1
|
Rodrigues MP, Tissi LH, Oliveira VM, Wistuba GASM, Araujo FB, Mattar-Júnior R, Rezende MR, Wei TH, Godoy-Santos AL, Santos MCLG. MMP-1, MMP-8, and MMP-13 Gene Polymorphisms and Haplotype Is a Risk Factor for Dupuytren Contracture: A Case-Control Study. Hand (N Y) 2024:15589447241242818. [PMID: 38660990 DOI: 10.1177/15589447241242818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND There is an increased tissue expression of matrix metalloproteinases (MMPs) on Dupuytren contracture (DC). Genetic polymorphisms (single nucleotide polymorphism [SNPs]) in genes of these enzymes may individually influence these transcriptions. Haplotype analysis, which is the observation of a group of alleles, could be more useful to identify the association between SNPs and DC. The purpose of this study was to evaluate the influence of MMP-1 g.-1607 G>GG (rs1799750), MMP-8 g.-799 C>T (rs11225395), and MMP-13 g.-77 A>G (rs2252070) SNPs individually and in haplotype on DC. METHODS A total of 60 patients with a clinical diagnosis of DC were evaluated and matched, according to age and gender, with the control group of 100 patients without this clinical diagnosis. Genomic DNA was extracted from saliva samples, and genotypes were obtained by polymerase chain reaction-restriction fragment length polymorphism. Statistical analysis of the results included Mann-Whitney U test, Chi-squared test, and PHASE and R software, with a significance level of 5%. RESULTS The 3 SNPs studied showed significant differences in allele and genotype frequencies between the groups: 2G in MMP-1 (P = .018; odds ratio [OR] 1.80 (95% confidence interval [CI], 1.13-2.88)), T in MMP-8 (P = .015; OR 0.53 (95% CI, 0.33-0.88)), and A in MMP-13 (rs2252070) SNPs (P = .040, OR 0.54 (95% CI, 0.33-0.90)) are risk alleles. The global haplotype analysis indicated a significant difference between both groups. CONCLUSIONS In conclusion, MMP-1 g.-1607 G>GG (rs1799750), MMP-8 g.-799 C>T (rs11225395), and MMP-13 g.-77 A>G (rs2252070) SNPs, individually and in haplotype, are a risk factor for DC, indicating that these SNPs may be a potential diagnostic and prognostic factor for DC.
Collapse
Affiliation(s)
- Mauricio P Rodrigues
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, Brazil
| | - Larissa H Tissi
- Department of Cell Biology, University Federal of Paraná, Centro Politécnico, Curitiba, Brazil
| | - Vinicius M Oliveira
- Department of Cell Biology, University Federal of Paraná, Centro Politécnico, Curitiba, Brazil
| | - Guilherme A S M Wistuba
- Department of Cell Biology, University Federal of Paraná, Centro Politécnico, Curitiba, Brazil
| | - Francielle B Araujo
- Laboratory for Applied Science and Technology in Health, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz), Curitiba, Brazil
| | - Rames Mattar-Júnior
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, Brazil
| | - Marcelo R Rezende
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, Brazil
| | - Teng H Wei
- Department of Orthopaedics, Foot and Ankle Service, University of São Paulo, Brazil
| | | | | |
Collapse
|
2
|
Riesmeijer SA, Nolte IM, Olde Loohuis LM, Reus LM, Boltz T, Ng M, Furniss D, Werker PMN, Ophoff RA. Polygenic Risk Associations with Clinical Characteristics and Recurrence of Dupuytren Disease. Plast Reconstr Surg 2024; 153:573e-583e. [PMID: 37257093 PMCID: PMC10876167 DOI: 10.1097/prs.0000000000010775] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/22/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Dupuytren disease (DD) is a common complex trait, with varying severity and incompletely understood cause. Genome-wide association studies (GWAS) have identified risk loci. In this article, we examine whether genetic risk profiles of DD in patients are associated with clinical variation and disease severity and with patient genetic risk profiles of genetically correlated traits, including body mass index (BMI), triglycerides, high-density lipoproteins, type 2 diabetes mellitus, and endophenotypes fasting glucose and glycated hemoglobin. METHODS The authors used a well-characterized cohort of 1461 DD patients with available phenotypic and genetic data. Phenotype data include age at onset, recurrence, and family history of disease. Polygenic risk scores (PRSs) of DD, BMI, triglycerides, high-density lipoprotein, type 2 diabetes, fasting