GINGIVAL HYPERPLASIA IN RENAL-ALLOGRAFT RECIPIENTS RECEIVING CYCLOSPORINE-A AND CALCIUM-ANTAGONISTS

被引:105
作者
KING, GN
FULLINFAW, R
HIGGINS, TJ
WALKER, RG
FRANCIS, DMA
WIESENFELD, D
机构
[1] ROYAL MELBOURNE HOSP,DENT UNIT,PARKVILLE,VIC 3050,AUSTRALIA
[2] ROYAL MELBOURNE DENT HOSP,MELBOURNE,AUSTRALIA
[3] UNIV MELBOURNE,SCH DENT SCI,PARKVILLE,VIC 3052,AUSTRALIA
[4] ROYAL MELBOURNE HOSP,DEPT CLIN PHARMACOL & THERAPEUT,MELBOURNE,VIC 3000,AUSTRALIA
[5] ROYAL MELBOURNE HOSP,DEPT NEPHROL,MELBOURNE,VIC 3000,AUSTRALIA
[6] ROYAL MELBOURNE HOSP,DEPT SURG,MELBOURNE,VIC 3000,AUSTRALIA
关键词
GINGIVAL HYPERPLASIA; CYCLOSPORINE-A; NIFEDIPINE; DILTIAZEM; RENAL ALLOGRAFT; PLAQUE; SALIVA;
D O I
10.1111/j.1600-051X.1993.tb00360.x
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Although it is established that the immunosuppressant cyclosporin-A (CsA) and calcium antagonists [Nifedipine (Nif) and Diltiazem (Dz)] can independently induce gingival enlargement, little has been documented on the significance of the salivary CsA levels and the combined effect of CsA and a calcium antagonist upon gingival tissues. In the present cross-sectional investigation, clinical periodontal parameters and the pharmacologic profiles of CsA, Nif, and Dz were determined for 66 renal transplant recipients. Subjects were divided into the following groups: Group (Gp) 1: CsA [n = 18]; Gp 2: CsA + Nif [n = 15]; Gp 3: CsA + Dz [n = 12] and a negative Control Gp 4: azathioprine [n = 21]. A gingival enlargment score was assessed for each patient from study models using a hyperplastic index (HI). Pharmacologic profiles included CsA whole blood and whole saliva levels as measured by fluorescence polarization immunoassay. The HI scores between Gp 1, 2 and 3 were not significantly different. However, when compared with controls (Gp 4), there was a significant difference in HI and all individual groups (Gp 1, 2, 3) (p < 0.05). Gingival hyperplasia was only weakly related to plaque and calculus but was unrelated to CsA dose (mg/kg/day), duration of CsA therapy (months), CsA blood or saliva levels (ng/ml), or the concurrent administration of a Nif or Dz. Gingival enlargement was found to occur in 49% of subjects who were either on CsA or CsA and a calcium antagonist. It is concluded that CsA alone or in combination with a calcium antagonist caused a significant increase in gingival enlargement compared with controls. However, the CsA effect in inducing gingival hyperplasia did not appear to be potentiated by the addition of a calcium antagonist.
引用
收藏
页码:286 / 293
页数:8
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