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Aboujaoude S, Aoun G, Majzoub Z. Local and Systemic Effects of Cyclosporine A on the Severity of Gingival Overgrowth in Post-Transplant Renal Patients. Mater Sociomed 2021; 33:51-55. [PMID: 34012351 PMCID: PMC8116086 DOI: 10.5455/msm.2021.33.51-55] [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] [Indexed: 12/01/2022] Open
Abstract
Background: Cyclosporine A (CsA) is a potent immunosuppressant widely used to prevent renal post transplantation rejection. Gingival overgrowth (GO) is among various side effects of the long-term administration of CsA. Up to 90% of the patients under CsA therapy has been reported to develop CsA-induced GO. Objectives: The aim of the present prospective pilot study is to determine the local and systemic effects of Cyclosporine A (CsA) on the severity of gingival overgrowth and its relationship with periodontal parameters in post-transplant renal patients Methods: Twenty post-transplant renal patients, 12 females and 8 males, presenting gingival overgrowth were selected from Rizk Hospital’s clinic in Beirut. Patient’s CsA plaque levels were evaluated when CsA is administered by syrup and capsules mode. Periodontal parameters including gingival overgrowth, papillary bleeding, plaque and gingival indices were assessed for all patients. Results: Plaque concentration CsA levels, when administered in syrup mode, affected significantly the severity of gingival overgrowth as opposed to the administration by capsule mode. Significant correlations between severity of gingival overgrowth on one hand and plaque index, gingival index, and papillary bleeding index on the other hand were only observed in the Capsule group but not in the syrup group. A significant relationship was established between the severity of gingival overgrowth and all periodontal parameters (gingival, papillary and plaque). Conclusion: The present study underlines CsA dental plaque local effect, as a co-factor, in the development of gingival overgrowth. Cyclosporine plaque accumulation acts as a reservoir in the gingival inflammation and the periodontal indices seem to be the most accurate parameters associated with gingival overgrowth severity. Plaque CsA concentrations could be considered as a risk factor for inflammation and gingival overgrowth depending on CsA delivery mode in renal transplant patients.
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Affiliation(s)
- Samia Aboujaoude
- Department of Pediatric Dentistry and Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Georges Aoun
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Zeina Majzoub
- Department of Periodontology and Research, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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SPOCK1 is a novel inducer of epithelial to mesenchymal transition in drug-induced gingival overgrowth. Sci Rep 2020; 10:9785. [PMID: 32555336 PMCID: PMC7300011 DOI: 10.1038/s41598-020-66660-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/22/2020] [Indexed: 11/28/2022] Open
Abstract
Few studies have investigated the role of extracellular-matrix proteoglycans in the pathogenesis of drug-induced gingival overgrowth (DIGO). SPOCK1 is an extracellular proteoglycan that induces epithelial to mesenchymal transition (EMT) in several cancer cell lines and exhibits protease-inhibitory activity. However, the role of SPOCK1 in non-cancerous diseases such as DIGO has not been well-addressed. We demonstrated that the expression of SPOCK1, TGF-β1, and MMP-9 in calcium channel blocker-induced gingival overgrowth is higher than that in non-overgrowth tissues. Transgenic mice overexpressing Spock1 developed obvious gingival-overgrowth and fibrosis phenotypes, and positively correlated with EMT-like changes. Furthermore, in vitro data indicated a tri-directional interaction between SPOCK1, TGF-β1, and MMP-9 that led to gingival overgrowth. Our study shows that SPOCK1 up-regulation in a noncancerous disease and SPOCK1-induced EMT in gingival overgrowth occurs via cooperation and crosstalk between several potential signaling pathways. Therefore, SPOCK1 is a novel therapeutic target for gingival overgrowth and its expression is a potential risk of EMT induction in cancerous lesions.
