LUCIAN LIOR MARCOVICI

Dottore di ricerca

ciclo: XXXVI


supervisore: Prof. Roberto Gradini
relatore: Prof. Roberto Gradini
co-supervisore: Prof. Roberto Gradini

Titolo della tesi: Comparison of Immunohistochemical and Histopathological Findings Between Patients with Diabetic and Idiopathic Carpal Tunnel Syndrome

Introduction: Carpal tunnel syndrome (CTS) is the most common and widely studied nerve entrapment syndrome. It is caused by compression of the median nerve at the wrist as it passes through a space-limited osteofibrous canal. The exact cause of CTS is unknown, and a multifactorial origin is presumed; in such cases, CTS is defined as idiopathic. It affects 4-5% of the population especially between the ages of 45-60 years. There is strong evidence that patients with diabetes mellitus type 1 and 2 are at greater risk of developing CTS when compared to the general population. Although the exact cause of compression is unknown, oedema, neo-angiogenesis and increase in non-inflammatory fibrosis in the sub-synovial connective tissue (SSCT) remains the hallmark in the development and progression of CTS. Different studies showed an important role of vascular endothelial growth factor (VEGF) A as a promoter of vascular permeability and angiogenesis in the epineurium and SSCT especially in diabetic patients. The aim of our study was to compare the histopathological differences and correlate them to the expression of VEGF and its receptors 1 and 2 in the carpal tunnel environment between patients with idiopathic and diabetic related CTS. Materials & Methods: A total of 45 CTS patients matched the study inclusion criteria and were divided in to 3 groups: 1. CTS-I– 15 patients, 2. CTS-DM1– 15 patients 3. CTS-DM2– 15 patients. During surgery biopsy specimens were taken from Transverse ligament, Tenosynovium and Epineurium. For the histological examination, prepared sections were stained with hematoxylin–eosin and blind examination was performed for fibrosis, oedema, vascular proliferation, and vascular wall thickness, data was documented and scored in all specimens. For the Immunohistochemistry evaluation, sections were incubated with primary antibodies for 30 min at room temperature, rabbit polyclonal Abs to VEGF-A (1:100) (Biocare Medical), VEGFR-1 (1:25) (Diagnostic Biosystem) and VEGFR-2 (1:50) (Diagnostic Biosystem). Blind examination was performed for Cell type and percentage of expression in each tissue section were recorded. Results: Histopathological findings of the transverse ligament showed that vascular proliferation and vascular thickness were more expressed in the CTS-DM1 group when compared to the CTS-I group (p<0.01) and the CTS-DM2 group (p<0.05), while tenosynovium specimens revealed significantly higher oedema, vascular proliferation and vascular thickness in both CTS-DM1 and CTS-DM2 groups compared to the CTS-DM1 group (p<0.001). Epineurium samples evidenced no significant statistical differences in terms of oedema between the 3 groups, while significantly higher vascular proliferation and vascular thickness were seen in both CTS-DM1 and CTS-DM2 groups when compared to the CTS-I group (p<0.001). Immunohistochemical findings showed a significantly higher expression of VEGF and its receptors 1 and 2 on fibroblast and endothelial cells of both CTS-DM1 and CTS-DM2 groups when compared to the CTS-I group in all tissues (TL, Tenosynovium and Epineurium). Signific high expression was seen also in synovial cells at tenosynovium specimens of both CTS-DM1 and CTS-DM2 groups when compared to the CTS-I group. Conclusion: Our study evidenced an increased expression of VEGF and its receptors 1 and 2 in endothelial cells, fibroblast and synovial cells of the transverse ligament, tenosynovium e epineurium inside the carpal tunnel in patients with DM type 1 and 2 related CTS when compared with idiopathic CTS patients. We also noticed an increased oedema, vascular proliferation and vascular wall thickness and Tenosynovial fibrosis in these population of patients when comparing them with idiopathic CTS patients. Those Histological findings are known to be promoted by VEGF. These results may provide a potential pathophysiological basis for CTS in this group of patients and might even provide a therapeutic rationale for anti-VEGF therapy as an adjunct or alternative to the surgical treatment of CTS in these population of patients.

