Dupuytren’s Disease

 Description

The main events in Dupuytren’s Disease -- 

1)  accumulation of cell masses in an injured or stressed area.

2)  fibroblast proliferation in the cell masses, accumulating as nodules.  Increasing transformation of fibroblasts to myofibroblasts (producing excess filaments/collagen-III both interior and exterior to the cells).  All of this is perhaps provoked by narrowed microvessels (occluded capillaries) in combination with  localized ischemia and oxygen free radicals.  The myofibroblasts may also develop from blood platelet cells that accumulate in the area.  Growth factors (released from fibroblasts and platelets, plus transforming growth factor-b) stimulate myofibroblast proliferation and myofibroblast collagen production.

 3)  gradual disappearance of the nodules/fibroblasts, and conversion of myofibroblasts to fibrocytes (producing collagen-I), leaving a residue of filaments/collagen-I fibers as a dense network, with immobility and contracture.

Treatment

No cures are known at present.  Surgery can relieve contracture and restore some flexibility.  Research is examining possible means of repressing fibroblast proliferation and collagen accumulation.

Surgery cannot remove all tissue that eventually gets involved -- the tissue is too widespread; therefore, recurrence is frequent after surgery.  Focus should be on the nodules where the disease progresses.  Fibrous chords (end-stage deposits) are the response (not the cause), so acting on them does not affect the progress of the disease, although surgery can restore some movement. 

New dietary treatment possibilities and concerns explored below are focused on inhibiting collagen production and on inhibiting platelet aggregation (which promotes collagen production).

Possible Dietary Approaches

With the papers below, a comment regarding each paper or group of papers is provided at the start --

 3)  Garlic inhibits platelet aggregation.  The following are only 2 of the many articles indicating the benefits of garlic in inhibiting platelet aggregation.

Srivastava K.C. "Evidence for the mechanism by which garlic inhibits platelet aggregation." Prostaglandins Leukot Med. 1986 Jun; 22: 313 – 321.

Apitz-Castro R., Cabrera S., Cruz M.R., Ledezma E., Jain M.K.  " Effects of garlic extract and of three pure components isolated from it on human platelet aggregation, arachidonate metabolism, release reaction and platelet ultrastructure." Thromb Res 1983 Oct 15;32(2):155-69.

 4)  Endurance exercise transiently activates bone and collagen turnover, hopefully preventing a static buildup.

Wallace J.D., Cuneo R.C., Lundberg P.A., Rosen T., Jorgensen J.O., Longobardi S., Keay N., Sacca L., Christiansen J.S., Bengtsson B.A., Sonksen P.H. "Responses of markers of bone and collagen turnover to exercise, growth hormone (GH) administration, and GH withdrawal in trained adult males." J Clin Endocrinol Metab. 2000 Jan; 85: 124 - 133.

5)  L-arginine normalizes platelet aggregation.  Arginine is an amino acid.  A good vitamin tablet with arginine may help normalize platelet aggregation.

Wolf A., Zalpour C., Theilmeier G., Wang B.Y., Ma A., Anderson B., Tsao P.S., Cooke J.P. "Dietary L-arginine supplementation normalizes platelet aggregation in hypercholesterolemic humans." J Am Coll Cardiol. 1997 Mar 1; 29: 479 - 485.

7)  Olive oil components inhibit platelet aggregation.

Petroni A., Blasevich M., Salami M., Papini N., Montedoro G.F., Galli C. "Inhibition of platelet aggregation and eicosanoid production by phenolic components of olive oil."  Thromb Res 1995 Apr 15;78(2):151-60.

 8)  Soy lecithin inhibits collagen-induced platelet aggregation.

Brook J.G., Linn S., Aviram M. "Dietary soya lecithin decreases plasma triglyceride levels and inhibits collagen- and ADP-induced platelet aggregation." Biochem Med Metab Biol. 1986 Feb; 35: 31 – 39.