Arora Hitesh, Madapusi Balaji Thodur, Ramamurti Anjana, Narasimhan Malathi, Periasamy Soundararajan, Rao Suresh Ranga
Post Graduate Student, Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University , Porur, Chennai, India .
Associate Professor, Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University , Porur, Chennai, India .
J Clin Diagn Res. 2016 Aug;10(8):ZC48-52. doi: 10.7860/JCDR/2016/20808.8271. Epub 2016 Aug 1.
INTRODUCTION: Cyclosporine, an immunosuppressive agent used in the management of renal transplant patients is known to produce Drug Induced Gingival Overgrowth (DIGO) as a side effect. Several mechanisms have been elucidated to understand the pathogenesis of DIGO. Recently, epithelial mesenchymal transition has been proposed as a mechanism underlying fibrosis of various organs. AIM: The aim of the study was to investigate if Epithelial Mesenchymal Transition (EMT) operates in Cyclosporine induced gingival overgrowth. MATERIALS AND METHODS: The study involved obtaining gingival tissue samples from healthy individuals (n=17) and subjects who exhibited cyclosporine induced gingival overgrowth (n=18). Presence and distribution of E-Cadherin, S100 A4 and alpha smooth muscle actin (α-SMA) was assessed using immunohistochemistry and cell types involved in their expression were determined. The number of α- SMA positive fibroblasts were counted in the samples. RESULTS: In control group, there was no loss of E-Cadherin and a pronounced staining was seen in the all layers of the epithelium in all the samples analysed (100%). S100 A4 staining was noted in langerhans cells, fibroblasts, endothelial cells and endothelial lined blood capillaries in Connective Tissue (CT) of all the samples (100%) while α - SMA staining was seen only on the endothelial lined blood capillaries in all the samples (100%). However in DIGO, there was positive staining of E-Cadherin only in the basal and suprabasal layers of the epithelium in all the samples (100%). Moreover there was focal loss of E-Cadherin in the epithelium in eight out of 18 samples (44%). A break in the continuity of the basement membrane was noted in three out of 18 samples (16%) on H & E staining. CONCLUSION: Based on the analysis of differential staining of the markers, it can be concluded that EMT could be one of the mechanistic pathways underlying the pathogenesis of DIGO.
引言:环孢素是一种用于肾移植患者管理的免疫抑制剂,已知会产生药物性牙龈增生(DIGO)作为副作用。已经阐明了几种机制来理解DIGO的发病机制。最近,上皮-间质转化被提出作为各种器官纤维化的潜在机制。 目的:本研究的目的是调查上皮-间质转化(EMT)是否在环孢素诱导的牙龈增生中起作用。 材料和方法:该研究涉及从健康个体(n = 17)和表现出环孢素诱导的牙龈增生的受试者(n = 18)中获取牙龈组织样本。使用免疫组织化学评估E-钙黏蛋白、S100 A4和α平滑肌肌动蛋白(α-SMA)的存在和分布,并确定参与其表达的细胞类型。对样本中α-SMA阳性成纤维细胞的数量进行计数。 结果:在对照组中,E-钙黏蛋白没有丢失,在所有分析的样本(100%)的上皮各层中均可见明显染色。在所有样本(100%)的结缔组织(CT)中的朗格汉斯细胞、成纤维细胞、内皮细胞和内皮衬里的毛细血管中均观察到S100 A4染色,而在所有样本(100%)中仅在内皮衬里的毛细血管上观察到α-SMA染色。然而,在DIGO中,所有样本(100%)中E-钙黏蛋白仅在上皮的基底层和基底上层呈阳性染色。此外,18个样本中有8个(44%)的上皮中E-钙黏蛋白有局灶性丢失。在苏木精和伊红染色的18个样本中有3个(16%)注意到基底膜连续性中断。 结论:基于对标志物差异染色的分析,可以得出结论,EMT可能是DIGO发病机制的机制途径之一。
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