scholarly journals Estimation of Bcl-2 and Ki-67 in Gingival Epithelium of Epileptic Patients

2020 ◽  
Vol 7 (3) ◽  
pp. 53-58
Author(s):  
Mohamed Helmy Salama ◽  
Abdelraheem R. Algendy ◽  
Saleem Shaikh
Keyword(s):  
Side Effects ◽  
Proliferative Activity ◽  
Gingival Tissue ◽  
Oral Epithelium ◽  
Drug Induced ◽  
Ki 67 ◽  
Gingival Overgrowth ◽  
Oral Side ◽  
Epileptic Patients ◽  
Gingival Epithelium

Abstract   Introduction: Gingival overgrowth is one of several oral side effects of phenytoin, a potent antiepileptic drug.  Several mechanisms have been elucidated to understand the pathogenesis of drug induced gingival overgrowth. The frequency of gingival overgrowth associated with chronic phenytoin therapy remains controversial. and the possible subclinical effects of this drug on the gingival epithelium should be investigated histopathologically and immunohistochemically. Purpose of the study: To investigate the Bcl-2 for apoptosis rate and Ki-67 for the epithelial proliferative activity in epileptic patients. Materials and methods: Twenty four samples of gingival tissue from epileptic patients treated with phenytoin and in eight samples of gingival tissue from healthy patients who didn’t use phenytoin (control) were evaluated for Bcl-2 and Ki-67 immunohistochemically. Results: The results revealed moreproliferative activity of the overlying epithelium and an increased pattern of Bcl-2 and Ki-67 in phenytoin users compared to controls. Conclusion: These results concluded that the increased epithelial thickness observed in phenytoin induced gingival overgrowth is associated with increased apoptotic rate and mitotic activity , especially in the oral epithelium.   Keywords: Gingival overgrowth, Bcl-2, Ki-67, Phenytoin.

scholarly journals On the Cellular and Molecular Mechanisms of Drug-Induced Gingival Overgrowth

2017 ◽  
Vol 11 (1) ◽  
pp. 420-435 ◽  
Author(s):  
Albert Ramírez-Rámiz ◽  
Lluís Brunet-LLobet ◽  
Eduard Lahor-Soler ◽  
Jaume Miranda-Rius
Keyword(s):  
Extracellular Matrix ◽  
Molecular Mechanisms ◽  
Phenotypic Variability ◽  
Membrane Receptors ◽  
Gingival Tissue ◽  
Inflammatory Factor ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Pubmed Database ◽  
Gingival Enlargement

Introduction: Gingival overgrowth has been linked to multiple factors such as adverse drug effects, inflammation, neoplastic processes, and hereditary gingival fibromatosis. Drug-induced gingival overgrowth is a well-established adverse event. In early stages, this gingival enlargement is usually located in the area of the interdental papilla. Histologically, there is an increase in the different components of the extracellular matrix. Objective: The aim of this manuscript is to describe and analyze the different cellular and molecular agents involved in the pathogenesis of Drug-induced gingival overgrowth. Method: A literature search of the MEDLINE/PubMed database was conducted to identify the mechanisms involved in the process of drug-induced gingival overgrowth, with the assistance of a research librarian. We present several causal hypotheses and discuss the advances in the understanding of the mechanisms that trigger this gingival alteration. Results: In vitro studies have revealed phenotypic cellular changes in keratinocytes and fibroblasts and an increase of the extracellular matrix with collagen and glycosaminoglycans. Drug-induced gingival overgrowth confirms the key role of collagenase and integrins, membrane receptors present in the fibroblasts, due to their involvement in the catabolism of collagen. The three drug categories implicated: calcineuron inhibitors (immunosuppressant drugs), calcium channel blocking agents and anticonvulsant drugs appear to present a multifactorial pathogenesis with a common molecular action: the blockage of the cell membrane in the Ca2+/Na+ ion flow. The alteration of the uptake of cellular folic acid, which depends on the regulated channels of active cationic transport and on passive diffusion, results in a dysfunctional degradation of the connective tissue. Certain intermediate molecules such as cytokines and prostaglandins play a role in this pathological mechanism. The concomitant inflammatory factor encourages the appearance of fibroblasts, which leads to gingival fibrosis. Susceptibility to gingival overgrowth in some fibroblast subpopulations is due to phenotypic variability and genetic polymorphism, as shown by the increase in the synthesis of molecules related to the response of the gingival tissue to inducing drugs. The authors present a diagram depicting various mechanisms involved in the pathogenesis of drug-induced gingival overgrowth. Conclusion: Individual predisposition, tissue inflammation, and molecular changes in response to the inducing drug favor the clinical manifestation of gingival overgrowth.

