Drug-Induced Gingival Overgrowth - A Review

1970 ◽  
pp. 26-29
Author(s):  
Mst Fatema Akhter ◽  
Shaheen Lipika Quayum ◽  
Afrin Bintal Ali ◽  
Zia Mamoon
Keyword(s):  
Extracellular Matrix ◽  
Collagen Synthesis ◽  
Immunosuppressive Agents ◽  
Channel Blockers ◽  
Gingival Fibroblasts ◽  
Connective Tissues ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Collagen Phagocytosis ◽  
Synthesis And Degradation

Drug-induced gingival overgrowth is a side effect associated with 3 types of drugs: anticonvulsants (phenytoin), immunosuppressive agents (cyclosporine A), and various calcium channel blockers for cardiovascular diseases. Gingival overgrowth is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components with various degrees of inflammation. Although the mechanisms of these disorders have not been elucidated, recent studies suggest that these disorders seem to be induced by the disruption of homeostasis of collagen synthesis and degradation in gingival connective tissue, predominantly through the inhibition of collagen phagocytosis of gingival fibroblasts. In this review, we focus on collagen metabolism in drug-induced gingival overgrowth, focusing on the regulation of collagen phagocytosis in fibroblasts. DOI: 10.3329/bjpp.v25i1.5743Bangladesh J Physiol Pharmacol 2009; 25(1&2) : 26-29

scholarly journals Phenytoin-Induced Gingival Overgrowth: A Review of the Molecular, Immune, and Inflammatory Features

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Jôice Dias Corrêa ◽  
Celso Martins Queiroz-Junior ◽  
José Eustáquio Costa ◽  
Antônio Lúcio Teixeira ◽  
Tarcilia Aparecida Silva
Keyword(s):  
Extracellular Matrix ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Side Effect ◽  
Channel Blockers ◽  
Connective Tissues ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Matrix Metabolism

Gingival overgrowth (GO) is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. GO is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. One of the main drugs associated with GO is the antiepileptic phenytoin, which affects gingival tissues by altering extracellular matrix metabolism. Nevertheless, the pathogenesis of such drug-induced GO remains fulfilled by some contradictory findings. This paper aims to present the most relevant studies regarding the molecular, immune, and inflammatory aspects of phenytoin-induced gingival overgrowth.

scholarly journals Drug-Induced Gingival Overgrowth: A Pilot Study on the Effect of Diphenylhydantoin and Gabapentin on Human Gingival Fibroblasts

2020 ◽  
Vol 17 (21) ◽  
pp. 8229
Author(s):  
Dorina Lauritano ◽  
Giulia Moreo ◽  
Luisa Limongelli ◽  
Elena Tregambi ◽  
Annalisa Palmieri ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Direct Action ◽  
Human Fibroblasts ◽  
Matrix Metalloproteases ◽  
Channel Blockers ◽  
Gingival Hyperplasia ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Matrix Deposition ◽  
Extracellular Matrix Deposition

Introduction. The administration of several classes of drugs can lead to the onset of gingival overgrowth: anticonvulsants, immunosuppressants, and calcium channel blockers. Among the anticonvulsants, the main drug associated with gingival overgrowth is diphenylhydantoin. Materials and Methods. In this study, we compared the effects of diphenylhydantoin and gabapentin on 57 genes belonging to the “Extracellular Matrix and Adhesion Molecule” pathway, present in human fibroblasts of healthy volunteers. Results. Both molecules induce the same gene expression profile in fibroblasts as well as a significant upregulation of genes involved in extracellular matrix deposition like COL4A1, ITGA7, and LAMB3. The two treatments also induced a significant downregulation of genes involved in the expression of extracellular matrix metalloproteases like MMP11, MMP15, MMP16, MMP24, and transmembrane receptor ITGB4. Conclusions. Data recorded in our study confirmed the hypothesis of a direct action of these drugs at the periodontium level, inducing an increase in matrix production, a reduction in its degradation, and consequently resulting in gingival hyperplasia.

