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Cyclosporine A: Novel concepts in its role in drug-induced gingival overgrowth.

Ponnaiyan D, Jegadeesan V - Dent Res J (Isfahan) (2015 Nov-Dec)

Bottom Line: Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice.Plaque-induced gingival inflammation appears to enhance this interaction.Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India.

ABSTRACT
Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of cyclosporine, in particular the action of the drug on the gingival tissues. In addition, elucidates the current concepts in mechanisms of cyclosporine-induced gingival overgrowth. Clinical and cell culture studies suggest that the mechanism of gingival overgrowth is a result of the interaction between the drug and its metabolites with susceptible gingival fibroblasts. Plaque-induced gingival inflammation appears to enhance this interaction. However, understanding of the pathogenesis of gingival overgrowth is incomplete at best. Hence, it would be pertinent to identify and explore possible risk factors relating to both prevalence and severity of drug-induced gingival overgrowth. Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.

No MeSH data available.


Related in: MedlinePlus

Depicting molecular structure of cyclosporine A.
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Figure 1: Depicting molecular structure of cyclosporine A.

Mentions: Cyclosporine A [Figure 1] is a neutral, hydrophobic cyclic peptide composed of 11 amino acids (mol. wt. 1202.6), all having the S-configuration of the L-amino acids, with the sole exception of the D-alanine in position 8, which has the R-configuration.[1] CsA taken orally in a vehicle such as olive oil enters the circulation where it is distributed and bound to blood components.[3] CsA rapidly equilibrates between plasma and red cells, with the establishment of a steady state within 20 min.[3] Erythrocytes account for 50% of binding and lymphocytes 4-9%. Of the total amount of CsA in blood, about 5% is free drug, and 25% is bound to blood lipoproteins.


Cyclosporine A: Novel concepts in its role in drug-induced gingival overgrowth.

Ponnaiyan D, Jegadeesan V - Dent Res J (Isfahan) (2015 Nov-Dec)

Depicting molecular structure of cyclosporine A.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4696350&req=5

Figure 1: Depicting molecular structure of cyclosporine A.
Mentions: Cyclosporine A [Figure 1] is a neutral, hydrophobic cyclic peptide composed of 11 amino acids (mol. wt. 1202.6), all having the S-configuration of the L-amino acids, with the sole exception of the D-alanine in position 8, which has the R-configuration.[1] CsA taken orally in a vehicle such as olive oil enters the circulation where it is distributed and bound to blood components.[3] CsA rapidly equilibrates between plasma and red cells, with the establishment of a steady state within 20 min.[3] Erythrocytes account for 50% of binding and lymphocytes 4-9%. Of the total amount of CsA in blood, about 5% is free drug, and 25% is bound to blood lipoproteins.

Bottom Line: Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice.Plaque-induced gingival inflammation appears to enhance this interaction.Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India.

ABSTRACT
Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of cyclosporine, in particular the action of the drug on the gingival tissues. In addition, elucidates the current concepts in mechanisms of cyclosporine-induced gingival overgrowth. Clinical and cell culture studies suggest that the mechanism of gingival overgrowth is a result of the interaction between the drug and its metabolites with susceptible gingival fibroblasts. Plaque-induced gingival inflammation appears to enhance this interaction. However, understanding of the pathogenesis of gingival overgrowth is incomplete at best. Hence, it would be pertinent to identify and explore possible risk factors relating to both prevalence and severity of drug-induced gingival overgrowth. Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.

No MeSH data available.


Related in: MedlinePlus