Turkish Journal of Medical Sciences




Cyclosporine-A (CsA) is widely used to prevent organ rejection in recipients of transplanted organs and also in the treatment of various systemic diseases. CsA has a number of side effects, including gingival overgrowth (GO). However, the pathogenesis of CsA-induced GO remains uncertain. It has been postulated that CsA alters fibroblast activity. CsA is transported in plasma by binding to lipid components. It is possible that changes in serum lipid levels could alter the interaction between the CsA and gingival fibroblasts within the gingival tissues. It has also been reported that CsA may alter serum lipid levels in the transplant population. The aim of this study was to investigate the relationship between the serum lipids and CsA-induced GO. A total of 47 renal transplant recipients receiving CsA, azathioprine and prednisolone were the subjects of this study. Periodontal measurements were taken including plaque index (PII) and GO scores (GO). GO was classified into four categories according to the clinical changes. The whole blood CsA concentration, serum total cholesterol, triglyceride and ceratinine levels, and duration of CsA theraph of these patients were obtained from the subject's medical records. These were assessed monthly. CsA-treated recipitents were divided for statistical purposes into two groups according to their GO scores. The recipients having sites with clinically significant GO (scores of 2 and 3) were classified as responders, and those without evidence of overgrowth (GO score=0) as non-responders. There were no differences in age, plaque scores, duration of CsA therapy, and azathioprine and prednisolone dosage between responders and non-responders. Similarly, no statistically significant differences in serum lipids and whole blood CsA concentration were found between these two groups. These data indicate that CsA-induced GO is unrelated to serum lipid components. To our knowledge, this is the first report describing the relationship between the serum lipids and CsA-induced GO. We believe thata additional studies will be necesarry for complete understanding of the mechanism of gingival overgrowth.

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