Produzione scientifica

11573/1692784 - 2023 - Benign and malignant tumors of the fingertip
Molayem, Iakov; Marcovici, Lucian Lior; Formica, Virginia; Pagnotta, Alessia - 02a Capitolo o Articolo
libro: An evidence-based approach to the fingertip diseases - (9789392819360)

11573/1672621 - 2023 - Arthroscopic Assisted Treatment of Combined Trapezium and Bennett Fracture-Dislocation
Tandioy-Delgado, Fabio Andrés; Marcovici, Lucian Lior; Luchetti, Riccardo; Atzei, Andrea - 01a Articolo in rivista
rivista: TECHNIQUES IN HAND & UPPER EXTREMITY SURGERY (Hagerstown, MD : Lippincott-Raven Publishers, c1997-) pp. 30-37 - issn: 1089-3393 - wos: (0) - scopus: 2-s2.0-85148678601 (1)

11573/1672620 - 2022 - The Pre-1D Lesion of the TFCC-A New Variant of the Palmer 1D Class
Luchetti, Riccardo; Cozzolino, Roberto; Marcovici, Lucian Lior; Atzei, Andrea - 01a Articolo in rivista
rivista: ARTHROSCOPY TECHNIQUES (Amsterdam: Elsevier) pp. e1435-e1440 - issn: 2212-6287 - wos: WOS:000863976200010 (2) - scopus: 2-s2.0-85135510757 (1)

11573/1672622 - 2022 - Arthroscopic Technique of Wafer Resection
Luchetti, Riccardo; Marcovici, Lucian Lior; Cozzolino, Roberto - 02a Capitolo o Articolo
libro: Arthroscopy and Endoscopy of the Elbow, Wrist and Hand - (978-3-030-79422-4; 978-3-030-79423-1)

11573/1619434 - 2021 - The Hook Test Is More Accurate Than the Trampoline Test to Detect Foveal Tears of the Triangular Fibrocartilage Complex of the Wrist
Atzei, A.; Luchetti, R.; Carletti, D.; Marcovici, L. L.; Cazzoletti, L.; Barbon, S. - 01a Articolo in rivista
rivista: ARTHROSCOPY (Philadelphia, Usa: W B Saunders Company: -New York, N.Y.] : Raven Press, [c1985]-) pp. 1800-1807 - issn: 0749-8063 - wos: WOS:000657457700020 (20) - scopus: 2-s2.0-85103932808 (15)

11573/1619440 - 2021 - Allinside Anatomic Arthroscopic (3A) Reconstruction of Irreparable TFCC Tear
Atzei, Andrea; Andrés Tandioy-Delgado, Fabio; Marcovici, Lucian Lior; Aust, Thomas W.; Luchetti, Riccardo - 01a Articolo in rivista
rivista: JOURNAL OF WRIST SURGERY (New York, NY : Thieme Publishers) pp. - - issn: 2163-3916 - wos: WOS:000703652400004 (2) - scopus: (0)

11573/1672619 - 2021 - Ulnocarpal Arthroscopy and Distal Radioulnar Arthroscopy
Atzei, Andrea; Luchetti, Riccardo; Marcovici, Lucian Lior; Baixauli, Vicente Carratalá; Lucas García, Francisco J.; Andrade, Cristóbal Martínez; Delgado, Pedro J.; Polo, Fernando; García-Medrano, Belén; Lui, Tun Hing - 02a Capitolo o Articolo
libro: Arthroscopy and Endoscopy of the Hand, Wrist and Elbow10.1007/978-3-030-79423-1 - (978-981-16-4141-1; 978-981-16-4142-8)

11573/1619429 - 2021 - Arthroscopic Assisted Treatment of Thumb Metacarpal Base Articular Fractures
Marcovici, L. L.; Atzei, A.; Cozzolino, R.; Luchetti, R. - 01a Articolo in rivista
rivista: ARTHROSCOPY TECHNIQUES (Amsterdam: Elsevier) pp. e1783-e1792 - issn: 2212-6287 - wos: WOS:000681317400018 (4) - scopus: 2-s2.0-85110299580 (6)

11573/1619432 - 2021 - Arthroscopic treatment in traumatic lesion of the wrist
Marcovici, L. L.; Cozzolino, R.; Atzei, A.; Luchetti, R. - 01a Articolo in rivista
rivista: MINERVA ORTHOPEDICS (Torino: Minerva medica) pp. 140-164 - issn: 2784-8469 - wos: WOS:000654053400007 (4) - scopus: 2-s2.0-85106907491 (4)

