Drug-induced fibrosis: interference with the intracellular collagen degradation pathway

Drug-induced fibrosis and overgrowth of the extracellular matrix are high prevalence lesions of the oral mucosa. Drugs, such as dilantin, cyclosporin A and nifedipine can cause the gum tissues to overgrow, thereby preventing normal mastication and promoting infection. The causes of these disorders are poorly understood but recent evidence suggests that a common pathway targeted by these three drugs is the regulation of the intracellular pathway of collagen degradation. In this review, recent data that implicate calcium deregulation of the critical actin-dependent binding step of collagen phagocytosis will be discussed. These new insights highlight the need for a greater choice of medications for the treatment of transplant rejection and epilepsy to reduce the side effect of gingival overgrowth.