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Casu C, Murgia MS, Orrù G, Scano A. Photodynamic therapy for the successful management of cyclosporine-related gum hypertrophy: A novel therapeutic option. J Public Health Res 2022; 11:22799036221116177. [PMID: 36226306 PMCID: PMC9549190 DOI: 10.1177/22799036221116177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background Drug-induced gingival overgrowth is associated with the intake of three classes of drugs: anticonvulsants, immunosuppressants, and calcium channel blockers. It is clinically characterized by hyperplasia of the gingival connective tissue which appears edematous, bloody, and purplish-red in color. In more severe cases, drug-induced gingival hyperplasia negatively affects the patient's quality of life, making it difficult to eat and practice good oral hygiene. Drug-induced gingival overgrowth therapy is controversial and, in fact, no studies in the literature highlight a well-defined therapeutic protocol. The therapies that are described provide primarily for non-surgical periodontal treatment and second-line surgical treatment. The aim of this work is to highlight a case of drug-induced gingival hyperplasia which was completely resolved thanks to photodynamic therapy which is completely free from side effects. Design and Methods Photodynamic therapy was performed on an 18 year-old female patient with LEDs at a power of 450-470 nm and 5500 mW/cm2 + 7500 mW/cm2, combined with a Curcuma longa-based photosensitizer. A single session was performed, with applications of approximately 30 s for each interdental papilla. Results The patient improved markedly after only one cycle of PDT. There was an absence of clinically detectable inflammation, edema, and rubor of the involved dental papillae. At the 4, 6, and 12 week follow-ups there were no recurrences. Conclusions This case report highlights the first case of drug-induced gingival hypertrophy entirely treated with photodynamic therapy to be described in the literature. Therefore, although it is only a case report, this therapy which is free from side effects should be investigated as an alternative to current therapies.
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Affiliation(s)
- Cinzia Casu
- International Ph.D. in Innovation
Sciences and Technologies, University of Cagliari, Cagliari, Italy,Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy,Cinzia Casu, International Ph.D. in
Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy,
Cagliari 09124 Emails: ;
| | | | - Germano Orrù
- Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy
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Beihaghi S, Mohammadi M, Zarei MR, Azmandian J, Aval HB, Sahebkar M. Inflammatory and fibroblastic effects of azithromycin on cyclosporine-induced gingival overgrowth in renal transplanted patients with and without scaling: A randomized clinical trial. J Oral Biosci 2020; 62:175-181. [PMID: 32439482 DOI: 10.1016/j.job.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study aimed to evaluate the effect of azithromycin (AZM) on the inflammatory and fibroblastic part of cyclosporine A (CsA)-induced gingival overgrowth (GO) in renal transplanted patients. METHODS In this randomized clinical trial, subjects with GO receiving CsA were randomly divided into two groups: those receiving 5-day AZM only (n = 12; group 1) and those receiving scaling and prescribed AZM after 2 months (n = 12; group 2). Both groups were evaluated for several indices (gingival hyperplastic index, plaque and bleeding index, clinical crown length) at the first visit and the 4th and 8th week in group 1, and at the first visit and the 4th, 8th, 12th, and 16th week in group 2. RESULTS The sample included 24 individuals. The mean (SD) age of participants was 30.81 (11.13) and 34.80 (9.33) years in group 1 and 2, respectively. Based on ANCOVA, the changes in the hyperplastic index (GHI) and apico-coronal dimension (ACD) of it were statistically significant in professional scaling accompanied by AZM group (P = 0.012 and 0.031, respectively). However, no significant change was observed in mean indices after prescribing AZM in 5-day AZM regimen group (P = 0.664 and 0.882, respectively). According to one-way ANOVA, we found a statistically significant correlation in GHI, ACD, bleeding index (BI), and plaque index (PI) accounting for P = 0.012, 0.003, 0.002, and <0.001, respectively. CONCLUSIONS Findings suggest that AZM cannot influence the fibroblastic part of GO in presence of gum inflammation while the therapy can improve GO after resolving it with scaling.
