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By Brittany Ferri October 17, 2020

The real cause of Dupuytren's contracture is not fully understood, but many have classified it as an unknown type of autoimmune disease. For this reason, there has been much controversy over what an autoimmune condition is and whether or not Dupuytren's falls under that category.

Autoimmune disease definition

An autoimmune disease causes the body’s immune system to enter overdrive. The immune system is our body's main defense in that it fights infections and foreign substances. This means that immune system dysfunction will cause it to mistakenly attack healthy parts of our body.

Normally, our immune system is intelligent enough to tell our own cells apart from invaders, but autoimmune diseases impair the body's ability to recognize good from bad. There are many kinds of autoimmune diseases and they can affect different areas of the body. Some affect a specific organ or two while others can even have an impact on the whole body.

What causes autoimmune conditions?

Surprisingly, no one knows the exact reason for this malfunctioning yet. However, research has observed patterns that indicate some people are more susceptible to these conditions than other people are. For example, women are two times more likely to suffer from autoimmune diseases when compared to men. Many autoimmune diseases are more common in particular races and ethnicities; they can also passed on through families from one generation to the next. All these tendencies show thatgenetics play a major role in the immune system. But environmental factors such as nutrition and exposure to chemicals have been known to impact the development of autoimmune diseases. 

Is Dupuytren’s Contracture an autoimmune disease?

Research has not yet confirmed the exact cause of Dupuytren's disease, so it's hard to determine whether it's an autoimmune disorder or not. Despite this, many researcherspostulate that it is autoimmune in nature. There are two major reasons for this assumption. The first is statistics: patterns of its occurrence in the population are somewhat predictable in terms of age, gender, and ethnicity, meaning there is a genetic component to Dupuytren's.

As we mentioned above, autoimmune diseases show similar features and they are also strongly connected with certain genetic traits. Moreover, theMayo Clinic states that people with diabetes (another autoimmune disorder) have an increased risk of developing Dupuytren’s. These patterns are similar, since people with one autoimmune condition are more likely to develop others.

About half of the people who suffer from a Dupuytren’s contracture also suffer from what is called frozen shoulder. The cause of frozen shoulder is also a mystery, but it's commonly thought of as an autoimmune reaction that has developed into a disease.

Secondly, the pathology of Dupuytren's shows some connection with the immune system. Although nothing is confirmed, some findings call the cellular response a “spontaneous disturbed-tolerance auto-immune disease.” The same research also explains that the disease may be initiated by a series of gene mutations in thelymphatic system, which is part of the immune system.

In Dupuytren's, symptoms develop as a result of mutated lymphocytes, which may then attack healthy tissue and cause the excess production of other cells called fibroblasts.

Other research suggests that T and B lymphocytes contribute to the development of Dupuytren's, and it has even been called a “T-cell mediated autoimmune disorder.” Some experiments claim to find higher levels of T-cells in the tissue affected by Dupuytren’s compared to healthy tissue. Other studies claim to have found higher levels of antibodies in affected tissues of the hand. All these findings suggest an autoimmune reaction is present in Dupuytren's.

Negative evidence for Dupuytren's

There are also studies that have shown no significant correlation between components of the immune system and Dupuytren’s, though they did show correlation with other fibrotic diseases. For example, onestudy details the link between eosinophils (little sacs that are part of the immune system) and Dupuytren’s contracture. Although there was strong evidence of abnormal eosinophil levels in other fibrotic conditions, researchers did not find the same for Dupuytren’s.

As you can see, although Dupuytren's hassome immune involvement, there is no outstanding evidence that connects it directly or definitively to other autoimmune conditions.

Brittany Ferri
Brittany Ferri

Brittany is a registered and licensed occupational therapist who has 6 years of clinical experience treating conditions such as Dupuytren's, arthritis, carpal tunnel, and more. She is passionate about educating others about their health.