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Novotny T, Eckhardt A, Doubkova M, Knitlova J, Vondrasek D, Vanaskova E, Ostadal M, Uhlik J, Bacakova L, Musilkova J. The possible role of hypoxia in the affected tissue of relapsed clubfoot. Sci Rep 2022; 12:4462. [PMID: 35292718 PMCID: PMC8924187 DOI: 10.1038/s41598-022-08519-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Our aim was to study the expression of hypoxia-related proteins as a possible regulatory pathway in the contracted side tissue of relapsed clubfoot. We compared the expression of hypoxia-related proteins in the tissue of the contracted (medial) side of relapsed clubfoot, and in the tissue of the non-contracted (lateral) side of relapsed clubfoot. Tissue samples from ten patients were analyzed by immunohistochemistry and image analysis, Real-time PCR and Mass Spectrometry to evaluate the differences in protein composition and gene expression. We found a significant increase in the levels of smooth muscle actin, transforming growth factor-beta, hypoxia-inducible factor 1 alpha, lysyl oxidase, lysyl oxidase-like 2, tenascin C, matrix metalloproteinase-2, matrix metalloproteinase-9, fibronectin, collagen types III and VI, hemoglobin subunit alpha and hemoglobin subunit beta, and an overexpression of ACTA2, FN1, TGFB1, HIF1A and MMP2 genes in the contracted medial side tissue of clubfoot. In the affected tissue, we have identified an increase in the level of hypoxia-related proteins, together with an overexpression of corresponding genes. Our results suggest that the hypoxia-associated pathway is potentially a factor contributing to the etiology of clubfoot relapses, as it stimulates both angioproliferation and fibroproliferation, which are considered to be key factors in the progression and development of relapses.
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Affiliation(s)
- Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, Usti nad Labem, Czech Republic.,Department of Histology and Embryology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Adam Eckhardt
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Martina Doubkova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic. .,Second Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Jarmila Knitlova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - David Vondrasek
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.,Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Eliska Vanaskova
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Martin Ostadal
- Department of Orthopaedics, University Hospital Bulovka, Charles University, Prague, Czech Republic
| | - Jiri Uhlik
- Department of Histology and Embryology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lucie Bacakova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jana Musilkova
- Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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