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Affiliation(s)
| | - Mohammad Mohammadi
- Department of Periodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Zarei
- Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Jalal Azmandian
- Department of Nephrology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamidreza Baghani Aval
- Department of Urology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. https://mail.google.com/mail/u/0/h/sif60x9sjdad/?&cs=wh&v=b&to=
| | - Mohammad Sahebkar
- Department of Social Medicine, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Parlar A, Arslan SO, Çam SA. Glabridin Alleviates Inflammation and Nociception in Rodents by Activating BK Ca Channels and Reducing NO Levels. Biol Pharm Bull 2020; 43:884-897. [DOI: 10.1248/bpb.b20-00038] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Ali Parlar
- Department of Pharmacology, Faculty of Medicine, University of Adiyaman
| | | | - Saliha Ayşenur Çam
- Department of Pharmacology, Faculty of Medicine, University of Ankara Yildirim Beyazit
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Jiang L, Liu MN, Wang GD, Wu Q, Zhao YF. Cyclosporin A suppresses Porphyromonas gingivalis lipopolysaccharide induced matrix metalloproteinases activities in the co-culture of human gingival fibroblasts and monocyte cell line THP-1. Growth Factors 2020; 38:65-74. [PMID: 32321312 DOI: 10.1080/08977194.2020.1755280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cyclosporine-A (CsA) is a widely used immunosuppressant. In this study, we explore the pathway through which CsA suppressed the Porphyromonas gingivalis lipopolysaccharide (P.g-LPS)-induced increase in matrix metalloproteinase (MMP) activities in co-cultured human gingival fibroblasts (HGFs) and THP-1 monocytes. In the co-culture, we found that CsA inhibited the expression of cyclophilin A (CyPA), CD147 and the activities of MMPs, which were all induced by P.g-LPS. We also found that P.g-LPS and recombinant human CyPA increased activation of ERK1/2 and IκB (an NF-κB inhibitory protein), but CsA and the anti-CD147 antibody significantly inhibited these effects. Taken together, CsA in the presence of P.g-LPS might suppress MMP activities by blocking the CyPA/CD147 interaction that results in the inhibition of ERK1/2 and NF-κB signaling by interfering with the phosphorylation of ERK1/2 and IκB.
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Affiliation(s)
- Lei Jiang
- Department of Stomatology, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Min Ni Liu
- Department of Stomatology, Characteristic Medical Center, Second Military Medical University, Shanghai, P. R. China
| | - Guo Dong Wang
- Department of Stomatology, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Qun Wu
- Department of Stomatology, Characteristic Medical Center, Second Military Medical University, Shanghai, P. R. China
| | - Yun Fu Zhao
- Department of Stomatology, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
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Lack of Association Between TGF-β1 and MDR1 Genetic Polymorphisms and Cyclosporine-Induced Gingival Overgrowth in Kidney Transplant Recipients: A Meta-analysis. Transplant Proc 2018; 49:1336-1343. [PMID: 28736004 DOI: 10.1016/j.transproceed.2017.01.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/13/2017] [Accepted: 01/24/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Gingival overgrowth (GO) induced by cyclosporine (CsA), one of the common complications after kidney transplantation, is associated with a genetic component. However, the effect of TGF-β1 and MDR1 gene polymorphisms on the pathogenesis of CsA-induced GO remains to be determined. This study aimed to determine the association between TGF-β1 and MDR1 gene polymorphisms and CsA-induced GO in kidney transplant recipients. METHODS The Pubmed, Embase, Cochrane Library, and Chinese CNKI (China National Knowledge Infrastructure) and Wanfang databases were comprehensively searched. Data were extracted and pooled results estimated from odds ratios (ORs) and 95% confidence intervals (CIs). In addition, quality assessment and publication bias of each eligible study were examined. RESULTS Three trials focusing on the relationship between TGF-β1 +869T>C and +915G>C and 3 studies on MDR1 C3435T gene polymorphisms and the onset of CsA-induced GO were included. No association between the +869T>C polymorphism and CsA-induced GO was found in the dominant model (TT+TC vs CC: OR, 0.77; 95% CI, 0.29-2.10; P = .614). In the recessive model, no association was found between the +915G>C polymorphism and CsA-induced GO (CC vs GG+GC: OR, 1.40; 95% CI, 0.81-2.43; P = .225). And in the dominant model, no significance was calculated between MDR1 C3435T gene polymorphisms and CsA-induced GO in kidney transplant recipients (TT vs CC+CT: OR, 1.14; 95% CI, 0.62-2.09; P = .68). CONCLUSIONS No significant association exists between TGF-β1 +869T>C, and +915G>C and MDR1 C3435T gene polymorphisms and the pathogenesis of CsA-induced GO in kidney transplant recipients.