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Kanno CM, Oliveira JAD, Ervolino E, Soubhia AMP. Effects of cyclosporin, nifedipine and phenytoin on gingival myofibroblast transdifferentiation in monkeys. J Appl Oral Sci 2018; 27:e20180135. [PMID: 30427475 PMCID: PMC6223785 DOI: 10.1590/1678-7757-2018-0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Myofibroblasts have been associated with the development of several pathologic fibrotic conditions. This longitudinal study aims to assess the proliferative and antiapoptotic effects of cyclosporin, nifedipine and phenytoin on gingival connective tissue cells of nonhuman primate, as well as to analyze a possible role of myofibroblasts in gingival overgrowth. MATERIALS AND METHODS Gingival samples from the right superior canine area were obtained from 12 male monkeys ( Sapajus spp ) to comprise the control group. After one week, the animals were randomly assigned to three groups, which received daily oral doses of cyclosporin, nifedipine or phenytoin for 120 days. Gingival samples were collected from the left superior canine area of two animals of each group at 52 and 120 days. Histological sections were stained with hematoxylin and eosin, and immunoreacted against α-SMA, Ki- 67 and bcl-2. RESULTS α-SMA immunoreaction was negative in the control and experimental groups. Similarly, no difference between groups concerning immunostaining against Ki-67 and bcl-2 was observed in connective tissue cells. CONCLUSION Based on this methodology, it may be concluded that gingival overgrowths induced by cyclosporin, nifedipine and phenytoin are not associated with neither myofibroblast transdifferentiation, proliferation nor apoptosis of gingival connective cells in monkeys.
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Affiliation(s)
- Claudia Misue Kanno
- Univ. Estadual Paulista, Faculdade de Odontologia, Departamento de Emergência, Araçatuba, São Paulo, Brasil
| | - Jose Americo de Oliveira
- Univ. Estadual Paulista, Faculdade de Odontologia, Departamento de Ciências Básicas, Araçatuba, São Paulo, Brasil
| | - Edilson Ervolino
- Univ. Estadual Paulista, Faculdade de Odontologia, Departamento de Ciências Básicas, Araçatuba, São Paulo, Brasil
| | - Ana Maria Pires Soubhia
- Univ. Estadual Paulista, Faculdade de Odontologia, Departamento de Patologia e Propedêutica Clínica, Araçatuba, São Paulo, Brasil
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Takeuchi R, Matsumoto H, Arikawa K, Taguchi C, Nakayama R, Nasu I, Hiratsuka K. Phenytoin-induced gingival overgrowth caused by death receptor pathway malfunction. Oral Dis 2017; 23:653-659. [PMID: 28160766 DOI: 10.1111/odi.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/02/2016] [Accepted: 01/26/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In this study, we investigated the role of phenytoin (PHT) in death receptor-induced apoptosis of gingival fibroblasts to clarify the mechanism of PHT-induced gingival overgrowth. METHODS Human gingival fibroblasts were cultured to semiconfluence and treated with PHT (0.025, 0.1, 0.25, and 1.0 μM) for 48 h, and then, the apoptotic cell numbers were relatively determined by absorptiometry. After 24 h of 0.25 μM PHT treatment, caspase activity was measured by absorptiometry, apoptotic and cell cycle phase distribution was analyzed by flow cytometry, expression levels of apoptotic genes were quantified by real-time qPCR, and expression of apoptotic proteins was detected by Western blot analysis. After 48 h of 0.25 μM PHT treatment, appearance of apoptotic cells was detected by TUNEL assay. RESULTS PHT treatment decreased the proportion of apoptotic cells in gingival fibroblasts compared to a serum-free control culture in response to the protein changes as follows: PHT upregulated c-FLIP and, in turn, downregulated FADD, caspase-8, and caspase-3; PHT upregulated c-IAP2 and downregulated TRAF2; PHT downregulated caspase-9 and caspase-3 via decreased RIPK1 activity and increased Bcl-2 activity. CONCLUSION PHT-induced gingival overgrowth may result from the above-mentioned mechanisms involving apoptosis inhibition in gingival fibroblasts.
