London scientist researches painful chronic hand disease


A scientist from the Lawson Health Research Institute has been recognized for research that may contribute to an increased quality of life for people suffering from Dupuytren’s contracture. Dupuytren’s contracture is a disease of the hand that results in an inability to straighten the fingers. Because the cause of Dupuytren’s contracture is unknown, the development of a curative therapy has been hampered and treatment is now symptomatic. Molecular studies, performed by a team lead by Dr. Bing Siang Gan, a Scientist at the Lawson Health Research Institute and Staff Surgeon at the Hand and Upper Limb Centre, have now uncovered a possible cause of Dupuytren’s contracture, thereby making it possible that curative therapies can be developed.

For fourteen years Valerie Allen’s Dupuytren’s contracture got progressively worse until she could no longer straighten her fingers or flatten the palm of her right hand. Valerie’s family doctor referred her to Dr. Gan who performed the much needed surgery last September. “After the surgery I had four months of intensive and painful physiotherapy before I could return to work,” commented Valerie, “luckily my employers allowed me paid sick leave, for many people this may not be an option.”

The Institute of Musculoskeletal Health and Arthritis (IMHA), one of 13 Institutes under the umbrella of the Canadian Institutes of Health Research, predicts that over the next two decades, the prevalence of many chronic diseases and conditions will increase, consuming a far greater proportion of Canada’s health care resources. Unfortunately, for those diagnosed with Dupuytren’s contracture, chronic pain and loss of mobility and function are common outcomes of the disease. IMHA has created its annual Quality of Life Research Awards to recognize outstanding research that focuses on diseases and conditions of the musculoskeletal system. This year, Dr. Gan’s work on the “molecular mechanisms of Dupuytren’s contracture” was the winner in the Pain, Disability and Chronic Diseases category, one of six focus and three priority areas recognized by the IMHA.

Currently, the only accepted treatment for Dupuytren’s contracture is surgical resection of the affected tissues, followed by prolonged post-operative rehabilitation. However, epidemiological data suggests that the changes to the tissues in the hand may be the result of an inheritable genetic defect. Dr. Gan and his colleagues are studying the molecular and cellular mechanisms of Dupuytren’s contracture and have identified specific molecules that may be responsible for the disease process. They are currently investigating whether manipulation of these molecules may alter the characteristics of the disease.

“Studies such as Dr. Gan’s are important because they result in better understanding of the genetic, socioeconomic and environmental causes of disease, as well as optimal methods of treatment to eliminate pain and disability,” said Dr. Cyril Frank, IMHA’s scientific director. Dr. Gan hopes his study will eventually lead to the development of alternative methods of diagnosis and treatment of Dupuytren’s contracture, and possibly other closely related disorders such as desmoid tumors, hypertrophic scars and abnormal wound healing.

The Lawson Health Research Institute in London, Ontario, Canada is the research arm of London Health Sciences Centre, and St. Joseph’s Health Care London.