Plasminogen activators and plasminogen activator inhibitors in gingival crevicular fluid of cyclosporin A-treated patients.
BACKGROUND
The plasminogen activator (PA) system plays many roles in the inflammatory process and tissue remodelling and repair and is considered to play a significant role in periodontal tissue destruction and healing. The aim of this study was to evaluate the role of the PA system in cyclosporin A (CsA)-induced gingival overgrowth in renal transplant patients.


METHODS
Eighteen renal transplant patients exhibiting moderate to severe CsA-induced gingival overgrowth, 10 other renal transplant patients receiving CsA therapy but showing no sign of CsA-induced gingival overgrowth (CsA-H), 16 chronic gingivitis patients (CG) and 16 systemically and periodontally healthy control subjects (H) were included in the study. Gingival crevicular fluid (GCF) samples were obtained from four randomly selected sites in each subject with the exception of the CsA-induced gingival overgrowth group, where four GCF samples were harvested from sites with severe overgrowth (CsA GO+) and from four sites without any gingival overgrowth (CsA GO-). The GCF levels of albumin, tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA), plasminogen activator inhibitor 1 (PAI-1) and plasminogen activator inhibitor 2 (PAI-2) were analysed by enzyme-linked immunosorbent assay. The results were tested for statistical differences.


RESULTS
In CsA GO+ sites t-PA levels were significantly elevated in comparison with gingivitis and healthy sites, while PAI-2 levels in these sites showed statistically significant differences only with CsA-H and gingivitis sites (p<0.05). The levels of t-PA and PAI-2 were significantly higher in CsA GO- sites compared with those of CsA-H, gingivitis and healthy sites (p<0.05). The levels of u-PA and PAI-1 failed to show significant differences between the study groups.


CONCLUSIONS
The findings of the present study indicate alterations in GCF t-PA and PAI-2 levels in CsA-induced gingival overgrowth and might suggest involvement of the plasminogen activating system in the pathogenesis of this side-effect of CsA therapy. However, to what extent these molecules contribute to the pathogenesis of CsA-induced gingival overgrowth remains to be determined.
Buduneli
Nurcan
N
Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey. nurcan@bornova.ege.edu.tr
Buduneli
Eralp
E
Ciotanar
Sema
S
Atilla
Gül
G
Lappin
David
D
Kinane
Denis
D
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D016572:Cyclosporine / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry / Q000378:metabolism*; D019214:Gingival Overgrowth / Q000139:chemically induced* / Q000378:metabolism*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D015849:Plasminogen Inactivators / Q000032:analysis / Q000378:metabolism*; D018709:Statistics, Nonparametric; D010959:Tissue Plasminogen Activator / Q000032:analysis / Q000378:metabolism*
D015849:Plasminogen Inactivators; D016572:Cyclosporine; D010959:Tissue Plasminogen Activator