Analysis of Peripheral Blood Leukocytes in Patients With Cyclosporine A‐Induced Gingival Hyperplasia

• Published in: Journal of periodontology (1970) 1998-12, Vol.69 (12), p.1435-1439
• Main Authors: Cebeci, Írfan, Kantarci, Alpdoǧan, Gürel, Nuray, Adin, Suzan, Tuncer, Özen, Çarin, Mahmut, Badur, Selim, Firatli, Erhan
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Monoclonal; Antigens, CD19 - analysis; CD11 Antigens - analysis; CD2 Antigens - analysis; CD3 Complex - analysis; CD4-Positive T-Lymphocytes - drug effects; CD4-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - drug effects; CD8-Positive T-Lymphocytes - immunology; cyclosporine; Cyclosporine - adverse effects; Cyclosporine - blood; Cyclosporine - immunology; Dental Calculus - pathology; Dental Plaque Index; Female; Flow Cytometry; gingiva/hyperplasia; Gingival Hyperplasia - blood; Gingival Hyperplasia - chemically induced; Gingival Hyperplasia - immunology; Gingival Overgrowth - blood; Gingival Overgrowth - chemically induced; Gingival Overgrowth - immunology; HLA-DR Antigens - analysis; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - blood; Immunosuppressive Agents - immunology; Kidney Transplantation - immunology; Killer Cells, Natural - drug effects; Killer Cells, Natural - immunology; Leukocytes - drug effects; Leukocytes - immunology; Lymphocyte; Lymphocyte Subsets - drug effects; Lymphocyte Subsets - immunology; Male; monocyte; Monocytes - drug effects; Monocytes - immunology; natural killer cell; Periodontal Index; Periodontal Pocket - pathology; Receptors, IgG - analysis
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.1998.69.12.1435

Background: Gingival overgrowth is one of the major adverse effects of the immunosuppressive drug cyclosporine A (CsA). Although several studies have attempted to determine the immunological mechanisms of gingival hyperplasia (GO) due to CsA therapy, the pathogenesis remains unclear. In this study, the distribution of the peripheral blood leukocytes in a group of renal transplant patients undergoing CsA therapy was analyzed and possible correlations of periodontal and pharmacological variables to lymphocyte subpopulations, natural killer cells, and monocytes investigated. Methods: Thirty‐six patients were classified into 2 groups of 18 each according to the degree of gingival overgrowth. The periodontal evaluation included plaque index (PI), gingival index (GI), gingival overgrowth (GO), calculus index (CI), and probing depth (PD). The pharmacological variables of current doses of the therapeutic serum levels of CsA were investigated. The peripheral blood leukocytes were studied by 2color flow cytometric analysis using anti‐human CD2, CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, HLA‐DR, and CD3+HLA‐DR+ monoclonal antibodies. Results: Statistical evaluation revealed that none of the pharmacological variables varied between the 2 groups. Responders (GO >30%) had significantly higher GI, PD, and GO scores compared to nonresponders (GO ≤30%). Of the immunological parameters studied, only CD2 was higher in the responder group. None of the clinical parameters correlated to the immunological values. Conclusions: The results of this study may be useful in explaining the underlying mechanisms of drug‐induced gingival overgrowth. Several previously unsuspected cells and accessory activation mechanisms for T lymphocytes could play a role in the pathogenesis. J Periodontol 1998;69:1435–1439.