Abstract
Stenosing tenosynovitis of the first dorsal compartment of the wrist (a.k.a. de Quervain’s disease) is common but how estrogen is involved is still unknown. We previously reported that inflammation was involved in the pathogenesis of this ailment. In the present study, we extended our investigation of estrogen receptor (ER)-β expression to determine whether estrogen is involved in the pathogenesis of de Quervain’s. Intraoperative retinaculum samples were collected from 16 patients with the ailment. Specimens were histologically graded by collagen structure and immunohistochemically evaluated by quantifying the expression of ER-β, interleukin (IL)-1β and IL-6 (inflammatory cytokines), cyclooxygenase (COX)-2 (an inflammatory enzyme), and vascular endothelial growth factor (VEGF), and Von Willebrand’s factor (vWF). De Quervain’s occurs primarily in women. The female:male ratio in our study was 7:1. We found that ER-β expression in the retinaculum was positively correlated with disease grade and patient age. Additionally, disease severity was associated with inflammatory factors—IL-1β and IL-6, COX-2, and VEGF and vWF in tenosynovial tissue. The greater the levels of ER-β expression, tissue inflammation, and angiogenesis are, the more severe de Quervain’s disease is. ER-β might be a useful target for novel de Quervain’s disease therapy.
Highlights
De Quervain’s disease, “precisely defined as stenosing tenosynovitis of the first dorsal compartment” [1], is a common pathological condition of the wrist
We showed that estrogen receptor (ER)-β expression was higher in patients with de Quervain’s disease, that the degree of expression was related to the disease severity
ER-β is upregulated in the tenosynovial tissue of postmenopausal woman with idiopathic carpal tunnel syndrome, the pathogenesis of which has been associated with altered expression of ERs [15]
Summary
De Quervain’s disease, “precisely defined as stenosing tenosynovitis of the first dorsal compartment” [1], is a common pathological condition of the wrist. Because of thickening of the sheath containing the abductor pollicis longus and extensor pollicis brevis tendons at the radial styloid process [2,3], it causes swelling and pain on the radial side of the wrist. A number of non-surgical treatments, such as splinting, anti-inflammatory drugs (NSAIDs), and corticosteroid injections, are used to treat this disease [4,5]. Like trigger finger and carpal tunnel syndrome, de Quervain’s disease has been considered an overuse syndrome. They are all musculoskeletal disorders caused by repetitive hand posture and motion [6]
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