glucose, and hemoglobin A1c using various significance thresholds were calculated with PRSice using the most recent GWAS summary statistics. Control data from LifeLines were used to determine P value cutoffs for PRS generation explaining most variance. RESULTS The PRS for DD was significantly associated with a positive family history for DD, age at onset, disease onset before the age of 50, and recurrence. We also found a significant negative correlation between the PRSs for DD and BMI. CONCLUSIONS Although GWAS studies of DD are designed to identify genetic risk factors distinguishing case/control status, we show that the genetic risk profile for DD also explains part of its clinical variation and disease severity. The PRS may therefore aid in accurate prognostication, choosing initial treatment and in personalized medicine in the future. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
Collapse
Affiliation(s)
- Sophie A. Riesmeijer
- From the Departments of Plastic Surgery
- Epidemiology, University of Groningen, University Medical Center Groningen
| | - Ilja M. Nolte
- Epidemiology, University of Groningen, University Medical Center Groningen
| | - Loes M. Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Lianne M. Reus
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center
| | - Toni Boltz
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Michael Ng
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford
| | - Dominic Furniss
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford
| | | | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
- Department of Psychiatry, Erasmus University Rotterdam, Erasmus Medical Center
| |
Collapse
|
3
|
Green HD, Burden E, Chen J, Evans J, Patel K, Wood AR, Beaumont RN, Tyrrell J, Frayling TM, Hattersley AT, Oram RA, Bowden J, Barroso I, Smith C, Weedon MN. Hyperglycaemia is a causal risk factor for upper limb pathologies. Int J Epidemiol 2024; 53:dyad187. [PMID: 38205890 PMCID: PMC10859137 DOI: 10.1093/ije/dyad187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Diabetes (regardless of type) and obesity are associated with a range of musculoskeletal disorders. The causal mechanisms driving these associations are unknown for many upper limb pathologies. We used genetic techniques to test the causal link between glycemia, obesity and musculoskeletal conditions. METHODS In the UK Biobank's unrelated European cohort (N = 379 708) we performed mendelian randomisation (MR) analyses to test for a causal effect of long-term high glycaemia and adiposity on four musculoskeletal pathologies: frozen shoulder, Dupuytren's disease, carpal tunnel syndrome and trigger finger. We also performed single-gene MR using rare variants in the GCK gene. RESULTS Using MR, we found evidence that long-term high glycaemia has a causal role in the aetiology of upper limb conditions. A 10-mmol/mol increase in genetically predicted haemoglobin A1C (HbA1c) was associated with frozen shoulder: odds ratio (OR) = 1.50 [95% confidence interval (CI), 1.20-1.88], Dupuytren's disease: OR = 1.17 (95% CI, 1.01-1.35), trigger finger: OR = 1.30 (95% CI, 1.09-1.55) and carpal tunnel syndrome: OR = 1.20 (95% CI, 1.09-1.33). Carriers of GCK mutations have increased odds of frozen shoulder: OR = 7.16 (95% CI, 2.93-17.51) and carpal tunnel syndrome: OR = 2.86 (95% CI, 1.50-5.44) but not Dupuytren's disease or trigger finger. We found evidence that an increase in genetically predicted body mass index (BMI) of 5 kg/m2 was associated with carpal tunnel syndrome: OR = 1.13 (95% CI, 1.10-1.16) and associated negatively with Dupuytren's disease: OR = 0.94 (95% CI, 0.90-0.98), but no evidence of association with frozen shoulder or trigger finger. Trigger finger (OR 1.96 (95% CI, 1.42-2.69) P = 3.6e-05) and carpal tunnel syndrome [OR 1.63 (95% CI, 1.36-1.95) P = 8.5e-08] are associated with genetically predicted unfavourable adiposity increase of one standard deviation of body fat. CONCLUSIONS Our study consistently demonstrates a causal role of long-term high glycaemia in the aetiology of upper limb musculoskeletal conditions. Clinicians treating diabetes patients should be aware of these complications in clinic, specifically those managing the care of GCK mutation carriers. Upper limb musculoskeletal conditions should be considered diabetes complications.
