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Chen J, Xu X, Chen S, Lu T, Zheng Y, Gan Z, Shen Z, Ma S, Wang D, Su L, He F, Shang X, Xu H, Chen D, Zhang L, Xiong F. Double heterozygous pathogenic mutations in KIF3C and ZNF513 cause hereditary gingival fibromatosis. Int J Oral Sci 2023; 15:46. [PMID: 37752101 PMCID: PMC10522663 DOI: 10.1038/s41368-023-00244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare inherited condition with fibromatoid hyperplasia of the gingival tissue that exhibits great genetic heterogeneity. Five distinct loci related to non-syndromic HGF have been identified; however, only two disease-causing genes, SOS1 and REST, inducing HGF have been identified at two loci, GINGF1 and GINGF5, respectively. Here, based on a family pedigree with 26 members, including nine patients with HGF, we identified double heterozygous pathogenic mutations in the ZNF513 (c.C748T, p.R250W) and KIF3C (c.G1229A, p.R410H) genes within the GINGF3 locus related to HGF. Functional studies demonstrated that the ZNF513 p.R250W and KIF3C p.R410H variants significantly increased the expression of ZNF513 and KIF3C in vitro and in vivo. ZNF513, a transcription factor, binds to KIF3C exon 1 and participates in the positive regulation of KIF3C expression in gingival fibroblasts. Furthermore, a knock-in mouse model confirmed that heterozygous or homozygous mutations within Zfp513 (p.R250W) or Kif3c (p.R412H) alone do not led to clear phenotypes with gingival fibromatosis, whereas the double mutations led to gingival hyperplasia phenotypes. In addition, we found that ZNF513 binds to the SOS1 promoter and plays an important positive role in regulating the expression of SOS1. Moreover, the KIF3C p.R410H mutation could activate the PI3K and KCNQ1 potassium channels. ZNF513 combined with KIF3C regulates gingival fibroblast proliferation, migration, and fibrosis response via the PI3K/AKT/mTOR and Ras/Raf/MEK/ERK pathways. In summary, these results demonstrate ZNF513 + KIF3C as an important genetic combination in HGF manifestation and suggest that ZNF513 mutation may be a major risk factor for HGF.
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Affiliation(s)
- Jianfan Chen
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
- Experimental Department of Obstetrics and Gynecology Institute, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueqing Xu
- Department of Precision Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Song Chen
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Ting Lu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yingchun Zheng
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhongzhi Gan
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zongrui Shen
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Shunfei Ma
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Duocai Wang
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Leyi Su
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Fei He
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xuan Shang
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Huiyong Xu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Chen
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Leitao Zhang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Fu Xiong
- Department of Medical Genetics, Experimental Education/Administration Center, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Guangzhou, China.
- Department of Fetal Medicine and Prenatal Diagnosis, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Afonso RA, Godinho GV, Silva CA, Silva EJ, Volpato LE. Hereditary Gingival Fibromatosis and Developmental Anomalies: A Case Report. Cureus 2022; 14:e24219. [PMID: 35602830 PMCID: PMC9117822 DOI: 10.7759/cureus.24219] [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] [Accepted: 04/15/2022] [Indexed: 11/07/2022] Open
Abstract
Hereditary gingival fibromatosis is the most common genetic form of gingival fibromatosis that develops as a slow, progressive, benign, localized, or generalized enlargement of the keratinized gingiva. It is a genetically heterogeneous disorder transmitted as an autosomal dominant or autosomal recessive trait or appears sporadically. Here, we report a case of a male patient with generalized gingival hyperplasia with great tissue extension to the palatal region, bilateral mandibular torus, bilateral exostosis in the maxillary posterior region, anterior open bite, and diastema in anterior maxilla and mandible teeth. The mucous membranes were healthy and normal colored, with pale pink gums and firm teeth upon palpation. Computed tomography also revealed images suggestive of supernumerary teeth. The patient reported that his mother and a maternal aunt have the same gingival condition. Considering the gingival characteristic, the patient's family history, and the absence of other possible etiological factors of gingival hyperplasia, the diagnostic hypothesis was hereditary gingival fibromatosis. The surgical removal of the enlarged tissue through gingivectomy with internal bevel, osteoplasty, and removal of supernumerary teeth with a subsequent filling of the surgical sites with platelet and leukocyte-rich fibrin membranes in the same surgical time presented good functional and aesthetic results for the young patient with hereditary gingival fibromatosis. It is a viable possibility for clinical management of similar cases.
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Affiliation(s)
- Rhaina A Afonso
- Department of Dentistry, Hospital de Câncer de Mato Grosso, Cuiabá, BRA
| | - Géssica V Godinho
- Department of Dentistry, Hospital de Câncer de Mato Grosso, Cuiabá, BRA
| | - Cristhiane A Silva
- Department of Environment and Health, Universidade de Cuiabá, Cuiabá, BRA
| | - Everton J Silva
- Department of Dentistry, Hospital de Câncer de Mato Grosso, Cuiabá, BRA
| | - Luiz E Volpato
- Department of Dentistry, Hospital de Câncer de Mato Grosso, Cuiabá, BRA
- Cuiabá Dental School, Universidade de Cuiabá, Cuiabá, BRA
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Li N, Wang W, Sun Y, Wang H, Wang T. Seven-year follow-up of a patient with hereditary gingival fibromatosis treated with a multidisciplinary approach: case report. BMC Oral Health 2021; 21:473. [PMID: 34565352 PMCID: PMC8474844 DOI: 10.1186/s12903-021-01830-7] [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: 06/16/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported. CASE PRESENTATION This study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment. CONCLUSIONS The risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.
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Affiliation(s)
- Ning Li
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Wenfang Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, Shanxi, China
| | - Yuanyuan Sun
- Department of Periodontology, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Hongning Wang
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Tiejun Wang
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China.
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Cunha JLS, Ramos MACDC, Regis DM, Sanchéz-Romero C, de Andrade ME, Bezerra BT, de Albuquerque-Júnior RLC. Generalized hereditary gingival fibromatosis in a child: clinical, histopathological and therapeutic aspects. AUTOPSY AND CASE REPORTS 2020; 10:e2020140. [PMID: 32039068 PMCID: PMC6984817 DOI: 10.4322/acr.2020.140] [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: 05/11/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare genetic condition characterized by slow and progressive gingival enlargement. The gingival overgrowth often delays teeth eruption and may cause serious functional and aesthetic problems. We reported a case of a 10-year-old female child presenting a generalized gingival enlargement covering almost all the maxillary and mandibular teeth and resulted in problems for swallowing, speaking, and poor aesthetics. An incisional biopsy was performed and revealed a hypocellular and hypovascular dense collagenous tissue covered by squamous epithelium exhibiting acanthosis and elongated rete ridges. The diagnosis was HGF. The treatment instituted was an association of gingivectomy with a rigorous program of oral hygiene and follow-up. Herein, we describe a rare non-syndromic case of generalized HGF, including clinical and microscopical features, as well as highlighting the importance of correct diagnosis of this genetic condition.
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Affiliation(s)
- John Lennon Silva Cunha
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Oral Diagnosis. Piracicaba, SP, Brazil
| | | | | | - Celeste Sanchéz-Romero
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Oral Diagnosis. Piracicaba, SP, Brazil
| | - Maria Eliane de Andrade
- Tiradentes University, Institute of Technology and Research, Laboratory of Morphology and Experimental Pathology. Aracaju, SE, Brazil
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