11573/1672655 - 2021 - Arthroscopic treatment in traumatic lesion of the wrist
Marcovici, Ll; Cozzolino, R; Atzei, A; Luchetti, R - 01a Articolo in rivista
rivista: MINERVA ORTHOPEDICS (Torino: Minerva medica) pp. 140-164 - issn: 2784-8469 - wos: WOS:000654053400007 (4) - scopus: 2-s2.0-85106907491 (4)

11573/1580664 - 2021 - A novel local adipofascial flap for the management of recalcitrant ulnar tunnel syndrome
Pagnotta, A.; Formica, V. M.; Marcovici, L. L.; Molayem, I.; Taglieri, E. - 01a Articolo in rivista
rivista: HAND SURGERY & REHABILITATION (Issy-les-Moulineaux : Elsevier Masson SAS) pp. 377-381 - issn: 2468-1229 - wos: WOS:000688563500003 (2) - scopus: 2-s2.0-85103972855 (3)

11573/1581431 - 2017 - Osteochondral resurfacing in proximal row carpectomy.
Marcovici, Lucian Lior; Molayem, Iakov; Taglieri, Elena; Pagnotta, Alessia - 01a Articolo in rivista
rivista: RIVISTA DI CHIRURGIA DELLA MANO (Fidenza : Mattioli 1885, [2001]- .) pp. - - issn: 2384-8855 - wos: (0) - scopus: (0)

11573/1581435 - 2016 - Ruolo della chirurgia plastica.
Pagnotta, Alessia; Taglieri, Elena; Molayem, Iakov; Marcovici, Lucian Lior - 02a Capitolo o Articolo
libro: Il trattamento del deficit osseo: metodi e procedure di ricostruzione. - (978-8893890021)

11573/563604 - 2014 - Hip: Type of Prosthesis and Implantation Technique
Calistri, Alessandro; Marcovici, Lucian Lior; Villani, Ciro - 02a Capitolo o Articolo
libro: imaging of prosthetic joints - (9788847054837)

11573/1619436 - 2014 - Reconstruction with vascularized medial femoral condyle flaps in hindfoot and ankle defects: A report of two cases
Mattiassich, G.; Marcovici, L. L.; Dorninger, L.; Kerschhagl, M.; Buerger, H.; Kroepfl, A.; Larcher, L. - 01a Articolo in rivista
rivista: MICROSURGERY (Wiley Liss:111 River Street:Hoboken, NY 07030:(201)748-6000, (212)850-6645, EMAIL: subinfo@wiley.com, INTERNET: http://www.wiley.co.uk, Fax: (201)748-6088) pp. 576-581 - issn: 0738-1085 - wos: WOS:000342772800013 (13) - scopus: 2-s2.0-84907932986 (15)

11573/636782 - 2014 - DISTORSIONE DI CAVIGLIA - DALLA PREVENZIONE AL TRATTAMENTO Ankle sprains - from prevention to treatment
Villani, Ciro; Marcovici, L. L.; Zucchi, B.; Sacco, E.; Persiani, Pietro - 01a Articolo in rivista
rivista: GIORNALE ITALIANO DI ORTOPEDIA E TRAUMATOLOGIA (Pisa : Pacini, 2000- Bologna : A. Gaggi, 1975-1999) pp. S77-S81 - issn: 0390-0134 - wos: (0) - scopus: (0)

11573/1619438 - 2013 - Delta III reverse shoulder arthroplasty in the treatment of complex 3- and 4-part fractures of the proximal humerus: 6 to 42 months of follow up
Mattiassich, G.; Marcovici, L. L.; Krifter, R. M.; Ortmaier, R.; Wegerer, P.; Kroepfl, A. - 01a Articolo in rivista
rivista: BMC MUSCULOSKELETAL DISORDERS (pubblicata da: BIOMED CENTRAL LTD, MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON, ENGLAND, W1T 4LB) pp. 231- - issn: 1471-2474 - wos: WOS:000322993000001 (13) - scopus: 2-s2.0-84881167579 (18)

11573/1582856 - 2012 - Le lesioni osteocondrali della caviglia
Villani, C; Molayem, I; Marcovici, Ll; Persiani, P. - 02a Capitolo o Articolo
libro: Le patologie cartilaginee e legamentose della caviglia - ()

