Pascu Eugen IonuŢ, Pisoschi Cătălina Gabriela, Andrei Ana Marina, Munteanu Maria Cristina, Rauten Anne Marie, Scrieciu Monica, Taisescu Oana, SurpăŢeanu Mihai, BaniŢă Ileana Monica
Department of Biochemistry, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2015;56(1):49-61.
In this work, we compared the histological features of the gingival lesions clinically diagnosed as fibrotic overgrowths due to various etiologic factors as well as an immunohistochemical assessment of fibroblasts phenotypic heterogeneity using the specific labeling for vimentin, α-smooth muscle actin (α-SMA) and fibroblast specific protein-1 (FSP1).
Tissue samples were obtained from 12 patients clinically diagnosed with fibrotic gingival overgrowth, divided in four groups. Fragments of gingiva were processed for paraffin embedding. Serial sections were used for routine staining Hematoxylin-Eosin, trichromic Masson and Goldner-Szekely, and for immunohistochemical reactions to label vimentin, α-SMA and FSP1 using for signal amplification several techniques (EnVision, LSAB, ABC).
Storage of collagen fibers, increase of fibroblast number and frequent presence of inflammatory infiltrate are histological issues of all fibrotic gingival overgrowth. The incidence of granulation tissue varies but the frequency of its presence point the attention to the involvement in collagen metabolism imbalance. Immunostaining for vimentin showed a difference between its expression in samples from different groups. Except the cases of fibrosis induced by orthodontic devices, cells positive for α-SMA were rare. FSP1-positive fibroblasts were the most frequent in all cases from all the groups selected for this study.
The phenotype of fibroblasts is different in gingival fibrosis in relation to the risk factor, at present the most common being vimentin-positive and FSP1-positive fibroblasts. Myofibroblasts are rare in gingival fibrosis, the most numerous being in local lesions caused by wearing orthodontic devices and in syndromic fibromatosis. Further studies are required to elucidate the manner in which the active fibroblasts are recruited in relation to the etiologic factor of gingival overgrowth.
在本研究中，我们比较了临床上诊断为因各种病因导致的纤维化过度生长的牙龈病变的组织学特征，并使用波形蛋白、α-平滑肌肌动蛋白（α-SMA）和成纤维细胞特异性蛋白-1（FSP1）的特异性标记对成纤维细胞表型异质性进行免疫组织化学评估。
从12例临床诊断为纤维化牙龈过度生长的患者获取组织样本，分为四组。将牙龈组织碎片进行石蜡包埋。连续切片用于苏木精-伊红常规染色、三色马松染色和戈德纳-塞克利染色，以及使用多种技术（EnVision、LSAB、ABC）进行波形蛋白、α-SMA和FSP1标记的免疫组织化学反应以进行信号放大。
胶原纤维蓄积、成纤维细胞数量增加以及炎症浸润频繁出现是所有纤维化牙龈过度生长的组织学表现。肉芽组织的发生率有所不同，但其出现频率提示其参与了胶原代谢失衡。波形蛋白免疫染色显示不同组样本中其表达存在差异。除正畸装置诱导的纤维化病例外，α-SMA阳性细胞罕见。FSP1阳性成纤维细胞在本研究选取的所有组的所有病例中最为常见。
与危险因素相关的牙龈纤维化中，成纤维细胞的表型不同，目前最常见的是波形蛋白阳性和成纤维细胞特异性蛋白-1阳性的成纤维细胞。肌成纤维细胞在牙龈纤维化中罕见，在佩戴正畸装置引起的局部病变和综合征性纤维瘤病中数量最多。需要进一步研究以阐明与牙龈过度生长病因相关的活跃成纤维细胞的募集方式。