Collapse
Affiliation(s)
- Harry D Green
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Ella Burden
- Shoulder Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Ji Chen
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Jonathan Evans
- Shoulder Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Kashyap Patel
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Andrew R Wood
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Robin N Beaumont
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Jessica Tyrrell
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Timothy M Frayling
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Andrew T Hattersley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Richard A Oram
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Jack Bowden
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Inês Barroso
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Christopher Smith
- Shoulder Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Michael N Weedon
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| |
Collapse
|
4
|
Riesmeijer SA, Kamali Z, Ng M, Drichel D, Piersma B, Becker K, Layton TB, Nanchahal J, Nothnagel M, Vaez A, Hennies HC, Werker PMN, Furniss D, Nolte IM. A genome-wide association meta-analysis implicates Hedgehog and Notch signaling in Dupuytren's disease. Nat Commun 2024; 15:199. [PMID: 38172110 PMCID: PMC10764787 DOI: 10.1038/s41467-023-44451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
Dupuytren's disease (DD) is a highly heritable fibrotic disorder of the hand with incompletely understood etiology. A number of genetic loci, including Wnt signaling members, have been previously identified. Our overall aim was to identify novel genetic loci, to prioritize genes within the loci for functional studies, and to assess genetic correlation with associated disorders. We performed a meta-analysis of six DD genome-wide association studies from three European countries and extensive bioinformatic follow-up analyses. Leveraging 11,320 cases and 47,023 controls, we identified 85 genome-wide significant single nucleotide polymorphisms in 56 loci, of which 11 were novel, explaining 13.3-38.1% of disease variance. Gene prioritization implicated the Hedgehog and Notch signaling pathways. We also identified a significant genetic correlation with frozen shoulder. The pathways identified highlight the potential for new therapeutic targets and provide a basis for additional mechanistic studies for a common disorder that can severely impact hand function.
Collapse
Affiliation(s)
- Sophie A Riesmeijer
- University of Groningen, University Medical Center Groningen, Department of Plastic Surgery, Groningen, The Netherlands.
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
| | - Zoha Kamali
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
- Department of bioinformatics, School of Advanced Medical Technologies, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Michael Ng
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Dmitriy Drichel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
- Faculty of Medicine and the Cologne University Hospital, Cologne, Germany
| | - Bram Piersma
- University of Groningen, Groningen, The Netherlands
| | - Kerstin Becker
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | | | | | - Michael Nothnagel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
- Faculty of Medicine and the Cologne University Hospital, Cologne, Germany
| | - Ahmad Vaez
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
- Department of bioinformatics, School of Advanced Medical Technologies, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hans Christian Hennies
- Faculty of Medicine and the Cologne University Hospital, Cologne, Germany
- Department of Biological Sciences, University of Huddersfield, Huddersfield, UK
| | - Paul M N Werker
- University of Groningen, University Medical Center Groningen, Department of Plastic Surgery, Groningen, The Netherlands
| | - Dominic Furniss
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Ilja M Nolte
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| |
Collapse
|
5
|
Shared genetic architecture between attention-deficit/hyperactivity disorder and lifespan. Neuropsychopharmacology 2023; 48:981-990. [PMID: 36906694 PMCID: PMC10209393 DOI: 10.1038/s41386-023-01555-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/03/2023] [Accepted: 02/20/2023] [Indexed: 03/13/2023]
Abstract
There is evidence linking ADHD to a reduced life expectancy. The mortality rate in individuals with ADHD is twice that of the general population and it is associated with several factors, such as unhealthy lifestyle behaviors, social adversity, and mental health problems that may in turn increase mortality rates. Since ADHD and lifespan are heritable, we used data from genome-wide association studies (GWAS) of ADHD and parental lifespan, as proxy of individual lifespan, to estimate their genetic correlation, identify genetic loci jointly associated with both phenotypes and assess causality. We confirmed a negative genetic correlation between ADHD and parental lifespan (rg = -0.36, P = 1.41e-16). Nineteen independent loci were jointly associated with both ADHD and parental lifespan, with most of the alleles that increased the risk for ADHD being associated with shorter lifespan. Fifteen loci were novel for ADHD and two were already present in the original GWAS on parental lifespan. Mendelian randomization analyses pointed towards a negative causal effect of ADHD liability on lifespan (P = 1.54e-06; Beta = -0.07), although these results were not confirmed by all sensitivity analyses performed, and further evidence is required. The present study provides the first evidence of a common genetic background between ADHD and lifespan, which may play a role in the reported effect of ADHD on premature mortality risk. These results are consistent with previous epidemiological data describing reduced lifespan in mental disorders and support that ADHD is an important health condition that could negatively affect future life outcomes.