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Affiliation(s)
- R Takeuchi
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - H Matsumoto
- Department of Pharmacology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - K Arikawa
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - C Taguchi
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - R Nakayama
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - I Nasu
- Department of Preventive and Public Oral Health, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - K Hiratsuka
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
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Ma S, Liu P, Li Y, Hou L, Chen L, Qin C. Cyclosporine A Inhibits Apoptosis of Rat Gingival Epithelium. J Periodontol 2014; 85:1126-34. [DOI: 10.1902/jop.2013.130512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kwok V, Caton JG, Polson AM, Hunter PG. Application of evidence-based dentistry: from research to clinical periodontal practice. Periodontol 2000 2012; 59:61-74. [DOI: 10.1111/j.1600-0757.2011.00437.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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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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Martelli-Júnior H, Santos CDO, Bonan PR, Moura PDF, Bitu CC, León JE, Coletta RD. Minichromosome maintenance 2 and 5 expressions are increased in the epithelium of hereditary gingival fibromatosis associated with dental abnormalities. Clinics (Sao Paulo) 2011; 66:753-7. [PMID: 21789376 PMCID: PMC3109371 DOI: 10.1590/s1807-59322011000500008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 02/07/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Gingiva fibromatosis is a relatively rare condition characterized by diffuse enlargement of the gingiva, which is caused by expansion and accumulation of the connective tissue. OBJECTIVE The aim of the present study was to investigate proliferative and apoptotic biomarker expression in normal gingiva and two forms of gingival fibromatosis. METHODS Archived tissue specimens of hereditary gingival fibromatosis, gingival fibromatosis and dental abnormality syndrome and normal gingiva were subject to morphological analysis and immunohistochemical staining. The results were analyzed statistically. RESULTS Proteins associated with proliferation were found in the nuclei of epithelial cells from the basal and suprabasal layers, whereas apoptotic proteins were detected in the cytoplasm of the upper layers of the epithelium. Increased expressions of minichromosome maintenance proteins 2 and 5 were observed in the gingival fibromatosis and dental abnormality syndrome samples. In contrast, geminin expression was higher in normal gingiva samples. No difference in the expression of apoptotic proteins was observed among the groups. CONCLUSION Our findings support a role for augmented proliferation of epithelial cells within the overgrown tissues associated with gingival fibromatosis or dental abnormality syndrome. However, our data suggest that different biological mechanisms may account for the pathogenesis of different types of gingival fibromatosis.
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Affiliation(s)
- Hercílio Martelli-Júnior
- Health Science Programme, State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
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Tang L, Li N, Xie H, Jin Y. Characterization of mesenchymal stem cells from human normal and hyperplastic gingiva. J Cell Physiol 2010; 226:832-42. [DOI: 10.1002/jcp.22405] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Artese L, Piattelli A, de Gouveia Cardoso LA, Ferrari DS, Onuma T, Piccirilli M, Faveri M, Perrotti V, Simion M, Shibli JA. Immunoexpression of angiogenesis, nitric oxide synthase, and proliferation markers in gingival samples of patients with aggressive and chronic periodontitis. J Periodontol 2010; 81:718-26. [PMID: 20429651 DOI: 10.1902/jop.2010.090524] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In periodontal tissues, angiogenesis seems to be important for the maintenance of healthy tissues and in periodontal diseases. Angiogenesis is regulated through a complex interplay of molecular signals mediated by growth factors involving extracellular matrix remodeling, endothelial cell migration and proliferation, capillary differentiation and anastomosis. However, the influence of angiogenesis in the development, progression, and healing of periodontal lesions is currently under investigation. This immunohistochemical study evaluates the expression of vascular endothelial growth factor (VEGF), microvessel density (MVD), nitric oxide synthase (NOS) 1 and 3, and Ki-67 in gingival tissues of patients with aggressive and chronic periodontitis. METHODS Twenty-seven human gingival biopsies were taken from patients with chronic periodontitis (n = 14 patients), generalized aggressive periodontitis (n = 6 patients), and healthy periodontia (n = 7 patients). The specimens were immunohistochemically stained for VEGF, MVD, NOS 1 and 3, and Ki-67. RESULTS The levels of VEGF, MVD, NOS 1 and 3, and Ki-67 were found to be significantly different among groups (P >0.001). Patients with aggressive periodontitis had higher levels of these markers compared to those in patients with chronic periodontitis and healthy patients. CONCLUSIONS The analysis demonstrates a higher expression of all immunologic markers particularly in subjects with aggressive periodontitis. In summary, the data from this pilot investigation suggests that VEGF is an important factor in the pathogenesis of the aggressive and chronic forms of periodontitis.
