Apoptosis Study Of Dupuytren's Contracture

Objective: Dupuytren's Disease's main characteristic is palmar aponeurosis hyperplasy and contract which lead to finger flexion contracture, this disease prevails in Northern Europe and other Europe countries, but less in easten and black ones.With the development of our country old people increasing Dupuytren's contracture patients become more. For 170 years, it that causes the Dupuytren's contracture is a hot topic in medical science field. In recent foreign reseach, Myofibroblasts appeared to be a important factor in the pathogenesis of Dupuytren's contracture and myofibroblasts play a role in Dupuytren's contracture advanced stage catagen apoptosis.The new reseach is that why myofibroblasts disappear in normal healing wound , oppositely fiber hyperplasy and proliferating exist in a long time. The explanation is that the myofibroblasts apoptosis disorders. The apoptosis inductor is unknown someones thought a certain gene may play a role in the apoptosis such as ced-3, c-Myc, transforming growth factor-R, TGF-R, R-platelet derived growth factor PDGF, tumor necrosis factor, TNF.Based on the foreign reseach, our study purpose are that to investigate the pathological changes of Dupuytren's disease in our country through the observation of light microscope and electron microscope, to observe the apoptosis cells through tunnel, to stuy the bcl-2/bax genes influence in the pathological changes of Dupuytren's disease. So it can make a good foundation for further study and provide a new method for clinical treatment.Methods: From 2006 to 2008, we have cured 24 Dupuytren's disease patiens whith 26 hands, we took the Dupuytren's disease samples during the operations under the patiens'agreement.All the samples are assured of diagnosis by pathology test .We got 21 normal palmar aponeurosis samples, of which fifteen were taken by traumatic amputation, three by the operation, three by fresh corpses.To observe the samples through light microscope and electron microscope; Streptoavidin peroxidase methods were applied to.The ultrastructure of lesioned aponeurosis was examined with electron microscope. All dates were analyzed statistically.Results: 1 The light microscope observation:Normal palmar aponeurosis samples:Type I collagens distribute in interstitial substance uniformitily. Fibrocytes are slender,of equal rank and regular. Type III collagens distribute in the interstitial substance in a steak or silkness form. Type III collagens gather in a certain area. Fibrocytes are slender and parallel at equal rank.The pathological changes palmar aponeurosis samples:Type I collagens distribute in a steak line and uneven. Fibrocytes gather in some areas at unregular.Type III collagens distribute in a steak , lamellar or a mesh way. Fibrocytes is short than normal one and rank not well-arranged .The quantity of the Fibrocytes becomes more than the normal.2 electron microscope observation:the pathological changes palmar aponeurosis samples: chondriosomes are meromixis partly and the quantity is uncountable. Rough endoplasmic reticulum expand and degranulate. Fibrocytes is fusiform shape,the cell nucleus is oval-shap. Electron density of the nuclear chromatin become more and gather under the nuclear membrane.Nearby the cell nucleus it could be seen a Golgi complex.3 According to tunnel test:Apoptotic index(AI)= number of apoptotic cells/total cells,we get the results:the AI of Dupuytren's contracture group is significantly higher than normal one.(P<0.05)4 Immunohistochemistry test:The optical density value(OD) of Dupuytren's contracture group is significantly higher than normal one. (P<0.05)Conclusions: 1 Apoptosis cells exist in the contracture of palmar fascia.2 In Dupuytren's contracture samples, type III collagen become more and type I collagen become less.3 The apoptosis which caused by bcl-2/bax genes play a important role through the pathological changes of Dupuytren's disease.