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Okanobu A, Matsuda S, Kajiya M, Fujita T, Kittaka M, Shiba H, Kurihara H. A novel gingival overgrowth mouse model induced by the combination of CsA and ligature-induced inflammation. J Immunol Methods 2017; 445:31-36. [DOI: 10.1016/j.jim.2017.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/16/2017] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
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Ponnaiyan D, Jegadeesan V. Cyclosporine A: Novel concepts in its role in drug-induced gingival overgrowth. Dent Res J (Isfahan) 2016; 12:499-506. [PMID: 26759584 PMCID: PMC4696350 DOI: 10.4103/1735-3327.170546] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of cyclosporine, in particular the action of the drug on the gingival tissues. In addition, elucidates the current concepts in mechanisms of cyclosporine-induced gingival overgrowth. Clinical and cell culture studies suggest that the mechanism of gingival overgrowth is a result of the interaction between the drug and its metabolites with susceptible gingival fibroblasts. Plaque-induced gingival inflammation appears to enhance this interaction. However, understanding of the pathogenesis of gingival overgrowth is incomplete at best. Hence, it would be pertinent to identify and explore possible risk factors relating to both prevalence and severity of drug-induced gingival overgrowth. Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.
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Affiliation(s)
- Deepa Ponnaiyan
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
| | - Visakan Jegadeesan
- Department of Oral and Maxillofacial Surgery, MIOT Hospitals, Manapakkam, Chennai, Tamil Nadu, India
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Ma S, Liu W, Liu P, Liu J, Chen L, Qin C. Tanshinone IIA treatment alleviated the rat gingival connective tissue overgrowth induced by cyclosporine A. J Periodontal Res 2015; 51:567-76. [PMID: 26547660 DOI: 10.1111/jre.12335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 01/09/2023]
Affiliation(s)
- S. Ma
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
- Longjiang Scholar Laboratory; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - W. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - P. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - J. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - L. Chen
- Longjiang Scholar Laboratory; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - C. Qin
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis; Texas, A&M University, Baylor College of Dentistry; Dallas TX USA
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Chang J, Wang L, Lu S, Huang C, Lu H. NF-κB Enhances Androgen Receptor Expression through 5′-UTR Binding in Gingival Cells. J Dent Res 2015; 94:1439-45. [DOI: 10.1177/0022034515594117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Dihydropyridine-induced gingival overgrowth (DIGO) is a side effect observed in patients treated for hypertension. The disease is aggravated by inflammation. Nifedipine (Nif), a dihydropyridine, causes gingival overgrowth by increasing the expression of the androgen receptor (AR). Furthermore, the proinflammatory cytokine interleukin 1β (IL-1β) induces collagen α1(I) expression through the AR in DIGO fibroblasts. These observations prompted us to investigate whether and how nuclear factor kappa B (NF-κB) affects AR expression in DIGO. Therefore, gingival fibroblasts obtained from the tissues of patients with DIGO and healthy subjects were stimulated with IL-1β, Nif, or both. mRNA and protein expression was detected with real-time polymerase chain reaction and Western blotting. High correlation coefficients were observed for the mRNA expression of the AR, connective tissue growth factor, and collagen α1(I) induced by both drugs. Western blot analysis showed that IL-1β and Nif increased and activated NF-κB more in DIGO cells than in healthy cells. An electrophoretic mobility shift assay demonstrated that the promoter and 5′-untranslated regions (5′-UTRs) of the AR gene contains 3 binding sites for the NF-κB p65 subunit. A chromatin immunoprecipitation assay revealed that the NF-κB p65 subunit was associated with AR 5′-UTRs in gingival fibroblasts. A site-directed mutagenesis study indicated that a mutation of NF-κB binding sites reduced Nif- and IL-1β-induced AR promoter activities. Collectively, these data indicate that NF-κB is an essential transcriptional regulator of AR gene expression and thus plays a crucial role in collagen overproduction in DIGO fibroblasts.
