A better understanding of the biology of metalloproteinases may lead to new treatment options for Dupuytren’s. Metalloproteinases (MMPS) are a group of enzymes in our bodies which break down certain proteins, including collagen. MMPS are blocked by tissue inhibitors of metalloproteinases (TIMPS). MMPS and TIMPS balance each other: imbalances have been implicated in conditions of excess collagen, as seen in Dupuytren’s, or inadequate collagen leading to rotator cuff tears. The article “Metalloproteinases and their inhibitors—diagnostic and therapeutic opportunities in orthopedics” (full text: https://dupuytrens.org/DupPDFs/2009_Pasternak.pdf) is a clearly written and thorough review of the topic and its implications for Dupuytren’s and other conditions. MMPs are involved in the biology of inflammation and wound healing, which overlaps the cell biology of Dupuytren’s. The authors note “In view of the strong hereditary component and a predilection for men in Dupuytren’s disease, it is interesting to note that TIMP-1 is located on the X-chromosome.” It may not be that a man’s Y chromosome puts him at special risk, but that a woman’s X chromosome offers her special protection. In addition to involvement with Dupuytren’s, MMPs and TIMPs appear to play key roles in unrelated disorders including arthritis, degenerative disk disease, tendinitis, fracture healing and other conditions. Inroads made in understanding their role in Dupuytren’s are likely to benefit people suffering from other conditions – an added incentive to work for a cure.