11573/488123 - 2012 - Le fratture periprotesiche tipo B: la nostra esperienza
Villani, Ciro; Moreschini, Oreste; Calistri, Alessandro; Bove, M.; Molayem, I.; Marcovici, L.; Di Martino, L. - 04a Atto di comunicazione a congresso
congresso: 97° Congresso Nazionale della Società Italiana di Ortopedia e Traumatologia (Roma)

11573/1582881 - 2011 - Idrossiapatite: dall’adesione alla clinica [Hydroxyapatite: from adhesion to the clinics]
Villani, C.; Persiani, P.; Bove, M.; Molayem, I.; Marcovici, L. L. - 04c Atto di convegno in rivista
rivista: GIORNALE ITALIANO DI ORTOPEDIA E TRAUMATOLOGIA (Pisa : Pacini, 2000- Bologna : A. Gaggi, 1975-1999) pp. 109-112 - issn: 0390-0134 - wos: (0) - scopus: (0)
congresso: 96° congresso nazionale società italiana di ortopedia e traumatologia (Rimini)

11573/1582858 - 2011 - Complicanze nella chirurgia del piede neurologico dell’infanzia
Villani, C; Molayem, I; Marcovici, Ll; Martini, L. - 02a Capitolo o Articolo
libro: Complicanze nella chirurgia della caviglia e del piede - Prevenzione e trattamento - ()

11573/470948 - 2011 - Idrossiapatite: dall'adesione alla clinica
Villani, Ciro; Persiani, Pietro; Bove, M.; Molayem, I.; Marcovici, Ll - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/471014 - 2010 - L'utilizzo del trigliceride di calcio (kryptonite) nel trattamento delle fratture del piatto tibiale: esperienza preliminare
Persiani, Pietro; Attala, D.; Molayem, I.; Marcovici, Ll; Lanzone, R.; Rosi, S.; Villani, Ciro - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/471006 - 2010 - BMI come indice prognostico nei pazienti sottoposti ad artroprotesi di anca
Persiani, Pietro; Calistri, Alessandro; Molayem, I.; Lanzone, R.; Marcovici, Ll; Villani, Ciro - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/471001 - 2010 - terapia cellulare nella necrosi avascolare della testa del femore con innesto e trapianto di midollo osseo autologo
Persiani, Pietro; Valeo, M.; Molayem, I.; Marcovici, Ll; Lanzone, R.; Villani, Ciro - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/1582860 - 2010 - La bella storia di Raffaele Paparella-Treccia
Romanini, L; Marcovici, Ll; Molayem, I. - 03a Saggio, Trattato Scientifico

11573/470982 - 2010 - studio comparativo con acido ialuronico sull'efficacia delle infiltrazioni intrarticolari di pappa piastrinica nei pazienti artrosici: valutazione clinica e con gait analysis
Valeo, M.; Persiani, Pietro; Clerici Bagozzi, F.; Lanzone, R.; Marcovici, Ll; Villani, Ciro - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/470991 - 2010 - trapianto autologo di cartilagine: prospettive e nostra esperienza
Valeo, M.; Persiani, Pietro; Clerici Bigozzi, F.; Lanzone, R.; Marcovici, Ll; Villani, Ciro - 04d Abstract in atti di convegno
rivista: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY (Editore Springer-Verlag Italia Luogo pubbl. Milano) pp. - - issn: 1590-9921 - wos: (0) - scopus: (0)

11573/229050 - 2009 - Complications following correction of the planovalgus foot in cerebral palsy by arthroereisis
Molayem, Iakov; Persiani, Pietro; L. L., Marcovici; S., Rosi; Calistri, Alessandro; Villani, Ciro - 01a Articolo in rivista
rivista: ACTA ORTHOPAEDICA BELGICA (Association for the Society of Scientifique Medica Belgique:Weldadigheidsstraat 49, 3000 Leuven Belgium:011 32 16 232000, EMAIL: acta.cardiologica@chello.be, INTERNET: http://www.ulb.ac.be/medecine/loce/amb.htm, Fax: 011 32 16 231800) pp. 374-379 - issn: 0001-6462 - wos: WOS:000267608600014 (10) - scopus: 2-s2.0-68149156927 (14)

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