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Affiliation(s)
- J.H. Chang
- Department of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - L.F. Wang
- Department of Biochemistry, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - S.L. Lu
- Department of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Periodontal Clinic, Dental Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - C.F. Huang
- Periodontal Clinic, Dental Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - H.K. Lu
- Department of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Periodontal Clinic, Dental Department, Taipei Medical University Hospital, Taipei, Taiwan
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Li WL, Wu CH, Yang J, Tang M, Chen LJ, Zhao SL. Local Inflammation Alters MMP-2 and MMP-9 Gelatinase Expression Associated with the Severity of Nifedipine-Induced Gingival Overgrowth: a Rat Model Study. Inflammation 2015; 38:1517-28. [DOI: 10.1007/s10753-015-0126-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Rao SR, Balaji TM, Prakash PSG, Lavu V. Elevated levels of cyclooxygenase 1 and 2 in human cyclosporine induced gingival overgrowth. Prostaglandins Other Lipid Mediat 2014; 113-115:69-74. [PMID: 25124319 DOI: 10.1016/j.prostaglandins.2014.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study was carried out to immuno-localize and estimate the levels of cyclooxygenase 1 and 2 in human gingival tissue samples from healthy individuals, chronic periodontitis patients and patients with cyclosporine induced gingival overgrowth. METHODS Group I consisted of individuals with healthy gingiva (n=6), Group II - cyclosporine induced gingival overgrowth (n=9) and Group III - chronic periodontitis patients (n=6). Gingival tissue samples were collected from subjects of all the three groups. COX-1, COX-2 levels were estimated in tissue homogenates by enzyme activity assay. Immuno-localization for COX-1 and COX-2 was also done in sections of gingival tissue. RESULTS The study results demonstrated a significantly higher mean levels of COX-1 and 2 in drug induced gingival overgrowth samples (p<0.05). COX-1 and COX-2 was localized to epithelium and connective tissue in human gingival tissue sections from cyclosporine induced gingival overgrowth. CONCLUSION Cyclooxygenase enzymes appear to be potential mediators involved in the pathogenesis of cyclosporine induced gingival overgrowth.
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Affiliation(s)
- Suresh Ranga Rao
- Department of Periodontology, Faculty of Dental Sciences, Sri Ramachandra University, No. 1 Ramachandra Nagar, Porur, Chennai 600 116, Tamil Nadu, India.
| | - T M Balaji
- Department of Periodontology, Faculty of Dental Sciences, Sri Ramachandra University, No. 1 Ramachandra Nagar, Porur, Chennai 600 116, Tamil Nadu, India
| | - P S G Prakash
- Department of Periodontology, SRM Dental College, SRM University, Ramapuram, Chennai 600 089, India
| | - Vamsi Lavu
- Department of Periodontology, Faculty of Dental Sciences, Sri Ramachandra University, No. 1 Ramachandra Nagar, Porur, Chennai 600 116, Tamil Nadu, India
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Johanson M, Zhao XR, Huynh-Ba G, Villar CC. Matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases, and inflammation in cyclosporine A-induced gingival enlargement: a pilot in vitro study using a three-dimensional model of the human oral mucosa. J Periodontol 2012; 84:634-40. [PMID: 22934840 DOI: 10.1902/jop.2012.120224] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND It has been suggested that cyclosporine A (CsA) induces gingival enlargement by promoting an increase in the gingival extracellular matrix (ECM). Nonetheless, the variable occurrence of CsA-induced gingival enlargement in patients receiving this medication indicates a multifactorial pathogenesis. Clinical observations suggest that local inflammation is associated with the development and severity of CsA-induced gingival enlargement. Therefore, the purpose of this study is to investigate the effects of CsA and inflammation on the production of ECM homeostatic mediators. METHODS The effects of CsA and inflammation (as assessed using interleukin [IL]-1β) on the secretion of mediators involved in ECM homeostasis were determined using fibroblast monolayers and three-dimensional (3D) models of the human oral mucosa. Fibroblast monolayers and 3D cultures were treated with CsA alone or in combination with IL-1β for up to 72 hours, and the secretion of matrix metalloproteinases (MMPs) 1, 2, 3, 8, 9, 10, and 13 and tissue inhibitors of MMPs (TIMPs) 1, 2, and 4 into the culture medium was assessed using enzyme-linked immunoassay-based antibody arrays. RESULTS Fibroblast monolayers responded to CsA with no changes in the secretion of ECM mediators. Conversely, 3D cultures responded to CsA treatment with a reduction in MMP-10 secretion. IL-1β alone triggered higher secretory levels of MMPs in both fibroblast monolayers (MMP-3 and MMP-10) and 3D cultures (MMP-9 and MMP-10). Importantly, fibroblast monolayers and 3D cultures treated with a combination of IL-1β and CsA showed a decrease in the MMP-1/TIMP-1 ratio. CONCLUSIONS These data support the hypothesis that inflammation may alter the pathogenesis of CsA-induced gingival enlargement by promoting a synergistic decrease in the MMP-1/TIMP-1 ratio.