scholarly journals VARIOUS MANIFESTATIONS OF HYPERPLASIA OF PERIODONTAL TISSUES IN CHILDREN

2013 ◽  
Vol 9 (3) ◽  
pp. 56-62
Author(s):  
Т. Закиров ◽  
T. Zakirov ◽  
Е. Бимбас ◽  
E. Bimbas ◽  
Т. Стати ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Oral Hygiene ◽  
Conservative Therapy ◽  
Genetic Disorder ◽  
Gingival Hyperplasia ◽  
Complex Treatment ◽  
Connective Tissues ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Periodontal Tissues

There are many reasons for gingival hyperplasia in  children. Mostly, proper oral hygiene is sufficient to achieve normal healthy gingiva. In some situations, however, gingival hyperplasia is drug induced or can be a manifestation of a genetic disorder. In the latter, it may exist as an isolated abnormality or as part of a syndrome. Gingival overgrowth is characterized by the accumulation of extracellular matrix in gingival connective  tissues, particularly collagenous components with various degrees of inflammation. The complex treatment of gingival overgrowth can include conservative therapy and traditional or laser gingivectomy

scholarly journals Drug-Induced Gingival Overgrowth: The Effect of Cyclosporin A and Mycophenolate Mophetil on Human Gingival Fibroblasts

Biomedicines ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. 221 ◽  
Author(s):  
Dorina Lauritano ◽  
Giulia Moreo ◽  
Luisa Limongelli ◽  
Annalisa Palmieri ◽  
Francesco Carinci
Keyword(s):  
Extracellular Matrix ◽  
Cell Viability ◽  
Cyclosporin A ◽  
Chronic Administration ◽  
Immunosuppressive Drugs ◽  
Matrix Metalloproteases ◽  
Human Gingival Fibroblasts ◽  
Gingival Fibroblasts ◽  
Drug Induced ◽  
Gingival Overgrowth

Drug-induced gingival overgrowth may occur after a chronic administration of three classes of systemic drugs: Anticonvulsants, immunosuppressants, and calcium channel blockers. This study aimed to investigate how cyclosporin A and mycophenolate mophetil (immunosuppressive drugs) could interfere with human gingival fibroblasts functions, leading to gingival enlargement. Human gingival fibroblasts derived from the tissue of a 60-year-old female were cultured in a DMEME medium. A stock solution with 1 mg/mL of mycophenolate and 1 mg/mL of cyclosporine were prepared and dissolved in a DMEM medium to prepare a serial dilution at the concentrations of 5000, 2000, 1000, 500, and 100 ng/mL, for both treatments. Cell viability was measured using the PrestoBlue™ Reagent Protocol. Quantitative real-time RT-PCR was performed in order to analyze the expression of 57 genes coding for gingival fibroblasts “Extracellular Matrix and Adhesion Molecules”. Mycophenolate and cyclosporine had no effect on fibroblast cell viability at 1000 ng/mL. Both the treatments showed similar effects on the expression profiling of treated cells: Downregulation of most extracellular matrix metalloproteases genes (MMP8, MMP11, MMP15, MMP16, MMP24) was assessed, while CDH1, ITGA2, ITGA7, LAMB3, MMP12, and MMP13 were recorded to be upregulated in fibroblasts treated with immunosuppressive drugs. It has been demonstrated that gingival overgrowth can be caused by the chronic administration of cyclosporin A and mycophenolate mophetil. However, given the contrasting data of literature, further investigations are needed, making clear the possible effects of immunosuppressive drugs on fibroblasts.

scholarly journals Connective Tissue Metabolism and Gingival Overgrowth

2004 ◽  
Vol 15 (3) ◽  
pp. 165-175 ◽  
Author(s):  
P. C. Trackman ◽  
A. Kantarci
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Oral Hygiene ◽  
Tissue Specificity ◽  
Gingival Fibroblast ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Connective Tissue Metabolism ◽  
Matrix Metabolism ◽  
Systemic Health