scholarly journals Gingival overgrowth and associated factors in a population of Nigerian hypertensives

2021 ◽  
Vol 12 (3) ◽  
pp. 164-174
Author(s):  
Soroye Modupeoluwa Omotunde ◽  
Sorunke Modupeore Ekua
Keyword(s):  
Oral Hygiene ◽  
Associated Factors ◽  
Statistical Significance ◽  
Gingival Tissue ◽  
Age Group ◽  
Gingival Inflammation ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Hygiene Measures ◽  
Gingival Enlargement

Background: Gingival overgrowth may be idiopathic or secondary. Drug Induced Gingival Overgrowth (DIGO) occurs within 3 months of treatment and is more prevalent in younger age group with predilection for the anterior gingival tissue and usually not associated with attachment loss or tooth mobility unless there is an existing periodontal disease. Methodology: 170 hypertensive patients were recruited for the study; 85 calcium channel blocker (CCB) and 85 non-CCB users. Interviewer-administered questionnaires was used to obtain socio-demographic information as well as medical and drug history. GO was assessed using New Clinical Index for DIGO and data was analyzed with SPSS version 21 (Armonk, NY: IBM Corp). Continuous and nominal variables were described with means, standard deviations and frequencies. Statistical significance was set at P < 0.05. Results: Amlodipine was the most commonly used CCB. The prevalence of DIGO in CCB and non-CCB was the same (49.5%). Gingival enlargement was found equally among both sexes in the CCB and non-CCB groups. A third of the participants with GO were 70 years and above while those without were majorly in the fifth and sixth decade of life. Two-third of those with DIGO had fair oral hygiene status, two-fifth had gingival bleeding and three-fifth had mild gingival inflammation. Those without DIGO in both groups had a slight female predominance and majorly good oral hygiene. Associated factors with DIGO were female sex, 60-69 age group, 10mg drug dosage, been on medication less than 10 years, mild gingival inflammation and generalized gingivitis. Conclusion: There was no difference in the prevalence of DIGO between BBC and non-BBC users. However, there was mild gingival inflammation in all participants with DIGO and amlodipine users were three times more at risk of developing DIGO than nifedipine users. Thus, it is imperative to advise the hypertensives on the importance of maintaining adequate oral hygiene measures and incorporate periodontal care in their management so as to ameliorate the side effects of their medication.

scholarly journals Localised Gingival Overgrowth in Patient taking Amlodipine

2020 ◽  
Vol 4 (2) ◽  
pp. 96-99
Author(s):  
Arjun Hari Rijal ◽  
Bhageshwar Dhami ◽  
Nashib Pandey ◽  
Deepa Aryal ◽  
Kamana Neupane
Keyword(s):  
Side Effects ◽  
Male Patient ◽  
Treatment Modalities ◽  
Third Generation ◽  
Middle Aged ◽  
Drug Induced ◽  
Aged Patients ◽  
Gingival Overgrowth ◽  
Drug Substitution ◽  
Gingival Enlargement

 Gingival enlargement is an increase in the size of gingiva. It is one of the side effects of systemic administration of antihypertensives, anticonvulsants, and immunosuppressants. Amlodipine, a new third-generation dihydropyridine, very useful in middle-aged to older aged patients for various cardiovascular conditions can cause gingival enlargement. Treatment modalities for drug induced gingival enlargement include removal of local irritating factors, meticulous plaque removal and drug substitution after consultation with a physician. This article reports an amlodipine induced gingival enlargement and its treatment in a 40 years old hypertensive male patient.