Collapse
|
6
|
Rydberg M, Zimmerman M, Löfgren JP, Gottsäter A, Nilsson PM, Melander O, Dahlin LB. Metabolic factors and the risk of Dupuytren's disease: data from 30,000 individuals followed for over 20 years. Sci Rep 2021; 11:14669. [PMID: 34282190 PMCID: PMC8289914 DOI: 10.1038/s41598-021-94025-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/30/2021] [Indexed: 01/22/2023] Open
Abstract
Dupuytren’s disease (DD) is a fibroproliferative disorder affecting the palmar fascia of the hand. Risk factors include diabetes mellitus (DM), whereas a high body mass index (BMI) is associated with a lower prevalence of DD. The aim of this study was to further elucidate risk and protective factors for the development of DD using longitudinal population-based data from the Malmö Diet and Cancer Study (MDCS). During 1991–1996, the inhabitants aged 46–73 years in the city of Malmö, Sweden were invited to participate in the population-based MDCS (41% participation rate). Data on incident DD were retrieved from Swedish national registers. Associations between DM, alcohol consumption, BMI, and serum apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) at baseline were analysed in multivariable Cox regression models adjusted for known confounders. Among 30,446 recruited participants, 347 men and 194 women were diagnosed with DD during a median follow-up time of 23 years. DM (men HR 2.23; 95% CI 1.50–3.30, women HR 2.69; 95% CI 1.48–4.90) and alcohol consumption (men HR 2.46; 95% CI 1.85–3.27, women HR 3.56; 95% CI 1.95–6.50) were independently associated with incident DD in the Cox regression models. Furthermore, inverse associations with incident DD were found for obesity among men, and ApoB/ApoA1 ratio among both sexes. DM and excess alcohol consumption constituted major risk factors for the development of DD. Furthermore, an inverse association between obesity among men and DD, and also between ApoB/ApoA1 ratio and DD was found in both sexes.
Collapse
Affiliation(s)
- Mattias Rydberg
- Department of Hand Surgery, Lund University, Skåne University Hospital, Jan Waldenströms gata 5, 205 02, Malmö, Sweden. .,Department of Translational Medicine-Hand Surgery, Lund University, Lund, Sweden.
