title: Cathepsin B, D, and L regulation in cyclosporin A-mediated gingival hyperplasia of a patient with sarcoidosis.
abstract: BACKGROUND
  Cyclosporin A (CsA) is an immunosuppressant with side effects including gingival hyperplasia. Sarcoidosis is a systemic disease characterized by granulomas. Here, we report on a rare case of sarcoidosis with gingival hyperplasia to clarify whether clinical observation corresponds to in vitro results.
  
  
  METHODS
  Gingival fibroblasts (HGFs) were isolated from healthy gingiva and cultured with CsA. Total RNA was collected and expression of mRNAs examined using semi-quantitative RT-PCR analysis. Cathepsin B, D, and L expression in overgrown gingiva of the patient was examined by immunohistochemistry.
  
  
  RESULTS
  Cathepsin D, L, and vascular endothelial growth factor (VEGF)165 mRNA were markedly suppressed in CsA-treated HGFs, whereas cathepsin B, matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA were not reduced. Next, the decrease of cathepsin B and L expression in enlarged gingiva was observed, whereas an increase of cathepsin D expression was observed. Clinically, the enlarged gingival lesions were fully resolved by performing oral infection control.
  
  
  CONCLUSIONS
  Cathepsins regulation might be an important factor in the development of CsA-mediated gingival hyperplasia.
authors: Division of Periodontology, Department of Conservative Dentistry and Oral Rehabilitation, Japan.
authors: Osamu
authors: O
authors: Murai
authors: Koji
authors: K
authors: Naruishi
authors: Satoshi
authors: S
authors: Ogihara
authors: Nagisa
authors: N
authors: Suwa
authors: Satomi
authors: S
authors: Kanazawa
authors: Takashi
authors: T
authors: Yaegashi
authors: Yasunori
authors: Y
authors: Takeda
authors: Kazushi
authors: K
authors: Kunimatsu
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D016866:Bacteroidaceae Infections / Q000150:complications; D002401:Cathepsin B / Q000096:biosynthesis / Q000235:genetics*; D002402:Cathepsin D / Q000096:biosynthesis / Q000235:genetics*; D056668:Cathepsin L / Q000096:biosynthesis / Q000235:genetics*; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012534:Dental Scaling; D004359:Drug Therapy, Combination; D004790:Enzyme Induction / Q000187:drug effects; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects*; D005885:Gingival Hyperplasia / Q000139:chemically induced / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control; D005891:Gingivitis / Q000150:complications / Q000382:microbiology / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D020781:Matrix Metalloproteinase 1 / Q000096:biosynthesis / Q000235:genetics; D008875:Middle Aged; D009910:Oral Hygiene; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D012507:Sarcoidosis / Q000150:complications / Q000188:drug therapy*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000096:biosynthesis / Q000235:genetics; D048373:Treponema denticola / Q000302:isolation & purification; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis / Q000235:genetics*
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D016572:Cyclosporine; C533912:CTSB protein, human; D002401:Cathepsin B; C534281:CTSL protein, human; D056668:Cathepsin L; C533922:CTSD protein, human; D002402:Cathepsin D; D020781:Matrix Metalloproteinase 1