j.1365-2362.1980.tb00003.x. [DOI] [PubMed] [Google Scholar]
  6. Bower M., Nelson M., Gazzard B. G. Dupuytren's contractures in patients infected with HIV. BMJ. 1990 Jan 20;300(6718):164–165. doi: 10.1136/bmj.300.6718.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Brickley-Parsons D., Glimcher M. J., Smith R. J., Albin R., Adams J. P. Biochemical changes in the collagen of the palmar fascia in patients with Dupuytren's disease. J Bone Joint Surg Am. 1981 Jun;63(5):787–797. [PubMed] [Google Scholar]
  8. Burdon R. H., Gill V., Rice-Evans C. Cell proliferation and oxidative stress. Free Radic Res Commun. 1989;7(3-6):149–159. doi: 10.3109/10715768909087937. [DOI] [PubMed] [Google Scholar]
  9. Flint M. H., Gillard G. C., Reilly H. C. The glycosaminoglycans of Dupuytren's disease. Connect Tissue Res. 1982;9(3):173–179. doi: 10.3109/03008208209160258. [DOI] [PubMed] [Google Scholar]
  10. HUESTON J. T. Further studies on the incidence of Dupuytren's contracture. Med J Aust. 1962 Apr 21;49(1):586–588. [PubMed] [Google Scholar]
  11. Larkin J. G., Frier B. M. Limited joint mobility and Dupuytren's contracture in diabetic, hypertensive, and normal populations. Br Med J (Clin Res Ed) 1986 Jun 7;292(6534):1494–1494. doi: 10.1136/bmj.292.6534.1494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Majno G., Gabbiani G., Hirschel B. J., Ryan G. B., Statkov P. R. Contraction of granulation tissue in vitro: similarity to smooth muscle. Science. 1971 Aug 6;173(3996):548–550. doi: 10.1126/science.173.3996.548. [DOI] [PubMed] [Google Scholar]
  13. Murrell G. A., Francis M. J., Bromley L. Free radicals and Dupuytren's contracture. Br Med J (Clin Res Ed) 1987 Nov 28;295(6610):1373–1375. doi: 10.1136/bmj.295.6610.1373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Murrell G. A., Francis M. J., Bromley L. Modulation of fibroblast proliferation by oxygen free radicals. Biochem J. 1990 Feb 1;265(3):659–665. doi: 10.1042/bj2650659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Murrell G. A., Francis M. J., Bromley L. The collagen changes of Dupuytren's contracture. J Hand Surg Br. 1991 Aug;16(3):263–266. doi: 10.1016/0266-7681(91)90050-x. [DOI] [PubMed] [Google Scholar]
  16. Murrell G. A., Francis M. J., Howlett C. R. Dupuytren's contracture. Fine structure in relation to aetiology. J Bone Joint Surg Br. 1989 May;71(3):367–373. doi: 10.1302/0301-620X.71B3.2722922. [DOI] [PubMed] [Google Scholar]
  17. Noble J., Heathcote J. G., Cohen H. Diabetes mellitus in the aetiology of Dupuytren's disease. J Bone Joint Surg Br. 1984 May;66(3):322–325. doi: 10.1302/0301-620X.66B3.6725338. [DOI] [PubMed] [Google Scholar]
  18. Oei H. H., Zoganas H. C., McCord J. M., Schaffer S. W. Role of acetaldehyde and xanthine oxidase in ethanol-induced oxidative stress. Res Commun Chem Pathol Pharmacol. 1986 Feb;51(2):195–203. [PubMed] [Google Scholar]
  19. Rabinowitz J. L., Ostermann L., Jr, Bora F. W., Staeffen J. Lipid composition and de novo lipid biosynthesis of human palmar fat in Dupuytren's disease. Lipids. 1983 May;18(5):371–374. doi: 10.1007/BF02537234. [DOI] [PubMed] [Google Scholar]
  20. Slack C., Flint M. H., Thompson B. M. Glycosaminoglycan synthesis by Dupuytren's cells in culture. Connect Tissue Res. 1982;9(4):263–269. doi: 10.3109/03008208209160272. [DOI] [PubMed] [Google Scholar]
  21. Vracko R. Basal lamina layering in diabetes mellitus. Evidence for accelerated rate of cell death and cell regeneration. Diabetes. 1974 Feb;23(2):94–104. [PubMed] [Google Scholar]
  22. Wylock P. The life and time of Guillaume Dupuytren. Can J Surg. 1989 Nov;32(6):473–477. [PubMed] [Google Scholar]

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