| | - Malin Zimmerman
- Department of Hand Surgery, Lund University, Skåne University Hospital, Jan Waldenströms gata 5, 205 02, Malmö, Sweden.,Department of Translational Medicine-Hand Surgery, Lund University, Lund, Sweden
| | - Jin Persson Löfgren
- Department of Hand Surgery, Lund University, Skåne University Hospital, Jan Waldenströms gata 5, 205 02, Malmö, Sweden.,Department of Translational Medicine-Hand Surgery, Lund University, Lund, Sweden
| | - Anders Gottsäter
- Department of Vascular Diseases, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Peter M Nilsson
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Lars B Dahlin
- Department of Hand Surgery, Lund University, Skåne University Hospital, Jan Waldenströms gata 5, 205 02, Malmö, Sweden.,Department of Translational Medicine-Hand Surgery, Lund University, Lund, Sweden
| |
Collapse
|
7
|
Gelbard MK, Rosenbloom J. Fibroproliferative disorders and diabetes: Understanding the pathophysiologic relationship between Peyronie's disease, Dupuytren disease and diabetes. Endocrinol Diabetes Metab 2021; 4:e00195. [PMID: 33855203 PMCID: PMC8029506 DOI: 10.1002/edm2.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/18/2020] [Accepted: 09/26/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction Fibrosis is characterized by dysregulation and accumulation of extracellular matrix. Peyronie's disease and Dupuytren disease are fibroproliferative disorders of the tunica albuginea of the penis and fascia of the hand, respectively. Chronic hyperglycaemia due to diabetes mellitus can also lead to tissue injury and fibrosis. A meta-analysis has shown a relationship between Dupuytren disease and diabetes (overall odds ratio, 3.1; 95% confidence interval, 2.7-3.5). This review explores commonalities in the pathogenesis of Peyronie's disease, Dupuytren disease and diabetes. Methods A search of the PubMed database was conducted using the search terms "diabetes" AND "Peyronie's disease"; and "diabetes" AND "Dupuytren." Results Genome-wide association and gene expression studies conducted with tissue from people with Peyronie's disease or Dupuytren disease identified signalling pathways associated with wingless-type mammary-tumour virus integration site signalling, extracellular matrix modulation and inflammation. Biochemical studies confirmed the importance of these pathways in the pathogenesis of fibrosis with Peyronie's disease and Dupuytren disease. Dysregulation of matrix metalloproteinase activity associated with extracellular matrix breakdown was implicated in fibroproliferative complications of diabetes and in the aetiology of Peyronie's disease and Dupuytren disease. A notable percentage of people with diabetes have comorbid Peyronie's disease and/or Dupuytren disease. Conclusions Studies have not been performed to identify fibroproliferative pathways that all 3 conditions might have in common, but data suggest that common pathways are involved in the fibroproliferative processes of Peyronie's disease, Dupuytren disease, and diabetes.
Collapse
Affiliation(s)
- Martin K. Gelbard
- Department of UrologyDavid Geffen School of Medicine at UCLALos AngelesCAUSA
| | - Joel Rosenbloom
- Department of Dermatology and Cutaneous BiologyThe Joan and Joel Rosenbloom Research Center for Fibrotic DiseasesSidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPAUSA
| |
Collapse
|
8
|
Garkisch A, Mittlmeier T, Kalpen A, Mühldorfer-Fodor M, Fischer DC, Wichelhaus A. Dynamic Manugraphy as a Promising Tool to Assess the Outcome of Limited Aponeurectomy in Patients With Dupuytren's Contracture. Front Med (Lausanne) 2021; 7:604891. [PMID: 33511143 PMCID: PMC7835140 DOI: 10.3389/fmed.2020.604891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Dupuytren's contractures interfere with physiological gripping. While limited aponeurectomy is an accepted treatment modality to restore finger mobility, methods to objectify functional outcome beyond determination of the range of motion are scarce. Methods: Patients with Dupuytren's contracture being scheduled for unilateral limited aponeurectomy were invited to participate. Clinical data were gathered prospectively by chart review and interview. The DASH-score and flexion contracture for fingers were registered prior to surgery, 3 and 6 months afterwards. At the same time, dynamic manugraphy for simultaneous recording of the grip pattern and forces generated by the affected hand and anatomic areas (i.e., thumb, index finger, middle finger, ring finger, little finger and palm) were performed. All findings obtained during the follow-up period were compared to the situation at baseline. Comparison between paired samples was done using Wilcoxon rank test. All p-values are two-sided and p < 0.05 was considered to be significant. Results: Out of 23 consecutively enrolled patients, 19 (15 men, 4 women) completed follow-up examinations. Manugraphy confirmed the impairment of physiological gripping with concomitant pathological load distribution at base line. Limited aponeurectomy significantly reduced flexion contractures. However, the DASH-score remained at an excellent level in one patient, indicated improvement in 11 and worsening in seven patients. Six patients had lower grip force at t6 compared to the preoperative condition, although the preoperative flexion contracture (≥110°) was considerably improved in all of them. In four of those, the DASH-score improved while it turned worse in two of them. The force of surgically treated fingers remained unchanged in three patients while it was improved and worsened in half of the remaining patients, respectively. Manugraphy revealed physiological gripping by enlargement of contact area and higher force transmission by the fingertips in 10 of 12 patients with constant or even improved DASH-score and in three of seven patients with a worsened DASH-score. Conclusions: Assessing the reduction of flexion contracture and grip force alone is not sufficient to comprehensively reflect the functional outcome of aponeurectomy for Dupuytren's disease. Visualizing physiological grip pattern provides an additional tool to objectify the success of surgical treatment.
