Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
J Clin Periodontol. 2011 Nov;38(11):984-91. doi: 10.1111/j.1600-051X.2011.01773.x. Epub 2011 Aug 24.
To determine whether incidence and severity of cyclosporine A (CsA)-induced gingival overgrowth (GO) is related to expression nuclear factor of activated T cells-regulated genes (NFAT-regulated genes).
Expression of NFAT-regulated genes was determined in 36 transplant patients medicated with CsA by real-time PCR before and 2 h after drug intake and residual NFAT activity was estimated as ratio of both measurements. Demographic, periodontal and pharmacologic parameters were recorded and GO assessed from models. Subjects were divided into two groups according to the degree of GO (responders: GO score≥10%). Groups were compared using parametric and non-parametric tests. The association of various CsA-specific and periodontal parameters on incidence and extent of GO were determined using regression analysis.
Responders had a more than twofold lower residual NFAT activity than non-responders (7.9% and 18.1%, respectively; p<0.001). Multiple regression analysis revealed gingival inflammation, salivary CsA concentration, and residual NFAT activity to be significant factors influencing the expression of GO. Seventy-seven percent of the variability of GO could be explained by these parameters.
This study showed that pharmacodynamic parameters such as residual NFAT activity may be promising prognostic indicators to identify patients with increased risk for GO.
确定环孢素 A（CsA）诱导的牙龈过度生长（GO）的发生率和严重程度是否与核因子活化 T 细胞调节基因（NFAT 调节基因）的表达有关。
通过实时 PCR 测定 36 例接受 CsA 治疗的移植患者在药物摄入前后 2 小时的 NFAT 调节基因表达，并将两者的测量比值估计为残留 NFAT 活性。记录人口统计学、牙周和药物参数，并通过模型评估 GO。根据 GO 的程度（反应者：GO 评分≥10%）将患者分为两组。使用参数和非参数检验比较组间差异。使用回归分析确定各种 CsA 特异性和牙周参数与 GO 发生率和严重程度的相关性。
反应者的残留 NFAT 活性比非反应者低两倍以上（分别为 7.9%和 18.1%；p<0.001）。多元回归分析显示，牙龈炎症、唾液中 CsA 浓度和残留 NFAT 活性是影响 GO 表达的重要因素。这些参数可以解释 GO 77%的变异性。
本研究表明，药效学参数如残留 NFAT 活性可能是预测 GO 风险增加的有前途的预后指标。