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Affiliation(s)
- Luciano Artese
- Dental School, University of Chieti-Pescara, Chieti, Italy
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Nakasone N, Kubota T, Hoshino C, Nohno K, Itagaki M, Shimizu T, Yoshie H. Differential gene and protein expression of tissue inhibitors of metalloproteinases (TIMP)-3 and TIMP-4 in gingival tissues from drug induced gingival overgrowth. Arch Oral Biol 2009; 54:634-41. [PMID: 19450793 DOI: 10.1016/j.archoralbio.2009.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 02/24/2009] [Accepted: 04/08/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to analyse mRNA expression and protein localization of tissue inhibitors of metalloproteinases (TIMP)-3 and TIMP-4 in gingival tissues removed from drug (calcium-channel blocker) induced gingival overgrowth and periodontitis patients. DESIGN Employing RT-PCR, we evaluated TIMP-3 and TIMP-4 mRNA levels of 20 human gingival tissue samples taken from patients suffering gingival overgrowth (GO) and periodontitis (P). Then, using immunohistochemistry we investigated the TIMP-3 and TIMP-4 protein localization of five sample tissues from each group. RESULTS TIMP-4 mRNA levels in GO-gingiva tended to be lower than in P-gingiva but the results differed little (p = 0.22). Varying degrees of inflammation in the protein localization of TIMP-3 and TIMP-4 were found. TIMP-4 immunoreactivity (IR) was weak in the endothelial cells, fibroblasts, epithelial basal and parabasal cells while the degree of inflammation differed as well. TIMP-3 and TIMP-4 IR in inflammatory cells, including lymphocytes, plasma cells, and macrophages, were faint and intense respectively. For P-gingiva, both TIMP-3 and TIMP-4 IR expression was weak in the endothelial cells, fibroblasts, basal and parabasal epithelial layers. Expression of TIMP-3 was faint in the inflammatory cells, whereas TIMP-4 IR was strong. CONCLUSION Our findings suggest that TIMP-3 and TIMP-4 expression differs in GO and P-gingival tissues, both of which are potentially involved in pathogenesis.
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Affiliation(s)
- Naohiro Nakasone
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata 951-8514, Japan.
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Jung JY, Jeong YJ, Jeong TS, Chung HJ, Kim WJ. Inhibition of apoptotic signals in overgrowth of human gingival fibroblasts by cyclosporin A treatment. Arch Oral Biol 2008; 53:1042-9. [PMID: 18471799 DOI: 10.1016/j.archoralbio.2008.03.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 03/10/2008] [Accepted: 03/14/2008] [Indexed: 02/06/2023]
Abstract
Cyclosporin A (CsA), an immunosuppressive drug, has overgrowth effects on human gingival fibroblasts (HGF) in vitro. However, the molecular mechanism responsible for the CsA-induced gingival overgrowth remains still unclear. The present study is aimed to investigate the correlation with the apoptotic signal pathway in CsA-induced overgrowth of HGF. CsA-treated HGF were assessed for cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, for reactive oxygen species (ROS) detection by flow cytometry, for proliferation ability using the 5-bromo-20-deoxyuridine (BrdU), for caspase activities biochemically, for expression of apoptotic signal molecules such as cytochrome c, Fas and Fas-L and Bcl-2 family by Western blotting and VDAC by RT-PCR. CsA increased the cell viability, but not the number of BrdU-positive HGF, indicating that CsA fails to induce the proliferation of HGF. CsA also decreased the intracellular reactive oxygen species level in HGF. This was accompanied by that the antiapoptotic protein Bcl-2 was upregulated whereas the proapoptotic protein Bax was downregulated. Moreover, CsA downregulated VDAC, a mitochondrial transition pore, and decreased the level of cytochrome c released from the mitochondria into the cytosol and activation of caspase-3 and -9 associated with mitochondria-mediated apoptosis. On the other hand, Fas-L level and caspase-8 activation, the major mediator of the death receptor-mediated apoptosis, were diminished in the CsA-treated HGF. CsA inhibits the apoptotic signal molecules such as cytochrome c, caspases and Fas-L with the regulation of Bcl-2 family whereas it has no effect on cell division, which can contribute to overgrowth of HGF. These findings suggest that the decreased apoptosis plays a more important role than the increased cell proliferation in the CsA-induced overgrowth of HGF.
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Affiliation(s)
- Ji-Yeon Jung
- Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju 500-757, South Korea
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Bulut S, Özdemir BH. Apoptosis and Expression of Caspase-3 in Cyclosporin-Induced Gingival Overgrowth. J Periodontol 2007; 78:2364-8. [DOI: 10.1902/jop.2007.070226] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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