Tacrolimus is not associated with gingival overgrowth in renal transplant patients.
BACKGROUND
Cyclosporin A is used extensively to prevent the rejection of allogenic renal transplants. However, it is associated with a variety of undesirable side effects including gingival overgrowth. Tacrolimus (FK506), has been marketed as an effective alternative immunosuppressant to cyclosporin A and recent subjective reports suggest patients taking it complain infrequently of gingival problems. This clinical investigation was undertaken to confirm whether or not tacrolimus adversely affected the gingival health of renal transplant recipients.


METHODS
Renal transplant patients (RTPs) under the care of the Renal Transplantation Service at the Manchester Royal Infirmary, who had received a renal allograft at least 18 months earlier, were recruited for this study. All but one of the RTPs had been taking tacrolimus since transplantation. The other had commenced tacrolimus therapy two months after receiving her allograft. A hospital based control group was recruited from non transplanted individuals attending the Turner Dental School, Manchester. Each patient underwent a detailed dental assessment and had dental impressions taken. The extent of gingival overgrowth was determined from plaster models.


RESULTS
25 renal transplant recipients and 26 control patients were included in the study. None of the individuals in either the tacrolimus or control groups had clinically significant overgrowth. The patients in the tacrolimus group with the highest overgrowth scores were those also taking calcium antagonists as treatment for hypertension.


CONCLUSIONS
This study demonstrates that tacrolimus has no adverse effects on the gingival tissues and thus has potential as an alternative immunosuppressant for individuals susceptible to developing cyclosporin A-induced gingival overgrowth.
James
J A
JA
University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK. jackie.james@man.ac.uk
Jamal
S
S
Hull
P S
PS
Macfarlane
T V
TV
Campbell
B A
BA
Johnson
R W
RW
Short
C D
CD
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000009:adverse effects; D016022:Case-Control Studies; D003774:Dental Plaque Index; D005260:Female; D019214:Gingival Overgrowth; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D016559:Tacrolimus