title: Mechanism of drug-induced gingival overgrowth revisited: a unifying hypothesis.
abstract: Drug-induced gingival overgrowth (DIGO) is a disfiguring side effect of anti-convulsants, calcineurin inhibitors, and calcium channel blocking agents. A unifying hypothesis has been constructed which begins with cation flux inhibition induced by all three of these drug categories. Decreased cation influx of folic acid active transport within gingival fibroblasts leads to decreased cellular folate uptake, which in turn leads to changes in matrix metalloproteinases metabolism and the failure to activate collagenase. Decreased availability of activated collagenase results in decreased degradation of accumulated connective tissue which presents as DIGO. Studies supporting this hypothesis are discussed.
authors.affiliation: Division of Oral Diagnosis, Department of Comprehensive Dentistry, Howard University College of Dentistry, Washington, DC, USA; Department of Otolaryngology, Georgetown University Medical Center, Washington, DC, USA; Hematology Branch, NHLBI/NIH, Bethesda, MD, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Brown
authors.forename: P R
authors.initials: PR
authors.lastname: Arany
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects; D065095:Calcineurin Inhibitors / Q000009:adverse effects; D002121:Calcium Channel Blockers / Q000009:adverse effects; D005881:Gingiva / Q000187:drug effects; D019214:Gingival Overgrowth / Q000139:chemically induced*; D006801:Humans; D008954:Models, Biological
chemical_list: D000927:Anticonvulsants; D065095:Calcineurin Inhibitors; D002121:Calcium Channel Blockers
keywords: calcineurin inhibitors; calcium channel blocking agents; drug-induced gingival overgrowth; folic acid; matrix metalloproteins; phenytoin