RNA, Growth Factors and Dupuytren’s
Sorting out the genetic basis of Dupuytren’s is not simply a matter of finding out which genes are involved. The goal is to understand the biochemistry of exactly what these specific genes do to either start or fail to stop the process of Dupuytren’s. Cell biology is always a domino like set of events with […]
Dupuytren’s Diathesis
What is Dupuytren’s Diathesis? Diathesis is a medical term meaning tendency toward a condition. One way of describing a person with Dupuytren’s diathesis is that they have more of whatever Dupuytren’s is. Diathesis usually means more aggressive Dupuytren’s: earlier age of onset; more fingers involved; more often bilateral; faster progression; more recurrence problems. The hallmark […]
Needle Aponeurotomy and Xiaflex compared
Xiaflex (Collagenase) has finally been approved by the FDA for the treatment of Dupuytren’s contracture. When work began on the development of collagenase to treat Dupuytren’s contracture, the bar was pretty low: anything better than fasciectomy in terms of either safety or efficacy would be a great advance. No other treatment options were available in […]
Growing bent fingers straight
Two things are needed for people dealing with Dupuytren’s: a way to reverse or restore fingers back to their natural state and a way to prevent progression/recurrence. For the former, progress is being made; the latter remains the elusive goal of a cure. Dupuytren’s is a shrinking process. The ideal treatment would be to reverse […]
Cellular biomechanics are the key to Dupuytren’s.
Dupuytren’s is truly a biomechanical process, and the ultimate process has to do with the way that fibroblasts and myofibroblasts attach to each other and physically attach to strands of collagen and other components of the tissue matrix which surrounds them. An investigation into the complex junction of living cells, strings of proteins and mechanical/chemical […]
Fasciectomy: Unsafe at any Speed?
Fasciectomy, invented by Goyrand just a few years after Dupuytren’s initial demonstration of open fasciotomy, has been the main treatment option for Dupuytren’s for nearly 200 years. There have been many refinements, but the central theme of removing fascia is unchanged. With so much time and experience, one might assume that all of the wrinkles […]
Flare reaction after fasciectomy for Dupuytren’s
Flare reaction refers to a disproportionate degree of swelling, pain and stiffness developing after surgery for Dupuytren’s contracture. Although commonly known, there is relatively little published on this. Flare shares some features with reflex sympathetic dystrophy, another poorly understood condition which is seen more often after Dupuytren’s surgery than other hand procedures. Flare reaction appears […]
Dupuytren’s and Associated Conditions
Dupuytren’s is associated with three conditions, Ledderhose, Peyronie’s and frozen shoulder. These all share a similar biology at a cellular level. Dupuytren’s is also associated with other conditions, such as diabetes, alcoholism, epilepsy, advanced HIV for reasons which are less clear. Is Dupuytren’s a risk factor for some of these other health issues or is […]
Genes, enzymes and Dupuytren’s: the alphabet name game.
A proteinase is an enzyme which breaks down proteins. Metalloproteinases (MPs) are proteinases with a molecular structure and function involves a metal atom, usually zinc. Matrix Metalloproteinases (MMPs) are MPs which act outside of cells, in the tissue matrix. Human collagenases are MMPs which break down different types of collagen. Membrane-type MMPs (MT-MMPs) are MMPs […]
LSD as a treatment for Dupuytren’s?
There is one published report of Dupuytren’s being cured, fingers suddenly straightened, under the influence of the psychedelic drug LSD (full text: https://dupuytrens.org/DupPDFs/1966_Solursh_1417.pdf). Is this true? Probably not. LSD is a serotonin antagonist, and other serotonin antagonist drugs, such as methysergide, have been shown to cause retroperitoneal and cardiac valve fibrosis. Based on this information, […]