Collapse
Affiliation(s)
- Angelina Garkisch
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
| | - Axel Kalpen
- Novel Biomechanics Laboratory, Munich, Germany
| | | | - Dagmar-C Fischer
- Department of Pediatrics, Rostock University Medical Centre, Rostock, Germany
| | - Alice Wichelhaus
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
| |
Collapse
|
9
|
Tuominen I, Fuqua BK, Pan C, Renaud N, Wroblewski K, Civelek M, Clerkin K, Asaryan A, Haroutunian SG, Loureiro J, Borawski J, Roma G, Knehr J, Carbone W, French S, Parks BW, Hui ST, Mehrabian M, Magyar C, Cantor RM, Ukomadu C, Lusis AJ, Beaven SW. The Genetic Architecture of Carbon Tetrachloride-Induced Liver Fibrosis in Mice. Cell Mol Gastroenterol Hepatol 2020; 11:199-220. [PMID: 32866618 PMCID: PMC7674618 DOI: 10.1016/j.jcmgh.2020.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Liver fibrosis is a multifactorial trait that develops in response to chronic liver injury. Our aim was to characterize the genetic architecture of carbon tetrachloride (CCl4)-induced liver fibrosis using the Hybrid Mouse Diversity Panel, a panel of more than 100 genetically distinct mouse strains optimized for genome-wide association studies and systems genetics. METHODS Chronic liver injury was induced by CCl4 injections twice weekly for 6 weeks. Four hundred thirty-seven mice received CCl4 and 256 received vehicle, after which animals were euthanized for liver histology and gene expression. Using automated digital image analysis, we quantified fibrosis as the collagen proportionate area of the whole section, excluding normal collagen. RESULTS We discovered broad variation in fibrosis among the Hybrid Mouse Diversity Panel strains, demonstrating a significant genetic influence. Genome-wide association analyses revealed significant and suggestive loci underlying susceptibility to fibrosis, some of which overlapped with loci identified in mouse crosses and human population studies. Liver global gene expression was assessed by RNA sequencing across the strains, and candidate genes were identified using differential expression and expression quantitative trait locus analyses. Gene set enrichment analyses identified the underlying pathways, of which stellate cell involvement was prominent, and coexpression network modeling identified modules associated with fibrosis. CONCLUSIONS Our results provide a rich resource for the design of experiments to understand mechanisms underlying fibrosis and for rational strain selection when testing antifibrotic drugs.
Collapse
Affiliation(s)
- Iina Tuominen
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Brie K Fuqua
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Calvin Pan
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Nicole Renaud
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts
| | - Kevin Wroblewski
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Mete Civelek
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Kara Clerkin
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Ashot Asaryan
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sara G Haroutunian
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Joseph Loureiro
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts
| | - Jason Borawski
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts
| | | | | | | | - Samuel French
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Brian W Parks
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Simon T Hui
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Margarete Mehrabian
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Clara Magyar
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Rita M Cantor
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Chinweike Ukomadu
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts
| | - Aldons J Lusis
- Departments of Medicine, Microbiology and Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California.
