Cyclosporine A ; Gingival overgrowth ; Gingival hyperplasia ; Azithromycin
Abstract
Purpose: Cyclosporine A is an immunosuppressant drug that is widely used to reduce mortality and morbidity from
graft-versus-host disease. Gingival overgrowth is a common adverse effect caused by cyclosporine A. However, the
exact mechanism is not fully elucidated. The aim of this study is to understand the mechanism, clinical/histological
characteris of cyclosporine A induced gingival overgrowth and the treatment.
Material and Methods: Four journals on cyclosporine A induced gingival overgrowth were published from the Department
of Periodontology, College of Dentistry, Yonsei University from 2000 to 2003. The authors reviewed these articles
systematically to answer the following question: “What is the mechanism and characteristics of cylosporine A induced
gingival overgrowth? And how can it be treated?”
Results: Histological, in vivo, in vitro and Azithromycin administration analysis were performed to elucidate the histological
characteristics, mechanism of gingival enlargement and proper treatment options.
Conclusion: The cause of gingival overgrowth is multifactorial including administration of Cyclosporine A, gingival
inflammation and genetic disposition. In histological view, increased amount of extracellular matrix, a number of fibroblasts
and multilayered epithelial layer were observed. Cyclosporine A prevents influx of Ca2+ ions and inhibit phagocytosis
of collagen to reduce collagen degradation. Maintaining of oral hygiene and regular check up should be
encouraged. And surgical excision is considered as a treatment of choice. However, Cyclosporine A induced gingival
overgrowth is a condition of collagen accumulation that can be treated by Azithromycin therapy.