REVIEW  DUPUYTREN 

Minerva Orthopedics 2023 December;74(6):504-13

DOI: 10.23736/S2784-8469.23.04353-5

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

The new collagenase from Vibrio alginolyticus in the treatment of Dupuytren’s disease

Michele RICCIO, Pier Paolo PANGRAZI, Francesco DE FRANCESCO ✉

Department of Reconstructive and Hand Surgery, A.O.U. Marche, Ancona, Italy

Collagens account for approximately 25% of total protein mass in mammals and consist of protein structures featured by a rigid left-handed triple-helical configuration rich in proline, hydroxyproline, and glycine. They are degraded by a family of proteins called collagenase, which are enzymes that are produced not only by humans but also by many bacteria such as Clostridium histolyticum and Vibrio alginolyticus. Collagenases are of great importance especially in the debridement of wounds, as they enable the removal of the necrotic tissue from their bottom, and in the treatment of fibroproliferative diseases of the fascia (i.e., Dupuytren) where they are a potential therapeutic option for the abnormal deposition of collagen in them. Dupuytren’s contracture is a benign, myoproliferative condition affecting the palmar fascia that results in progressive contractures of the fingers. Despite increased knowledge of the cellular and connective tissue changes involved, neither a cure nor an optimum form of treatment exists. The aim of this overview was to summarize the best available evidence on the management of this condition by a novel collagenase by Vibrio alginolyticus. The collagenase of Vibrio alginolyticus is confirmed as selective for collagens I and III, reducing the risk of vascular lesions or cutaneous solutions.

KEY WORDS: Vibrio alginolyticus; Clostridium histolyticum; Dupuytren contracture; Collagenases