The physical changes associated with Dupuytren’s are similar to the process which heals open wounds through contraction and collagen production. Thanks to sophisticated laboratory research, the molecular controls for this process are beginning to be understood. See http://multimedia.mcb.harvard.edu/anim_innerlife.html for an amazing animation of how molecular cellular controls act like tiny physical machines. In Dupuytren’s, two controls are ß Catenin and Transforming Factor ß. ß-catenin is a protein which is part of the physical scaffolding in a cell. Among many functions, ß-catenin forms part of a cellular trailer hitch which locks one cell to the next, called the adherens junctions (AJs). Transforming Factor ß is a protein which is produced by some cells to activate receptors on other cells, part of the autocrine system of cell signaling. It has different effects in different situations. Both ß Catenin and Transforming Factor ß are major players in Dupuytren’s type tissue contracture. How do they interact with each other? Somewhat independently, according to this study (full text http://www.dupuytrenfoundation.org/DupPDFs/2009_Poon.pdf). ß Catenin primarily activated cell migration while Transforming Factor ß mainly stimulated cell growth and contraction, which would seem to be the more important process in Dupuytren’s. Interesting, but more details are needed to crack the code to find a cure.