Cyclosporin- and nifedipine-induced gingival overgrowth in renal transplant patients: correlations with periodontal and pharmacological parameters, and HLA-antigens.
The factors associated with cyclosporin A (CsA)- and nifedipine (Nif)-induced gingival overgrowth were investigated in 113 renal transplant recipients receiving CsA alone (Group 1) [n = 61], CsA and Nif (Group 2) [n = 28], or azathioprine (Aza) (Control Group) [n = 24]. Periodontal and pharmacological parameters were assessed for each patient. The patients with a gingival overgrowth index (GOI) score >1 were considered responders (R); those with a score </= 1 were non-responders (NR). Gingival overgrowth occurred in 33.7% of the patients in Groups 1 and 2; 60% of the responders were receiving CsA+Nif. In R, no relationship was found between the GOI and the periodontal and pharmacological parameters, and although there was a trend towards an increased presence of HLA-A19 antigen (chi-square=4.40; P=0.04; RR=2.86), no significant difference was found between R and NR (Pc>0.05). It is concluded that the prevalence and severity of gingival overgrowth are greater in patients receiving CsA+Nif. As overgrowth appeared to be unrelated to local irritants, gingival inflammation or pharmacological parameters, it may be related to individual susceptibility.
Margiotta
V
V
Department of Oral Pathology, University of Palermo, Italy.
Pizzo
I
I
Pizzo
G
G
Barbaro
A
A
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000009:adverse effects* / Q000032:analysis / Q000097:blood; D002648:Child; D016572:Cyclosporine / Q000009:adverse effects* / Q000032:analysis / Q000097:blood; D003728:Dental Calculus / Q000150:complications; D003774:Dental Plaque Index; D004198:Disease Susceptibility; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced* / Q000473:pathology; D005891:Gingivitis / Q000150:complications; D006680:HLA Antigens / Q000032:analysis*; D015234:HLA-A Antigens / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000032:analysis / Q000097:blood; D007509:Irritants / Q000009:adverse effects; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects* / Q000032:analysis / Q000097:blood; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000150:complications; D015995:Prevalence; D012463:Saliva / Q000737:chemistry
D002121:Calcium Channel Blockers; D006680:HLA Antigens; D015234:HLA-A Antigens; C043205:HLA-A19 antigen; D007166:Immunosuppressive Agents; D007509:Irritants; D016572:Cyclosporine; D009543:Nifedipine; D001379:Azathioprine