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Possible roles of medullasin in nifedipine-induced human gingival overgrowth
1Department of Periodontology, Nagasaki University School of Dentistry, Japan.
Abstract:
In order to clarify a possible pathophysiological role of medullasin, a neutrophil elastase-like proteinase, in nifedipine (NF)-induced gingival overgrowth, the distributions of medullasin-positive cells immunostained in specimens from patients with NF-induced gingival overgrowth and chronic marginal gingivitis were compared in three different biopsy areas. Twenty gingival biopsies were obtained from five patients with gingival overgrowth and 20 biopsies from another five patients with chronic marginal gingivitis. In the marginal gingivitis group, the mean percentage of positive cells in the vicinity of pocket epithelium (zone I) was significantly higher than in the areas of connective tissue of the mid-portion (zone II) and adjacent to oral epithelium ( zone III) (p < 0.05). In the gingival overgrowth group, on the contrary, the positive cells significantly increased in zone II as compared with zones I and III (p < 0.05). Further, medullasin-positive cells of zones II and III in the overgrowth group had infiltrated more extensively than those in the gingivitis group (p < 0.001), indicating the participation of this enzyme in the mechanism of NF-induced gingival overgrowth. These observations suggest that medullasin may play a part in NF-induced overgrowth both in host defence and in immunoregulation, possibly cytotoxically.
Insights
Medullasin, a neutrophil elastase-like proteinase, is implicated in nifedipine-induced gingival overgrowth. Its distribution differs significantly between gingival overgrowth and chronic marginal gingivitis, suggesting a role in the condition.
Area of Science:
- Oral pathology
- Immunohistochemistry
- Enzyme activity
Background:
- Gingival overgrowth is a known side effect of nifedipine (NF).
- The specific pathophysiological mechanisms underlying NF-induced gingival overgrowth require further clarification.
- Medullasin, a neutrophil elastase-like proteinase, has a potential but unconfirmed role in this condition.
Purpose of the Study:
- To investigate the distribution of medullasin-positive cells in gingival tissues.
- To compare medullasin cell distribution in nifedipine (NF)-induced gingival overgrowth versus chronic marginal gingivitis.
- To elucidate the potential role of medullasin in the pathogenesis of NF-induced gingival overgrowth.
Main Methods:
- Immunohistochemical staining was used to identify medullasin-positive cells.
- Gingival biopsies were obtained from patients with NF-induced gingival overgrowth and chronic marginal gingivitis.
- Cell distribution was analyzed in three distinct biopsy areas: vicinity of pocket epithelium (zone I), mid-portion connective tissue (zone II), and adjacent to oral epithelium (zone III).
Main Results:
- In chronic marginal gingivitis, medullasin-positive cells were significantly higher in zone I compared to zones II and III.
- In NF-induced gingival overgrowth, medullasin-positive cells significantly increased in zone II compared to zones I and III.
- Extensive infiltration of medullasin-positive cells in zones II and III was observed in the overgrowth group compared to the gingivitis group (p < 0.001).
Conclusions:
- Medullasin distribution patterns differ significantly between NF-induced gingival overgrowth and chronic marginal gingivitis.
- Medullasin appears to play a role in the mechanism of NF-induced gingival overgrowth.
- Medullasin may contribute to NF-induced gingival overgrowth through host defense and immunoregulation, potentially via cytotoxic mechanisms.