| | - Simon W Beaven
- Department of Medicine, Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and Pfleger Liver Institute, David Geffen School of Medicine at UCLA, Los Angeles, California.
| |
Collapse
|
10
|
Johnson BZ, Stevenson AW, Prêle CM, Fear MW, Wood FM. The Role of IL-6 in Skin Fibrosis and Cutaneous Wound Healing. Biomedicines 2020; 8:biomedicines8050101. [PMID: 32365896 PMCID: PMC7277690 DOI: 10.3390/biomedicines8050101] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022] Open
Abstract
The timely resolution of wound healing is critical for restoring the skin as a protective barrier. The switch from a proinflammatory to a reparative microenvironment must be tightly regulated. Interleukin (IL)-6 is a key modulator of the inflammatory and reparative process: it is involved in the differentiation, activation, and proliferation of leukocytes, endothelial cells, keratinocytes, and fibroblasts. This review examines the role of IL-6 in the healing of cutaneous wounds, and how dysregulation of IL-6 signaling can lead to either fibrosis or a failure to heal. The role of an IL-6/TGF-β feedback loop is discussed in the context of fibrogenesis, while IL-6 expression and responses in advanced age, diabetes, and obesity is outlined regarding the development of chronic wounds. Current research on therapies that modulate IL-6 is explored. Here, we consider IL-6′s diverse impact on cutaneous wound healing.
Collapse
Affiliation(s)
- Blair Z. Johnson
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- Correspondence:
| | - Andrew W. Stevenson
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
| | - Cecilia M. Prêle
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- Institute for Respiratory Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Mark W. Fear
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
| | - Fiona M. Wood
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- WA Department of Health, 189 Royal St, East Perth, WA 6004, Australia
| |
Collapse
|
11
|
Major M, Freund MK, Burch KS, Mancuso N, Ng M, Furniss D, Pasaniuc B, Ophoff RA. Integrative analysis of Dupuytren's disease identifies novel risk locus and reveals a shared genetic etiology with BMI. Genet Epidemiol 2019; 43:629-645. [PMID: 31087417 PMCID: PMC6699495 DOI: 10.1002/gepi.22209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/04/2019] [Accepted: 04/19/2019] [Indexed: 12/26/2022]
Abstract
Dupuytren's disease is a common inherited tissue‐specific fibrotic disorder, characterized by progressive and irreversible fibroblastic proliferation affecting the palmar fascia of the hand. Although genome‐wide association study (GWAS) have identified 24 genomic regions associated with Dupuytrens risk, the biological mechanisms driving signal at these regions remain elusive. We identify potential biological mechanisms for Dupuytren's disease by integrating the most recent, largest GWAS (3,871 cases and 4,686 controls) with eQTLs (47 tissue panels from five consortia, total n = 3,975) to perform a transcriptome‐wide association study. We identify 43 tissue‐specific gene associations with Dupuytren's risk, including one in a novel risk region. We also estimate the genome‐wide genetic correlation between Dupuytren's disease and 45 complex traits and find significant genetic correlations between Dupuytren's disease and body mass index (BMI), type II diabetes, triglycerides, and high‐density lipoprotein (HDL), suggesting a shared genetic etiology between these traits. We further examine local genetic correlation to identify 8 and 3 novel regions significantly correlated with BMI and HDL respectively. Our results are consistent with previous epidemiological findings showing that lower BMI increases risk for Dupuytren's disease. These 12 novel risk regions provide new insight into the biological mechanisms of Dupuytren's disease and serve as a starting point for functional validation.
Collapse
Affiliation(s)
- Megan Major
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, California
| | - Malika K Freund
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kathryn S Burch
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, California
| | - Nicholas Mancuso
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Michael Ng
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Dominic Furniss
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK.,Department of Plastic and Reconstructive Surgery, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,NIHR Biomedical Research Centre, NDORMS, University of Oxford, Oxford, UK
| | - Bogdan Pasaniuc
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, California.,Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Biomathematics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Roel A Ophoff
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, California.,Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, California
| |
Collapse
|