Abstract
Cyclosporin A(CsA) - induced gingival overgrowth(GO) is a current problem of tissue-specific mechanism which is still incompletely explained. The apoptotic process has been of particular interest like a new concept in the etiology of this unwanted effect. The aim of our study was to detect the level of apoptosis, expression bcl-2 and p53, associated with the different doses of CsA. in gingival stroma. A cohort of 84 kidney transplant recipients was divided into four subgroups based on average daily dose of therapeutically applied CsA (Neoral®), (100 mg, 125 mg, 150 mg and 175 mg). The control group consisted of 21 patients, clinically diagnosed with periodontitis, who were not subjected to any medicamentous treatment causing gingival overgrowth. The following indexes were analyzed: plaque index (PI), index of gingival inflammation (GI) according to Loe-Silnes, and gingival overgrowth index (GOI) according to MacGaw et al. The tissue samples were subjected to a semiquantitative analysis to detect apoptotical cells and immunohistochemically stained to detect the expression of the bcl-2 and p53 proteins. The difference in percentage of apoptotic cells between the group taking 175 mg and other subgroups, as well as the control group was statistically significant (p<0.05). There was a significant difference in percentage of expression bcl-2 between the 175 mg group compared to the other three subgroups and the control (p=0.001). However, a statistically significant positive correlation between the medicament dose, p53, apoptosis, and bcl-2 was registered (p<0.05). Inflammation plays the most important role in the induction of apoptosis and proliferation in gingival tissues.
Highlights
Gingival overgrowth (GO) is very often associated with the use of cyclosporine A (CsA) [ ]
The following indexes were analyzed: plaque index (PI), index of gingival inflammation (GI) according to Loe-Silnes, and gingival overgrowth index (GOI) according to MacGaw et al The tissue samples were subjected to a semiquantitative analysis to detect apoptotical cells and imunohistochemically stained to detect the expression of the bcl- and p proteins
Considering the fact that tissue homeostasis is seriously impaired with CsA-induced GO, the aim of our research was to assess the level of apoptosis, bcl- and p expression in the gingival tissue at different CsA doses and compared to findings in healthy individuals with parodontitis
Summary
Gingival overgrowth (GO) is very often associated with the use of cyclosporine A (CsA) [ ]. Some studies indicate several factors as taking part in the pathogenesis of gingival overgrowth (GO), the dosage, the serum and saliva concentration of the medicament, the duration of treatment, oral hygiene and the age of each individual is worth emphasizing [ ]. The blockade of one or several steps in the cascade of the CsA interactions, may result in apoptotic changes and reduced caspase leading to an increased level of growth of the gingival tissue [ , ]. The apoptotic cell death is considered as a possible participant in the pathogenesis of many diseases, including cancer, autoimmune illnesses and virus infections alike [ , , ]. The crucial apoptotic regulation is realized through two transmembranic proteins: the deadly p gene
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