Expression of fibronectin-binding integrins in gingival epithelium in drug-induced gingival overgrowth

2007 ◽  
Vol 42 (2) ◽  
pp. 144-151 ◽  
Author(s):  
P. Walsh ◽  
L. Häkkinen ◽  
H. Pernu ◽  
M. Knuuttila ◽  
H. Larjava
Keyword(s):  
Drug Induced ◽  
Gingival Overgrowth ◽  
Gingival Epithelium ◽  
Fibronectin Binding

scholarly journals Drug-induced gingival hyperplasia: An in vitro study using amlodipine and human gingival fibroblasts

2019 ◽  
Vol 33 ◽  
pp. 205873841982774 ◽  
Author(s):  
Dorina Lauritano ◽  
Marcella Martinelli ◽  
Alessandro Baj ◽  
Giada Beltramini ◽  
Valentina Candotto ◽  
...  
Keyword(s):  
Gene Expression ◽  
Inflammatory Responses ◽  
Human Gingival Fibroblasts ◽  
Gingival Tissue ◽  
Gingival Fibroblast ◽  
Gingival Hyperplasia ◽  
Gingival Fibroblasts ◽  
Drug Induced ◽  
Gingival Overgrowth

Gingival overgrowth is a serious side effect that accompanies the use of amlodipine. Several conflicting theories have been proposed to explain the fibroblast’s function in gingival overgrowth. To determine whether amlodipine alters the inflammatory responses, we investigated its effects on gingival fibroblast gene expression as compared with untreated cells. Fragments of gingival tissue of healthy volunteers (11 years old boy, 68 years old woman, and 20 years old men) were collected during operation. Gene expression of 29 genes was investigated in gingival fibroblast cell culture treated with amlodipine, compared with untreated cells. Among the studied genes, only 15 ( CCL1, CCL2D, CCL5, CCL8, CXCL5, CXCL10, CCR1, CCR10, IL1A, IL1B, IL5, IL7, IL8, SPP1, and TNFSF10) were significantly deregulated. In particular, the most evident overexpressed genes in treated cells were CCR10 and IL1A. These results seem to indicate a possible role of amlodipine in the inflammatory response of treated human gingival fibroblasts.

scholarly journals AUMENTO GENGIVAL INFLUENCIADO POR DROGAS: UMA REVISÃO DE LITERATURA

2014 ◽  
Vol 5 (1) ◽  
Author(s):  
Tallita Evellyn Braga Mendes ◽  
Lennon Barreto Cerqueira ◽  
Maria Cecília Fonsêca Azoubel
Keyword(s):  
Early Diagnosis ◽  
Literature Review ◽  
Gingival Tissue ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Patient Prognosis ◽  
The Individual

The drug-induced gingival overgrowth is characterized by the excessive growth of gingival tissue surrounding the region of the interdental papillae. Only in severe cases can cover the dental elements and interfere the individual nutrition. The main associated drugs with this type of alteration are nifedipine, cyclosporine and phenytoin. Consultation preventive are fundamental for individuals who present risk  of developing this kind of gingival alteration, as well as early diagnosis, and both can considerably to improve the patient prognosis. The purpose of this paper is to conduct a literature review concerning the drug-induced gingival overgrowth, emphasizing the main drugs that can occasion it, as well as, the treatments indicated for this type of alteration.

scholarly journals Effects of long-term cyclosporin therapy on gingiva of rats: analysis by stereological and biochemical estimation

2005 ◽  
Vol 19 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Luis Carlos Spolidorio ◽  
Denise Madalena Palomari Spolidorio ◽  
Marinella Holzhausen ◽  
Patricia Oehlmeyer Nassar ◽  
Carlos Augusto Nassar
Keyword(s):  
Immunosuppressive Agent ◽  
Collagen Fibers ◽  
Gingival Tissue ◽  
Term Therapy ◽  
Oral Epithelium ◽  
Duration Of Treatment ◽  
Gingival Overgrowth ◽  
Biochemical Estimation ◽  
Long Term Therapy

Cyclosporin A (CsA) is used as an immunosuppressive agent and its prominent side effect is the induction of gingival overgrowth, which remains a significant problem. The risk factors appraised include the duration of treatment. However, there are no stereological and biochemical studies exploring the effects of long-term CsA therapy on gingival tissue. The purpose of the present study was to investigate the level of TGF-beta1 in saliva and describe the densities of fibroblasts and collagen fibers in the gingival tissue of rats treated with CsA for long periods. Rats were treated for 60, 120, 180 and 240 days with a daily subcutaneous injection of 10 mg/kg of body weight of CsA. At the end of the experimental periods, saliva was collected for the determination of TGF-beta1 levels. After histological processing, the oral epithelium and the connective tissue area were measured as well as the volume densities of fibroblasts (Vf) and collagen fibers (Vcf). After 60 and 120 days of CsA treatment, there was a significant increase in Vf and Vcf as well as a significant increase in TGF-beta1 levels. After 180 and 240 days, reduction in the gingival overgrowth associated with significant decreases in the level of TGF-beta1, and also decreased Vf and Vcf, were observed. The data presented here suggest that after long-term therapy, a decrease in TGF-beta1 levels occurs, which might contribute to an increase in the proteolytic activity of fibroblasts in the gingiva, favoring the normality of extracellular matrix synthesis.

