Skip to main content

Advertisement

SpringerLink
Log in

Expression of TRAIL and death receptor DR4 in Palmer type 2 TFCC lesions

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Degenerative articular disc perforations of the triangular fibrocartilage (TFC) of the wrist are characterized by fibrocartilage cell loss and are often associated with ulna-plus situations. Apoptosis has been found to play a crucial role in fibrocartilage cell loss, however, the molecular mechanism and mediators are still poorly understood.

Aim

The purpose of this study was to identify receptors to apoptosis in degenerative disc lesions.

Patients

Included in the study were 17 patients with degenerative articular disc tears of the TFC (Palmer type 2C). Following arthroscopic debridement of the TFC, histological sections were examined to assess the presence of apoptosis. Apoptosis was determined using TRAIL and death receptor DR4 agonists for immunohistochemical analyses. The number of cells positive for apoptosis was then correlated with ulna length.

Results

Cells positive for TRAIL and DR4 were found in all specimens. The number of cells positive for TRAIL was significantly increased in specimens of patients with an ulna positive variance (P = 0.040). However, DR4 was not significantly increased in ulna plus (P > 0.05). Both, TRAIL and DR4 positive cells were found to be evenly distributed throughout each specimen. There was no accumulation of any type of cells in any particular zone of the biopsies.

Conclusion

This is the first study that shows that TFCC cells express TRAIL and DR4, which suggests that apoptosis, as well as, mechanical trauma are involved in the development of disc perforation. The TRAIL/DR4 receptor system is a molecular mediator of apoptosis induction in TFC cells and therefore plays a role in cell loss in degenerative disc lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am] 14(4):594–606

    Article  CAS  Google Scholar 

  2. Palmer AK, Werner FW (1981) The triangular fibrocartilage complex of the wrist—anatomy and function. J Hand Surg [Am] 6(2):153–162

    CAS  Google Scholar 

  3. Mikic ZD (1989) Detailed anatomy of the articular disc of the distal radioulnar joint. Clin Orthop Relat Res 245:123–132

    PubMed  Google Scholar 

  4. Unglaub F, Fellenberg J, Germann G, Bickert B, Sauerbier M, Richter W (2007) Detection of apoptotic cartilage cells in symptomatic central tears of the triangular fibrocartilage. J Hand Surg [Am] 32(5):618–622

    Article  Google Scholar 

  5. Unglaub F, Wolf MB, Thome MA, Germann G, Sauerbier M, Reiter A (2008) Correlation of ulnar length and apoptotic cell death in degenerative lesions of the triangular fibrocartilage. Arthroscopy 24(3):299–304

    Article  PubMed  Google Scholar 

  6. Unglaub F, Thomas S, Kroeber M, Dragu A, Fellenberg J, Wolf MB et al (2009) Apoptotic pathways in degenerative disc lesions in the wrist. Arthroscopy 25(12):1380–1386

    Article  PubMed  Google Scholar 

  7. Wiley SR, Schooley K, Smolak PJ, Din WS, Huang CP, Nicholl JK et al (1995) Identification and characterization of a new member of the TNF family that induces apoptosis. Immunity 3(6):673–682

    Article  CAS  PubMed  Google Scholar 

  8. Bertram H, Nerlich A, Omlor G, Geiger F, Zimmermann G, Fellenberg J (2009) Expression of TRAIL and the death receptors DR4 and DR5 correlates with progression of degeneration in human intervertebral disks. Mod Pathol 22(7):895–905

    Article  CAS  PubMed  Google Scholar 

  9. Zhang L, Niu T, Yang SY, Lu Z, Chen B (2008) The occurrence and regional distribution of DR4 on herniated disc cells: a potential apoptosis pathway in lumbar intervertebral disc. Spine (Phila Pa 1976) 33(4):422–427

    Google Scholar 

  10. Chen B, Fellenberg J, Wang H, Carstens C, Richter W (2005) Occurrence and regional distribution of apoptosis in scoliotic discs. Spine 30(5):519–524

    Article  PubMed  Google Scholar 

  11. Tatebe M, Horii E, Nakao E, Shinohara T, Imaeda T, Nakamura R et al (2007) Repair of the triangular fibrocartilage complex after ulnar-shortening osteotomy: second-look arthroscopy. J Hand Surg [Am] 32(4):445–449

    Article  Google Scholar 

  12. Bednar MS, Arnoczky SP, Weiland AJ (1991) The microvasculature of the triangular fibrocartilage complex: its clinical significance. J Hand Surg [Am] 16(6):1101–1105