Gingival overgrowth occurs mainly as a result of certain anti-seizure, immunosuppressive, or antihypertensive drug therapies. Excess gingival tissues impede oral function and are disfiguring. Effective oral hygiene is compromised in the presence of gingival overgrowth, and it is now recognized that this may have negative implications for the systemic health of affected patients. Recent studies indicate that cytokine balances are abnormal in drug-induced forms of gingival overgrowth. Data supporting molecular and cellular characteristics that distinguish different forms of gingival overgrowth are summarized, and aspects of gingival fibroblast extracellular matrix metabolism that are unique to gingival tissues and cells are reviewed. Abnormal cytokine balances derived principally from lymphocytes and macrophages, and unique aspects of gingival extracellular matrix metabolism, are elements of a working model presented to facilitate our gaining a better understanding of mechanisms and of the tissue specificity of gingival overgrowth.

scholarly journals Drug-Induced Gingival Overgrowth in an 8-Year-Old Girl: A Case Report

2021 ◽  
Vol 13 (3) ◽  
pp. 109-112
Author(s):  
Parviz Torkzaban ◽  
Amir Talaie
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Immunological Tolerance ◽  
Systemic Autoimmune Disease ◽  
Channel Blockers ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Gingival Overgrowth

Systemic lupus erythematosus is a systemic autoimmune disease that involves multi organs. Genetic, endocrine, immunological, and environmental factors influence the loss of immunological tolerance against self-antigens leading to the formation of pathogenic autoantibodies that cause tissue damage through multiple mechanisms. The gingival overgrowth can be caused by three factors: noninflammatory, hyperplastic reaction to the medication; chronic inflammatory hyperplasia; or a combined enlargement due to chronic inflammation and drug-induced hyperplasia. Drug-Induced Gingival Overgrowth is associated with the use of three major classes of drugs, namely anticonvulsants, calcium channel blockers, and immunosuppressants. Due to recent indications for these drugs, their use continues to grow.

Amlodipine Induced Gum Hypertrophy – A Rare Case Report

2021 ◽  
Vol 16 ◽  
Author(s):  
Suryanarayana Challa Reddy ◽  
Naresh Midha ◽  
Vivek Chhabra ◽  
Deepak Kumar ◽  
Gopal Krishna Bohra
Keyword(s):  
Calcium Channel ◽  
Side Effect ◽  
Antihypertensive Drugs ◽  
Case Reports ◽  
Diagnostic Procedures ◽  
Channel Blockers ◽  
Gingival Hyperplasia ◽  
Drug Induced ◽  
Duration Of Action ◽  
Gingival Overgrowth

Background: DIGO or drug-induced gingival overgrowth occurs as a side effect of certain drugs. Until now, the etiology of drug-induced gingival overgrowth is not clearly understood. Among the calcium channel blockers, nifedipine has been shown to be most frequently associated with drug-induced gingival hyperplasia. Amlodipine is a comparatively newer calcium channel blocker that witha longer duration of action and lesser side effects as compared to nifedipine. There are only certain case reports of amlodipine-induced gum hyperplasia. Case presentation: We report a case of amlodipine-induced gum hyperplasia in a 66-year-old hypertensive patient taking amlodipine at a dose of 5 mg once a day. There was significant regression of gum hypertrophy after substitution of amlodipine by Losartan. Conclusion: Amlodipine is one of the commonly prescribed antihypertensive drugs, and gingival hyperplasia is one overlooked side effect in patients taking amlodipine. Awareness of this potential side effect of amlodipine may be helpful to reduce the anxiety of patients and the cost of diagnostic procedures.

scholarly journals Mechanism of Drug-induced Gingival Overgrowth: Phenytoin Inhibits the Apoptosis of Human Gingival Fibroblasts

2021 ◽  
Vol 20 (2) ◽  
pp. 109-116
Author(s):  
Reiri Takeuchi ◽  
Hiroko Matsumoto ◽  
Chieko Taguchi ◽  
Yuichiro Okada ◽  
Masaru Mizuta ◽  
...  
Keyword(s):  
Human Gingival Fibroblasts ◽  
Gingival Fibroblasts ◽  
Drug Induced ◽  
Gingival Overgrowth
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