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Affiliation(s)
- Matthew Johanson
- Department of Periodontics, The University of Texas Health Science Center, San Antonio, TX, USA
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Wentz LA, Oliveira SC, Moreira CHC, Rösing CK. Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin. Braz Oral Res 2012; 26:64-70. [PMID: 22344340 DOI: 10.1590/s1806-83242011005000016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 08/30/2011] [Indexed: 04/23/2024] Open
Abstract
Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t- and chi-square tests were used to compare means in groups with versus without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versus without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions.
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Affiliation(s)
- Luiz Augusto Wentz
- School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Kuo PJ, Tu HP, Chin YT, Lu SH, Chiang CY, Chen RY, Fu E. Cyclosporine-A inhibits MMP-2 and -9 activities in the presence of Porphyromonas gingivalis lipopolysaccharide: an experiment in human gingival fibroblast and U937 macrophage co-culture. J Periodontal Res 2012; 47:431-8. [PMID: 22321150 DOI: 10.1111/j.1600-0765.2011.01450.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Studies have shown that bacterial plaque and the associated gingival inflammation increase the severity of gingival overgrowth induced by cyclosporine-A (CsA). This in vitro study aimed to evaluate the effect of CsA on the activities of MMPs from the co-culture of human gingival fibroblasts and U937 macrophages in the presence or absence of Porphyromonas gingivalis lipopolysaccharide (LPS). MATERIAL AND METHODS Activities of pro-MMP-2, MMP-2 and pro-MMP-9 in the supernatants of independent cultures and co-cultures were examined by zymography. RT-PCR was selected to evaluate the expression of mRNA for membrane type-1 (MT1) MMP in the co-cultures. RESULTS Activities of MMPs in the co-cultures were significantly greater when compared with any of the independent cultures. Lipopolysaccharide significantly increased the MMP activities in a dose-dependent manner in the co-cultures, whereas CsA inhibited these activities. In the presence of both CsA and LPS, the MMP activities inhibited by CsA could still be observed in the co-cultures. In the individual cultures, in contrast, the CsA-inhibited MMP activities, in the presence of LPS, were minimally detected. The mRNA expression of MT1-MMP was significantly enhanced after LPS treatment; however, this enhancement was inhibited by CsA. CONCLUSION This study demonstrated that, in co-cultures of human gingival fibroblasts and U937 macrophages, CsA could inhibit MMP activities in the presence of P. gingivalis LPS. It might be part of the underlying reason for the persistent overgrowth of gingiva seen when bacterial plaque and local inflammation are present during CsA therapy.
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Affiliation(s)
- P-J Kuo
- Department of Periodontology, China Medical University, Taichung, Taiwan
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Alptekin NÖ, Üstün K, Yaprak E, Avunduk MC, Ataoğlu T. Immunohistochemical Analysis of CD45RO+ T Cells and Vascular Endothelial Growth Factor Expression in Cyclosporin A–Induced Rat Gingival Tissue. J Periodontol 2012; 83:248-55. [DOI: 10.1902/jop.2011.110034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sobral LM, Aseredo F, Agostini M, Bufalino A, Pereira MCC, Graner E, Coletta RD. Molecular events associated with ciclosporin A-induced gingival overgrowth are attenuated by Smad7 overexpression in fibroblasts. J Periodontal Res 2011; 47:149-58. [DOI: 10.1111/j.1600-0765.2011.01412.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Becerik S, Özsan N, Gürkan A, Öztürk VÖ, Atilla G, Emingil G. Toll like receptor 4 and membrane-bound CD14 expressions in gingivitis, periodontitis and CsA-induced gingival overgrowth. Arch Oral Biol 2011; 56:456-65. [DOI: 10.1016/j.archoralbio.2010.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/19/2010] [Accepted: 11/14/2010] [Indexed: 10/18/2022]