Immunohistochemical Analysis of S100-Positive Langerhans Cells in the Healthy Gingiva and Periodontal Disease

2018 ◽  
Vol 69 (1) ◽  
pp. 232-235
Author(s):  
Ciprian Ioan Roi ◽  
Pusa Nela Gaje ◽  
Raluca Amalia Ceausu ◽  
Ramona Amina Popovici ◽  
Marius Raica
Keyword(s):  
Langerhans Cells ◽  
Inflammatory Process ◽  
Hot Spot ◽  
Basal Layer ◽  
Immunohistochemical Analysis ◽  
Gingival Tissue ◽  
Oral Epithelium ◽  
Quantitative Score ◽  
Gingival Epithelium ◽  
The Relationship

Langerhans cells are antigen presenting cells, located in the stratified squamous epithelium of the skin and oral epithelium. A high density of Langerhans cells in gingival epithelium associated with an inflammatory process has been demonstrated in the literature by numerous studies, although the relationship with inflammation was less investigated.The aim of our study was to evaluate the distribution, density, morphology of Langerhans cells in both gingival epithelium and the associated inflammatory infiltrate in the lamina propria of the gingiva. The relationship between Langerhans cells and inflamatory process was also assesed. The present study included a number of 51 gingival biopsies. 12 of these didn� t show significant changes on routine examination. In all of the other 39 cases the presence of inflammatory lesions was noticed. The inflamatory infiltrate was described by using hematoxylin eosin staining and quantitative score, with values between 0 and 3. Langerhans cells were immunohistochemicaly highlighted by using S100 antibody and quantified with hot spot method.We found an increase of Langerhans cells density in all cases of inflammation as compared with healthy gingival tissue. The highest density was found in the 13 cases with severe inflammation. At these last cases was noticed a migration tendency of Langerhans cells from infiltrate inflamatory area to basal layer of the epithelium. The results of this study indicated that Langerhans cells number is higher in inflamatory gingival tissue comparative with normal tissue, and the density of these cells is in relation with the severity of the inflammatory process.

scholarly journals Influence of Mast Cells in Drug-Induced Gingival Overgrowth

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Tamilselvan Subramani ◽  
Vidhya Rathnavelu ◽  
Swee Keong Yeap ◽  
Noorjahan Banu Alitheen
Keyword(s):  
Mast Cells ◽  
Inflammatory Cells ◽  
Cellular Level ◽  
Gingival Tissue ◽  
Drug Induced ◽  
Effector Cells ◽  
Gingival Overgrowth ◽  
Systemic Medication ◽  
Immunohistochemical Studies ◽  
Inflammatory Changes

Mast cells (MCs) are multifunctional effector cells that were originally thought to be involved in allergic disorders. Now it is known that they contain an array of mediators with a multitude of effects on many other cells. MCs have become a recent concern in drug-induced gingival overgrowth (DIGO), an unwanted outcome of systemic medication. Most of the studies have confirmed the significant presence of inflammation as a prerequisite for the overgrowth to occur. The inflammatory changes within the gingival tissue appear to influence the interaction between the inducing drug and the fibroblast activity. The development of antibodies to MC-specific enzymes, tryptase and chymase, has facilitated the study of mast cells in DIGO. Many immunohistochemical studies involving MCs have been conducted; as a result, DIGO tissues are found to have increased the number of MCs in the gingiva, especially in the area of fibrosis. At the cellular level, gingival fibrogenesis is initiated by several mediators which induce the recruitment of a large number of inflammatory cells, including MCs. The purpose of this paper is to access the roles played by MCs in gingival overgrowth to hypothesize a relationship between these highly specialized cells in the pathogenesis of DIGO.

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