Plasma TGF-beta1 as a risk factor for gingival overgrowth.
OBJECTIVE
Induction of the pro-fibrotic growth factor TGF-beta1 has been suggested as a possible mechanism through which immunosuppressant drugs may induce gingival overgrowth. This study aims to investigate plasma levels of TGF-beta1 and relate them to the development and severity of gingival overgrowth in immunosuppressed transplant patients.


METHODS
One hundred and thirty-two ciclosporin-treated and 13 tacrolimus-treated transplant patients and 24 drug-free control subjects underwent a full periodontal examination including a determination of the presence and severity of gingival overgrowth.


RESULTS
Plasma TGF-beta1 concentrations were determined by ELISA, and were found to be significantly elevated in samples from the transplant patients (mean=29.1 ng/ml) as compared with controls (mean=6.1 ng/ml, p<0.0001). There was no significant difference between the levels of plasma TGF-beta1 in the ciclosporin- and tacrolimus-treated patient groups.


CONCLUSIONS
Furthermore, concomitant treatment with calcium channel blockers did not influence the levels of plasma TGF-beta1 in the patients group. The relationship between gingival overgrowth, independent periodontal variables and TGF-beta1 plasma concentrations was examined using univariate and multivariate regression analyses; low TGF-beta1 plasma concentrations were found to be a risk factor for gingival overgrowth in immunosuppressed patients concomitantly receiving a calcium channel blocker.
Ellis
J S
JS
University of Newcastle upon Tyne, School of Dental Sciences, Framlington Place, Newcastle upon Tyne, UK. j.s.ellis@ncl.ac.uk
Morgan
C L
CL
Kirby
J A
JA
Taylor
J J
JJ
Thomason
J M
JM
D000367:Age Factors; D000704:Analysis of Variance; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019214:Gingival Overgrowth / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D012044:Regression Analysis; D016559:Tacrolimus / Q000627:therapeutic use*; D016212:Transforming Growth Factor beta / Q000097:blood*; D053773:Transforming Growth Factor beta1; D014180:Transplantation
D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D016572:Cyclosporine; D016559:Tacrolimus