Effect of adjunctive roxithromycin therapy on interleukin‐1β, transforming growth factor‐β1 and vascular endothelial growth factor in gingival crevicular fluid of cyclosporine <scp>A</scp>‐treated patients with gingival overgrowth

Gong, Yi; Lu, Jing; Ding, Xiaobo; Yu, Yang

doi:10.1111/jre.12123

Cited by 10 publications

(9 citation statements)

References 51 publications

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“…One key immunological mechanism underlying the pathogensis of periodontitis has been described as a TNF-alpha-induced increase in vascular endothelial growth factor (VEGF) leading to an aberrant angiogenesis ( 61 ). Both AZM and RXM decreased TNF-alpha and VEGF concentrations as well as other cytokines including IL-1beta, IL-8, and transforming growth factor beta (TGF-beta) in gingival crevicular fluid ( 17 , 18 ). Since oral bacteria play an important role in periodontitis, however, some of the some of the benefits of macrolides may be attributable to antimicrobial rather than to immunomodulatory effects.…”

Section: Reviewmentioning

confidence: 99%

The Immunomodulatory Effects of Macrolides—A Systematic Review of the Underlying Mechanisms

et al. 2018

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BackgroundThe mechanisms underlying the non-antimicrobial immunomodulatory properties of macrolides are not well understood.ObjectivesTo systematically review the evidence for the immunomodulatory properties of macrolides in humans and to describe the underlying mechanism and extent of their influence on the innate and adaptive immune system.MethodsA systematic literature search was done in MEDLINE using the OVID interface from 1946 to December 2016 according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Original articles investigating the influence of four macrolides (azithromycin, clarithromycin, erythromycin, and roxithromycin) on immunological markers in humans were included.ResultsWe identified 22 randomized, controlled trials, 16 prospective cohort studies, and 8 case–control studies investigating 47 different immunological markers (186 measurements) in 1,834 participants. The most frequently reported outcomes were a decrease in the number of neutrophils, and the concentrations of neutrophil elastase, interleukin (IL)-8, IL-6, IL-1beta, tumor necrosis factor (TNF)-alpha, eosinophilic cationic protein, and matrix metalloproteinase 9. Inhibition of neutrophil function was reported more frequently than eosinophil function. A decrease in T helper (Th) 2 cells cytokines (IL-4, IL-5, IL-6) was reported more frequently than a decrease in Th1 cytokines (IL-2, INF-gamma).ConclusionMacrolides influence a broad range of immunological mechanisms resulting in immunomodulatory effects. To optimize the treatment of chronic inflammatory diseases by macrolides, further studies are necessary, particularly comparing different macrolides and dose effect relationships.

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Section: Reviewmentioning

confidence: 99%

The Immunomodulatory Effects of Macrolides—A Systematic Review of the Underlying Mechanisms

et al. 2018

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“…However, there is no effect on the level of IL-1β. 99 Furthermore, antibiotics at or below minimal inhibitory concentrations increase IL-1β secretion in macrophages by inducing the shedding of LPS by P. gingivalis. 100 Laser therapy Lasers could be used as a monotherapy, as an adjunct to SRP, or in a surgery for incision.…”

Section: Antibioticsmentioning

confidence: 99%

Interleukin-1β is a potential therapeutic target for periodontitis: a narrative review

et al. 2020

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Interleukin(IL)-1β, a pro-inflammatory cytokine, was elevated and participates in periodontitis. Not only the link between IL-1β and periodontitis was proved by clinical evidence, but also the increased IL-1β triggers a series of inflammatory reactions and promotes bone resorption. Currently, IL-1β blockage has been therapeutic strategies for autoimmune and autoinflammatory diseases such as rheumatoid arthritis, cryopyrin-associated periodic syndromes, gout and type II diabetes mellitus. It is speculated that IL-1β be a potential therapeutic target for periodontitis. The review focuses on the production, mechanism, present treatments and future potential strategies for IL-1β in periodontitis.

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“…GE induced by calcium channel blockers does not require treatment with antibiotics as it is not a result of bacterial infection. This is in contrast with cases related to Cyclosporine-A where adjunctive treatment with Roxithromycin together with SRP decreased levels of Transforming Growth Factor (TGF- β 1) in gingival crevicular fluid, which improved the state of gingival tissue in immunocompromised patients [ 30 ]. We believe that the underlying suppressed immune system of patients on Cyclosporine-A justifies the need for supportive antibiotic therapy to enhance treatment outcomes.…”

Section: Discussionmentioning

confidence: 97%

Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification

Khzam¹,

Bailey²,

Yie³

et al. 2016

Case Reports in Dentistry

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We present a case of a 47-year-old male who suffered from GE around his lower anterior teeth as soon as he started treatment with Felodipine 400 mg. We show that oral hygiene measures, antibiotics, and conventional periodontal treatment (scaling and root planing SRP) were all not sufficient to resolve the drug induced GE, which will persist and/or recur provided that systemic effect of the offending medication is still present. The condition immediately resolved after switching to a different medication. The mechanism of GE is complex and not fully understood yet. It is mainly due to overexpression of a number of growth factors due to high concentrations of calcium ions (Ca2+). This affects fibroblasts proliferation and DNA synthesis and leads to a heavy chronic inflammatory cell infiltrate. Our case was managed according to the suggested protocols in previous case studies. The unique features in our case were the immediate onset of the adverse effect after starting the medication and the absence of any underlying medical condition apart from high blood pressure. Improving the oral hygiene together with SRP and cessation of the medication resolves drug induced GE.

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Effect of adjunctive roxithromycin therapy on interleukin‐1β, transforming growth factor‐β1 and vascular endothelial growth factor in gingival crevicular fluid of cyclosporine A‐treated patients with gingival overgrowth

Cited by 10 publications

References 51 publications

The Immunomodulatory Effects of Macrolides—A Systematic Review of the Underlying Mechanisms

The Immunomodulatory Effects of Macrolides—A Systematic Review of the Underlying Mechanisms

Interleukin-1β is a potential therapeutic target for periodontitis: a narrative review

Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification

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