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Takeuchi R, Matsumoto H, Akimoto Y, Fujii A. Reduction in lipopolysaccharide-induced apoptosis of fibroblasts obtained from a patient with gingival overgrowth during nifedipine-treatment. Arch Oral Biol 2011; 56:1073-80. [PMID: 21474118 DOI: 10.1016/j.archoralbio.2011.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 01/25/2011] [Accepted: 03/12/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We have previously demonstrated that the mechanism of nifedipine (NIF)-induced gingival overgrowth is related to the observation that proliferation and cell cycle progression of gingival fibroblasts derived from NIF reactive patient (NIFr) are greater than those from NIF non-reactive patient (NIFn). Gingival overgrowth has also been reported to be a result of inhibited apoptosis of gingival fibroblasts. Apoptosis in fibroblasts is induced by lipopolysaccharide (LPS). Thus, we focused upon evaluating whether there is a difference in LPS-induced apoptosis between NIFn and NIFr. METHODS Both NIFn and NIFr were arrested in DMEM containing 0.5% FBS, stimulated by LPS, and assayed for apoptosis, cell cycle analysis, Western blotting, and caspase activity. RESULTS Compared to NIFn, the number of apoptotic cells was significantly decreased and the percentage of cells in S and G(2)/M phase was significantly increased in NIFr. The levels of Bax and cytochrome c proteins in NIFr were not up-regulated by LPS compared with NIFn. Both NIFn and NIFr displayed the following changes in protein expression: increased Bad, decreased Bcl-xL, and unchanged Bcl-2 and p53. Caspase-3 and -9 activities were significantly increased by LPS in NIFn but were unchanged in NIFr. Caspase-2 activity remained constant whilst caspase-8 activity significantly increased upon LPS treatment in both NIFn and NIFr. CONCLUSION Bad, Bax, cytochrome c, p53, and caspases-2, -3, -8, and -9 are pro-apoptotic proteins. Bcl-2 and Bcl-xL are anti-apoptotic proteins. Thus, the mechanism of NIF-induced gingival overgrowth might be related to decreased apoptosis in NIFr through a reduction of Bax, cytochrome c, and caspase-3 and -9.
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Affiliation(s)
- Reiri Takeuchi
- Department of Oral Molecular Pharmacology, Nihon University School of Dentistry at Matsudo, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.
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Lu HK, Tseng CC, Lee YH, Li CL, Wang LF. Flutamide inhibits nifedipine- and interleukin-1 beta-induced collagen overproduction in gingival fibroblasts. J Periodontal Res 2010; 45:451-7. [PMID: 20337887 DOI: 10.1111/j.1600-0765.2009.01255.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE To understand the role of the androgen receptor in gingival overgrowth, the effects of flutamide on interleukin-1 beta- and nifedipine-induced gene expression of connective tissue growth factor (CTGF/CCN2) and collagen production in gingival fibroblasts were examined. MATERIAL AND METHODS Gingival fibroblasts from healthy subjects and patients with dihydropyridine-induced gingival overgrowth (DIGO) were used. Confluent cells were treated with nifedipine, interleukin-1 beta or both. The mRNA expression was examined using real-time polymerase chain reaction, and the concentration of total soluble collagen in conditioned media was analysed by Sircol Collagen Assay. In addition, the protein expressions of androgen receptor, CTGF/CCN2 and type I collagen in gingival tissue were determined by western blot. RESULTS Interleukin-1 beta was more potent than nifedipine in stimulating CTGF/CCN2 and procollagen alpha1(I) mRNA expression, and there was an additive effect of the two drugs. Healthy cells exhibited an equal or stronger response of procollagen alpha1(I) than those with DIGO, but DIGO cells displayed a stronger response in the secretion of soluble collagen in the same conditions. Flutamide, an androgen receptor antagonist, inhibited stimulation by nifedipine or interleukin-1 beta. Additionally, the protein expressions of androgen receptor and type I collagen were higher in DIGO gingival tissue than those in healthy gingival tissue. CONCLUSION The data suggest that both nifedipine and interleukin-1 beta play an important role in DIGO via androgen receptor upregulation and that gingival overgrowth is mainly due to collagen accumulation. Flutamide decreases the gene expression and protein production of collagen from dihydropyridine-induced overgrowth cells.
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Affiliation(s)
- H-K Lu
- Periodontal Department, Taipei Medical University College of Oral Medicine, Taipei, Taiwan
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