Subsynovial Connective Tissue and Carpal Tunnel Syndrome

滑膜下结缔组织和腕管综合征

• 批准号: 6732780
• 负责人: Peter C. Amadio
• 金额: $ 27.34万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-15 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6732780
• 关键词: biomechanics; carpal tunnel syndrome; clinical research; collagen; connective tissue; connective tissue growth factor; decorin; digital imaging; disease /disorder etiology; dogs; human subject; immunocytochemistry; laboratory rabbit; light microscopy; membrane permeability; pathologic process; postmortem; scanning transmission electron microscopy; sensory neuropathy; statistics /biometry; synovial membrane; tendon injury; transmission electron microscopy

DESCRIPTION (provided by applicant): Carpal tunnel syndrome (CTS) is one of the most common causes of work-related disability in the US. The most common pathological finding is non-inflammatory synovial fibrosis and thickening, but whether this fibrosis is a cause of, or merely an associated finding with the compression neuropathy of the median nerve that is characteristic of CTS is unknown. This study will attempt to address this important issue by investigating the motion behavior, mechanical properties, and biological response of the synovium, and specifically the subsynovial connective tissue (SSCT), the gliding interface which links the tendons and synovium in the carpal tunnel. We hypothesize that activity-related damage may occur to the SSCT, resulting in fibrosis, diminished elasticity and increased gliding resistance in the carpal tunnel, setting up a vicious cycle of progressive injury that ultimately impairs permeability of the synovium, increases carpal tunnel pressure, and thereby causes the median neuropathy of CTS. To test this hypothesis, we propose three Specific Aims. Aim 1 is to describe the motion characteristics of the SSCT, by video, fluoroscopic, and ultrasound imaging, in normal human cadavers, patients with CTS, and in candidate animal models of CTS (dog and rabbit); in Aim 2, the mechanical properties and permeability of the SSCT in these same groups will be studied and compared. Aim 3 will characterize the histology and immunohistochemistry of the SSCT in these tissues; if this hypothesis regarding the etiology of CTS is correct, a biological basis for cumulative trauma as an etiology will be established for the first time for CTS. In addition, suitable animal models will be characterized for further experimental investigations of CTS. Finally, a new perspective would be provided, which could serve as a foundation for new therapies and prevention strategies for CTS.

描述（由申请人提供）：腕管综合征（CTS）是美国与工作有关的残疾最常见原因之一。最常见的病理发现是非炎性滑膜纤维化和增厚，但是这种纤维化是导致CTS特征的中位神经的压缩神经病的原因，还是仅是与压缩神经病相关的发现。这项研究将尝试通过研究滑膜的运动行为，机械性能和生物学反应来解决这一重要问题，尤其是子宫脑结缔组织（SSCT），该结缔组织（SSCT）是连接腕管中肌腱和滑膜的滑行界面。我们假设SSCT可能会发生与活动相关的损害，从而导致纤维化，弹性降低和腕管中的滑行阻力增加，从而产生了渐进式损伤的恶性循环，最终会损害Synovium的渗透性，从而增加腕管压力，从而导致CTS神经病变中间的神经性神经病。为了检验这一假设，我们提出了三个具体目标。 AIM 1是通过视频，荧光镜检查和超声成像描述SSCT的运动特性，在正常的人尸体，CTS患者以及CTS（狗和兔子）的候选动物模型中；在AIM 2中，将研究并比较这些组中SSCT的机械性能和SSCT的渗透性。 AIM 3将表征SSCT在这些组织中的组织学和免疫组织化学。如果有关CTS病因的这一假设是正确的，则将首次建立CTS累积创伤为病因的生物学基础。此外，将表征合适的动物模型，以进一步研究CTS。最后，将提供新的观点，这可以为CTS的新疗法和预防策略提供基础。