    Article  CAS  Google Scholar 

  13. Wolf MB, Kroeber MW, Reiter A, Thomas SB, Hahn P, Horch RE et al (2008) Ulnar shortening after TFCC suture repair of Palmer type 1B lesions. Arch Orthop Trauma Surg [Epub ahead of print]

  14. Unglaub F, Kroeber MW, Thomas SB, Wolf MB, Arkudas A, Dragu A et al (2009) Incidence and distribution of blood vessels in punch biopsies of Palmer 1A disc lesions in the wrist. Arch Orthop Trauma Surg 129(5):631–634

    Article  PubMed  Google Scholar 

  15. Estrella EP, Hung LK, Ho PC, Tse WL (2007) Arthroscopic repair of triangular fibrocartilage complex tears. Arthroscopy 23(7):729–737

    Article  PubMed  Google Scholar 

  16. Reiter A, Wolf MB, Schmid U, Frigge A, Dreyhaupt J, Hahn P et al (2008) Arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears. Arthroscopy 24(11):1244–1250

    Article  PubMed  Google Scholar 

  17. Lavrik IN, Golks A, Krammer PH (2005) Caspases: pharmacological manipulation of cell death. J Clin Invest 115(10):2665–2672

    Article  CAS  PubMed  Google Scholar 

  18. Green DR, Kroemer G (2005) Pharmacological manipulation of cell death: clinical applications in sight? J Clin Invest 115(10):2610–2617

    Article  CAS  PubMed  Google Scholar 

  19. Demjen D, Klussmann S, Kleber S, Zuliani C, Stieltjes B, Metzger C et al (2004) Neutralization of CD95 ligand promotes regeneration and functional recovery after spinal cord injury. Nat Med 10(4):389–395

    Article  CAS  PubMed  Google Scholar 

  20. Dang AC, Warren AP, Kim HT (2006) Beneficial effects of intra-articular caspase inhibition therapy following osteochondral injury. Osteoarthritis Cartilage 14(6):526–532

    Article  CAS  PubMed  Google Scholar 

  21. D’Lima D, Hermida J, Hashimoto S, Colwell C, Lotz M (2006) Caspase inhibitors reduce severity of cartilage lesions in experimental osteoarthritis. Arthritis Rheum 54(6):1814–1821

    Article  PubMed  Google Scholar 

  22. Costouros JG, Kim HT (2007) Preventing chondrocyte programmed cell death caused by iatrogenic injury. Knee 14(2):107–111

    Article  PubMed  Google Scholar 

  23. Park JB, Park IC, Park SJ, Jin HO, Lee JK, Riew KD (2006) Anti-apoptotic effects of caspase inhibitors on rat intervertebral disc cells. J Bone Joint Surg Am 88(4):771–779

    Article  PubMed  Google Scholar 

  24. Xu R, Shao Z, Xiong L (2008) Experimental study on inhibitory effect of niacinamide on tumor necrosis factor-alpha-induced matrix degradation of annulus fibrous tissue in vitro. J Huazhong Univ Sci Technolog Med Sci 28(5):576–579

    Article  CAS  PubMed  Google Scholar 

  25. Nuttall ME, Nadeau DP, Fisher PW, Wang F, Keller PM, DeWolf WE Jr et al (2000) Inhibition of caspase-3-like activity prevents apoptosis while retaining functionality of human chondrocytes in vitro. J Orthop Res 18(3):356–363

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by the ELAN Fonds, University of Erlangen, Germany.

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Plastic and Hand Surgery, University Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Germany

    Frank Unglaub, Susanne B. Thomas, Adrian Dragu, Maya B. Wolf & Raymund E. Horch

  2. Department of Orthopaedic Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Markus W. Kroeber

  3. Division of Experimental Orthopaedics, Orthopaedic University Hospital, Heidelberg, Germany

    Jörg Fellenberg

  4. Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany

    Thomas Mittlmeier

Authors
  1. Frank Unglaub
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne B. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Markus W. Kroeber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adrian Dragu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jörg Fellenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Mittlmeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maya B. Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Raymund E. Horch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frank Unglaub.

Additional information

F. Unglaub and S. B. Thomas contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Unglaub, F., Thomas, S.B., Kroeber, M.W. et al. Expression of TRAIL and death receptor DR4 in Palmer type 2 TFCC lesions. Arch Orthop Trauma Surg 130, 1215–1220 (2010). https://doi.org/10.1007/s00402-009-0988-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-009-0988-4

Keywords

Search

Navigation