Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Jing-An Dental Clinic, Shanghai, China.
J Periodontal Res. 2023 Jun;58(3):511-519. doi: 10.1111/jre.13115. Epub 2023 Mar 16.
To investigate the association between the prevalence of cyclosporin A-induced gingival overgrowth and the expression of the epithelial-to-mesenchymal transition factors in the gingival tissues of renal transplant patients.
Gingival overgrowth (GO) is a frequent complication in organ transplant patients treated with the immunosuppressant cyclosporin A (CsA). The epithelial-to-mesenchymal transition (EMT) is considered a factor contributing to CsA-induced GO. However, current knowledge on this topic is sparse.
Sixty-three renal transplant patients were divided into two groups according to the occurrence of GO: those with gingival overgrowth (GO+ group) and those without gingival overgrowth (GO- group). Data on age, sex, and use of immunosuppressant and calcium channel blocker medications, serum creatinine values, peak concentrations of blood CsA, and gingival hyperplasia scores were recorded to identify clinically pathogenic factors. Gingival tissues from five patients with CsA-induced GO and five healthy subjects were selected for histomorphological observation with hematoxylin-eosin staining, Masson staining, and immunohistochemical staining. The mRNA expression of EMT factors was detected with reverse transcription-quantitative PCR.
The use of CsA significantly increased the prevalence of GO in renal transplant patients. The expression of α-SMA, SMAD4, and TGM2 was upregulated and that of E-cadherin was downregulated in the gingival tissues of patients with CsA-induced GO compared with those of the corresponding controls.
Treatment with CsA is closely related to the occurrence of GO in renal transplant patients and EMT plays an important role in CsA-induced gingival tissue hyperplasia.
研究肾移植患者环孢素 A 诱导性牙龈过度生长的患病率与牙龈组织中上皮-间质转化因子表达之间的关系。
牙龈过度生长（GO）是器官移植患者接受免疫抑制剂环孢素 A（CsA）治疗的常见并发症。上皮-间质转化（EMT）被认为是导致 CsA 诱导性 GO 的一个因素。然而，目前对此主题的了解还很有限。
根据是否发生 GO，将 63 例肾移植患者分为两组：有牙龈过度生长组（GO+组）和无牙龈过度生长组（GO-组）。记录年龄、性别、免疫抑制剂和钙通道阻滞剂药物使用、血清肌酐值、血 CsA 峰值浓度和牙龈增生评分等数据，以确定具有临床致病性的因素。选择 5 例 CsA 诱导性 GO 患者和 5 例健康受试者的牙龈组织进行苏木精-伊红染色、Masson 染色和免疫组织化学染色的组织形态学观察。采用反转录-定量 PCR 检测 EMT 因子的 mRNA 表达。
CsA 的使用显著增加了肾移植患者 GO 的患病率。与相应对照组相比，CsA 诱导性 GO 患者的牙龈组织中 α-SMA、SMAD4 和 TGM2 的表达上调，而 E-钙黏蛋白的表达下调。
CsA 的治疗与肾移植患者 GO 的发生密切相关，EMT 在 CsA 诱导的牙龈组织增生中起重要作用。
