alcian-blue and Gingival-Hyperplasia

The overgrowth-affected gingiva of patients treated with cyclosporin A after kidney transplant was examined with ultrastructural and histochemical methods to evaluate the involvement of connective tissue. Gingival overgrowth has the same clinical signs as local edema. The ultrastructural study showed that the dimensional increase was largely due to increased production of amorphous ground substance by fibroblasts, possibly resulting from an increased release of histamine by mast cells. The histochemical data revealed that the affected tissues contained higher levels of glycosaminoglycans and that cyclosporin A induced comparably high levels of glycosaminoglycans in in vitro cultures of fibroblasts obtained from normal gingiva. The combination of ultrastructural and histochemical data, therefore, strongly suggests that the response of the connective tissue in gingival overgrowth cannot be ignored and may be the main cause of the observed pathological condition.

Topics: Alcian Blue; Capillaries; Chondroitin Sulfates; Coloring Agents; Connective Tissue; Cyclosporine; Dermatan Sulfate; Edema; Epithelium; Fibroblasts; Gingiva; Gingival Hyperplasia; Glycosaminoglycans; Heparin; Heparitin Sulfate; Histamine Release; Humans; Immunosuppressive Agents; Keratan Sulfate; Kidney Transplantation; Mast Cells; Tetrapyrroles

Gingival hyperplasia induced by nifedipine (Procardia), a calcium channel-blocking agent used as an anti-anginal drug, was studied. In recent months, the role of nifedipine in the etiology of gingival hyperplasia has attracted interest. The purpose of this study was to determine the causal relationship and compare nifedipine to other drug-induced (phenytoin) and nondrug-induced gingival hyperplasias. Histochemical studies revealed increased numbers of fibroblasts containing strongly sulfated mucopolysaccharides in the nifedipine- and phenytoin- (Dilantin) induced gingival hyperplasias as compared to the nondrug-induced cases. Numerous secretory granules were also noted in the fibroblast cytoplasm in the nifedipine-treated case studied by electron microscopy. These results imply that there is an increase in acid mucopolysaccharide production in the nifedipine- and phenytoin-induced gingival hyperplasias. The potential significance and comparisons of the drugs' effects at the cellular level are discussed.

Topics: Acid Phosphatase; Adult; Aged; Alcian Blue; Female; Fibroblasts; Gingiva; Gingival Hyperplasia; Humans; Male; Middle Aged; Nifedipine; Phenytoin