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Plasma TGF-beta1 as a risk factor for gingival overgrowth
J S Ellis1, C L Morgan, J A Kirby
1University of Newcastle upon Tyne, School of Dental Sciences, Framlington Place, Newcastle upon Tyne, UK. j.s.ellis@ncl.ac.uk
Journal of Clinical Periodontology
|September 16, 2004
Summary
Elevated transforming growth factor-beta1 (TGF-beta1) plasma levels are linked to gingival overgrowth in immunosuppressed transplant patients. Low TGF-beta1 concentrations, especially with calcium channel blockers, indicate a higher risk for this condition.
Area of Science:
- Immunology
- Periodontology
- Pharmacology
Background:
- Immunosuppressant drugs, such as ciclosporin and tacrolimus, are associated with gingival overgrowth.
- Transforming growth factor-beta1 (TGF-beta1), a pro-fibrotic growth factor, is a potential mediator of this drug-induced side effect.
Purpose of the Study:
- To investigate plasma levels of TGF-beta1 in immunosuppressed transplant patients.
- To correlate TGF-beta1 levels with the presence and severity of gingival overgrowth.
- To assess the influence of immunosuppressants and calcium channel blockers on TGF-beta1 levels.
Main Methods:
- Periodontal examination of 132 ciclosporin-treated, 13 tacrolimus-treated patients, and 24 controls.
- Measurement of plasma TGF-beta1 concentrations using ELISA.
- Univariate and multivariate regression analyses to determine risk factors for gingival overgrowth.
Main Results:
- Plasma TGF-beta1 concentrations were significantly higher in transplant patients (mean=29.1 ng/ml) compared to controls (mean=6.1 ng/ml).
- No significant difference in TGF-beta1 levels was observed between ciclosporin and tacrolimus groups.
- Concomitant use of calcium channel blockers did not affect TGF-beta1 plasma levels.
Conclusions:
- Elevated plasma TGF-beta1 is characteristic of immunosuppressed transplant patients.
- Low TGF-beta1 plasma concentrations emerged as a risk factor for gingival overgrowth in immunosuppressed patients, particularly those on calcium channel blockers.