CONNECTIVE TISSUE GROWTH FACTOR (CTGF) EXPRESSION IN THE TENOSYNOVIUM OF PATIENTS WITH CARPAL TUNNEL SYNDROME

摘要

Connective Tissue Growth Factor (CTGF) expression has been identified in a wide variety of fibrotic disorders; however, the expression of CTGF in carpal tunnel syndrome (CTS) has not yet been described in the literature. Both inflammatory and fibrotic etiologies have been implicated in the pathogenesis of CTS, with current evidence favoring an emphasis on a non-inflammatory fibrosis pathophysiological picture. Our objective was to identify whether CTGF is expressed in the tenosynovium of patients with CTS. Tenosynovial tissue was isolated from human subjects undergoing surgical decompression of the carpal tunnel (carpal tunnel release or CTR) for treatment of CTS following various durations of failed conservative management. Samples tested included patients with "idiopathic" CTS alone or CTS in the presence of associated co-morbidities including Type II Diabetes Mellitus (DM), Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE). SDS-PAGE protein analysis of tenosynovial tissue homogenate was performed to assess for differences in overall protein expression amongst all samples. Our findings demonstrate the presence varying levels of CTGF in tenosynovial samples from patients with CTS. Additionally, tenosynovial samples from patients with certain associated co-morbidities - specifically RA and SLE - exhibit significant upregulation of CTGF levels relative to the levels observed patients with "idiopathic" CTS. These findings indicate that there is likely to be a role for CTGF in the pathogenesis of CTS.