Dupuytren: it’s not just for surgeons anymore!
The Dupuytren Research Group is conducting biomarker discovery research to identify circulating Dupuytren rate biomarkers. Dupuytren biology straddles many biologic arenas. We are interested in collaborating with research biologists to find the cause and the cure for this common debilitating disease.
What is so important about Dupuytren Disease?
Dupuytren is the most common heritable disease affecting connective tissues. As many as 10 million Americans have clinical disease. Dupuytren is primarily known for characteristic progressive hand deformities but is actually a family of similar conditions which includes frozen shoulder, Ledderhose disease, and Peyronie disease. Dupuytren disease is also associated with diabetes, hyperlipidemia, a variety of other medical conditions, increased cancer risk and shortened lifespan.
There is no disease-modifying biologic treatment. Current treatments are limited to procedures to reduce deformity. Incomplete correction of deformity is common. Complications of procedures are common. Recurrence is common. Procedures for recurrence are increasingly risky and less effective. Disability is common. Many patients are eventually crippled despite all available treatment.
Failed Dupuytren treatment is the most common reason for elective finger amputation. There has been no progress in long-term Dupuytren treatment outcomes since the 1950s when dermofasciectomy surgery was developed. This must change.
There is no unique biologic test. Disease progression is slow and variable. The only quantifiable disease metrics are the angles of the contracted finger joints. Because progression is unpredictable and because there is no Dupuytren rate biomarker, preventive treatments cannot be properly studied.
Why should you be interested in Dupuytren research?
Dupuytren is a poster child for translational systems biology research. It involves genetic, mechanotransduction, gender-related, age-related, immune, inflammation, and tissue repair pathways. Despite this, it has remained under the radar because surgeons have been its exclusive caregivers. Research has focused on the technical treatment of bent fingers, not on the root biology of this chronic progressive medical disease. It’s a wide-open opportunity.
Dupuytren is a flagship fibrotic disease. It shares cellular and molecular pathways with pulmonary fibrosis, renal interstitial fibrosis, liver fibrosis, and arteriosclerosis. Progress in understanding Dupuytren biology is likely to give insights into a wider range of fibrotic diseases. Because it can be accurately self-diagnosed, Dupuytren offers a unique opportunity to study fibrosis in a relatively healthy cohort using self-reported data.
Our main research project is the International Dupuytren Data Bank, currently underway. The IDDB combines self-reported secure online survey data with blood analysis for biomarker discovery. If you are interested in discussing this or have any suggestions, please let me know.
Thanks very much!
Charles Eaton MD
Dupuytren Research Group