Influence of Mast Cells in Drug-Induced Gingival Overgrowth

Subramani, Tamilselvan; Rathnavelu, Vidhya; Yeap, Swee Keong; Alitheen, Noorjahan Banu

doi:10.1155/2013/275172

Cited by 18 publications

(16 citation statements)

References 66 publications

(68 reference statements)

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“…Recently, Subramani et al .,[22] observed that mast cells participate in many inflammatory oral diseases, particularly those associated with fibrosis. They possess very diverse roles ranging from proinflammatory to immunomodulatory.…”

Section: Role Of Matrix Metalloproteinasementioning

confidence: 99%

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Drug-induced gingival overgrowth: The nemesis of gingiva unravelled

Bharti¹,

Bansal²

2013

J Indian Soc Periodontol

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Drug-induced gingival overgrowth or enlargement manifests as abnormal growth of the gingiva due to an adverse drug reaction (ADR) in patients treated with anticonvulsants, immunosuppressants, and calcium channel blockers. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. It gradually becomes a source of pain and the condition often leads to disfiguration. Within the group of patients that develop this unwanted effect, there appears to be variability in the extent and severity of the gingival changes. It would seem pertinent to identify and explore possible risk factors and relating them with the treatment plan. This article throws light on respective drugs and their association with gingival overgrowth and approaches to treatment based on current knowledge and investigative observations.

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Section: Role Of Matrix Metalloproteinasementioning

confidence: 99%

“…Cyclosporin can modulate local expression of renin angiotensin system components such as angiotensinogen, angiotensin II and its receptors in gingival tissues, and gingival fibroblast cells. [2223]…”

Section: Role Of Matrix Metalloproteinasementioning

confidence: 99%

Drug-induced gingival overgrowth: The nemesis of gingiva unravelled

Bharti¹,

Bansal²

2013

J Indian Soc Periodontol

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“…The dose of the medicine, its usage period, serum concentrations, age of the patient, oral hygiene, level of inflammation at gums and genetic tendency have impact on gingival enlargement. Usually enlargement stops in toothless areas and after the medication is stopped [37,38].…”

Section: The Impact Of Polypharmacy On Oral and Dental Healthmentioning

confidence: 99%

Polypharmacy and Oral Health among the Elderly

Doğan¹

2016

JDODT

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Over the age of 65 populations is constantly increasing in the past 50 years. The elderly population is exploding. This is based on the fact that the living conditions of this population is improving, as well as individual and community health, and advances in sanitation. Elderly have the highest medication use in the world compared to other segments of the population. The goal of the medication use is to treat diseases and to make them feel better, which increases their quality of life. Over use of some medications has become a public health problem. Multiple drug use (Polypharmacy), causes an increase in the risk of side effects and interaction between drugs, treatment costs, hospitalization requirements, rates of incompatibility to medical treatment and resulting problems. The purpose of the scientific evidence of the literature can represent information and reviews based on polypharmacy during dental treatment to emphasize the importance of the recognition of the risks. As a result, periodontal disease, dental caries and xerostomia may be linked to complications associated with multiple drug use in the elderly.Keywords: Polypharmacy; Oral health; Dental caries; Oral diseases; Elderly population population accelerated. With the existing populationincrease projection it is estimated the world willbe home to 8.909 billion people in 2050. Due to the extension of life expectancy and decrease in birth rate, the world is aging more rapidly than the previous 50 years [2].Elderly population is constantly increasing in the past 50 years on a global scale. According to WHO, the number of people over the age of 65 will increase by 85% in the next 25 years, and working population will increase by 45 percent. As of 2015 901 million people are at the age of 60 or above, which makes 12% of the world population Figure 1. Over the age of 65 populations is increased by 3.26% on an annual basis. Over the age of 65 population is expected to reach 1.4 billion in 2030 and 2.1 billion in 2050 [3]. The most important reasons for this increase are the decrease in infant and child deaths, achievements in vaccination and health conditions and sustainability thereof as well as development of antibiotics. However, the fundamental factor is the decrease in mortality, not only in infants and children but in all age groups. Another reason is that people are exceeding the age of 65 which is life expectancy. For this reason, it is expected that welfare of elderly people will be found in the list of problems with priority in the areas with increase in the following years [4].With aging, deceleration and degeneration can be witnessed in system functions as a result of the changes in human body. Because of age or associated conditions, level of absorption, blood flow and emission of basal and stimulated stomach acid decreases in gastrointestinal system. Absorption can also be affected in the elderly as a result of using multiple medicines simultaneously. For example, congestive heart failure, which is one of the most frequently seen dise...

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“…An in vitro study using hamster cells treated with phenytoin and cyclosporine showed that cyclosporine increased signaling by TLR2 and TLR4, while phenytoin decreased this signaling with a decreased expression of adhesion molecules such as CD54 (47). The reduction in cell signaling induced by drugs such as phenytoin may alter the inflammatory response in gingival tissues, favoring bacterial invasion and proliferation and, therefore, may be an important factor in the pathogenesis of gingival fibrosis (48). Furthermore, cyclosporine-induced gingival overgrowth patients had a significantly higher number of TLR-4 expressing cells in the basal cell layer of the epithelium, as well as in connective tissue compared to healthy subjects (42).…”

Section: Tlrs and Drug-induced Gingival Overgrowthmentioning

confidence: 99%

Cellular crosstalk mechanism of Toll-like receptors in gingival overgrowth (Review)

Subramani

Rathnavelu

Alitheen

2015

International Journal of Molecular Medicine

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Abstract. Gingival overgrowth is an undesirable outcome of systemic medication and is evidenced by the accretion of collagenous components in gingival connective tissues along with diverse degrees of inflammation. Phenytoin therapy has been found to induce the most fibrotic lesions in gingiva, cyclosporine caused the least fibrotic lesions, and nifedipine induced intermediate fibrosis in drug-induced gingival overgrowth. In drug-induced gingival overgrowth, efficient oral hygiene is compromised and has negative consequences for the systemic health of the patients. Toll-like receptors (TLRs) are involved in the effective recognition of microbial agents and play a vital role in innate immunity and inflammatory signaling responses. TLRs stimulate fibrosis and tissue repairs in several settings, although with evident differences between organs. In particular, TLRs exert a distinct effect on fibrosis in organs with greater exposure to TLR ligands, such as the gingiva. Cumulative evidence from diverse sources suggested that TLRs can affect gingival overgrowth in several ways. Numerous studies have demonstrated the expression of TLRs in gingival tissues and suggested its potential role in gingival inflammation, cell proliferation and synthesis of the extracellular matrix which is crucial to the development of gingival overgrowth. In the present review, we assessed the role of TLRs on individual cell populations in gingival tissues that contribute to the progression of gingival inflammation, and the involvement of TLRs in the development of gingival overgrowth. These observations suggest that TLRs provide new insight into the connection among infection, inflammation, drugs and gingival fibrosis, and are therefore efficient therapeutic target molecules. We hypothesize that TLRs are critical for the development and progression of gingival overgrowth, and thus blocking TLR expression may serve as a novel target for antifibrotic therapy.

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Influence of Mast Cells in Drug-Induced Gingival Overgrowth

Cited by 18 publications

References 66 publications

Drug-induced gingival overgrowth: The nemesis of gingiva unravelled

Drug-induced gingival overgrowth: The nemesis of gingiva unravelled

Polypharmacy and Oral Health among the Elderly

Cellular crosstalk mechanism of Toll-like receptors in gingival overgrowth (Review)

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