环孢素A致牙龈增生与菌斑、胶原代谢的相关性研究

目的:探讨菌斑存在与否对环孢素A(CsA)所致牙龈增生(CIGO)的影响及其可能的发病机制。方法 :SD雄性大鼠40只,实验组、对照组各20只,均拔除左侧上颌磨牙,在同一SD大鼠口内建立有/无菌斑条件下的牙龈模型。实验组每天胃饲含CAS的橄榄油溶液(30 mg/kg),对照组胃饲等量纯橄榄油。定期观察两组大鼠牙龈增生情况,运用免疫组化和RT-PCR方法观察两组大鼠牙龈内CyPA、CD147、MMP-2的表达差异。结果:实验组上颌双侧牙龈增生明显,同一大鼠口内拔牙侧和非拔牙侧牙龈增生程度无显著差异;CyPA和MMP-2的蛋白和mRNA表达水平实验组较对照组均明显减少(P<0.01);CD147的蛋白质和mRMA表达水平在两组间均无显著差异(P>0.05);实验组和对照组中有牙侧和无牙侧CyPA、CD147和MMP-2的蛋白质和mRMA表达水平均无显著差异(P>0.05)。结论:即使无菌斑存在,仍有CIGO发生;CyPA与MMP-2表达的下降,可能是牙龈组织中胶原降解减少、牙龈增生的原因之一。     

环孢素A与牙龈增生

环孢素A是一种疗效显著的免疫抑制剂，广泛地被应用于器官移植患者，但它有一定的毒副作用，其中之一可引起牙龈增生，本文就环孢素A与牙龈增生的关系作一综合分析，为口腔医师和器官移植医师提供一些参考。     

环孢素A诱导牙龈增生动物模型的建立及其病理学表现

目的:建立环孢素A(CyclosporinACsA)诱导的牙龈增生小鼠动物模型,观察其病理学表现,并进行组织测量,确定其可靠性。方法:将CsA溶于橄榄油中,按 30mgCsA/kg体重 /d胃饲远交群ICR雄性小鼠,分别在给药 2、4、6、8周时,随机取实验组小鼠下颌前部标本,体视显微镜下测量其下颌前牙龈体积;制作切片,光镜下观察其牙龈病理表现,并利用图象分析系统测量舌侧牙龈缘上皮厚度。结果:小鼠经胃饲 30mg/kg体重 /d的CsA,①4周后,肉眼见部分下颌前牙舌侧牙龈球形肥大;②体视显微镜下牙龈体积测量显示下颌前牙舌侧牙龈 4周至 8周明显增大(P<0. 01);③此时光镜下开始出现明显的牙龈增生病理表现:上皮增厚,上皮钉突明显且变宽,牙龈结缔组织增厚,基质和成纤维细胞增生,血管扩张等。④龈缘上皮厚度测量 2周时上皮增厚(P<0. 01), 4周增厚更明显(P<0. 001),持续至 8周。结论:胃饲小鼠CsA可诱导牙龈增生,其病理表现与其他动物模型和临床病理一致,该模型有一定可靠性,可用于进一步研究CsA诱导的牙龈增生的发病机理。     

基质金属蛋白酶诱导因子和亲环素A在人根尖囊肿和根尖肉芽肿中的表达及临床意义

目的: 检测细胞外基质金属蛋白酶诱导因子(CD147)和亲环素A(CypA)在根尖肉芽肿和根尖囊肿中的表达,探讨CD147和CyPA在人慢性根尖周炎发生发展中的作用。方法: 收集经根尖手术切除所获得的根尖肉芽肿35例和根尖囊肿30例作为实验组,同时收集埋伏阻生智齿拔除术或行牙槽骨修整术凿下的8例健康牙槽骨作为正常对照组。CBCT图像记录病例的病损大小。运用免疫组织化学法检测所有样本中CD147和CypA的蛋白表达,分析CD147和CypA的蛋白表达水平。结果: 根尖囊肿组两种蛋白的表达水平均高于肉芽肿组(P<0.05)。CD147和CypA 的蛋白表达水平在根尖囊肿和根尖肉芽肿中呈正相关(P<0.05);CD147和CypA 的表达水平均与慢性根尖周炎的病变大小呈正相关(P<0.05)。结论: CD147和CypA可能参与根尖周病损的炎性反应和骨质吸收。CD147-CypA相互作用在人慢性根尖周病的发生发展过程中可能发挥了某种协同作用。     

亲环素A在人根尖周炎中的表达与临床表现的相关性研究

目的:初步探讨人根尖周炎中亲环素A(Cyp A)表达及与临床表现的关系。方法:收集根尖手术切除并经病理诊断证实的根尖周炎病损组织83例作为实验组;收集新鲜拔除的健康正畸牙牙髓6例作为正常对照组。用免疫组织化学染色法分析比较各组织中Cyp A及RANKL的表达情况,取蛋白平均吸光度值(A值)进行统计学分析,并比较其表达量与临床症状的相关性。结果:根尖周炎病变组织中Cyp A主要表达于炎细胞浸润区和上皮组织,主要阳性细胞为淋巴样细胞、上皮细胞、血管内皮细胞,正常对照组中少见Cyp A的表达;Cyp A在根尖肉芽肿组织中的表达量明显高于根尖囊肿组(P<0.05),RANKL在根尖囊肿组织中的表达量明显高于根尖肉芽肿组(P<0.05);有明显临床症状的根尖周炎组织中Cyp A和RANKL的A值均明显高于无症状组(P<0.05);Cyp A和RANKL的表达水平与根尖周炎病变大小均呈正相关(r=0.462,P<0.05;r=0.417,P<0.05)。结论:Cyp A存在于人根尖周炎病损组织中,可能参与人根尖周炎疾病的发病进程。     

环孢素A诱发牙龈增生的发生率与牙周健康指数的关系

环孢素A(cyclosporinA ,CsA)免疫抑制作用强 ,毒性及感染发生率低 ,应用广泛。CsA不良反应中牙龈增生的发生率较高 ,因目前尚无更加安全、有效、廉价的药物可替代CsA ,因此了解CsA诱发牙龈增生与牙周健康指数的关系 ,有助于寻求有效的综合防治措施 ,以提高器官移植 (及某些免疫性疾病 )患者的生存质量。1 材料和方法 :( 1)病例选择 :对象为 1997年 1月～ 2 0 0 1年 6月期间 ,同济医院器官移植病房的肾移植患者 2 34例 ,男性 198例 ,女性 36例。年龄 12～ 6 7岁 ( <2 5岁 :6例 ;>0岁 :13例 ) ,平均 ( 4 7 1± 11 9)岁。患者均未进行过牙…     

亲环蛋白A与CD147的相互作用及其在牙周炎中的意义

亲环蛋白A(cyclophilin A,CypA)是人类细胞中首个发现具有肽基脯氨酸顺反异构酶活性的折叠酶,具有强大的促炎作用;CD147可以作为CypA的信号受体;二者通过细胞表面肝素结合,相互作用后可启动巨噬细胞中细胞外调节蛋白激酶(extracellular regulated protein kinases,E...     

环孢素A诱发牙龈增生的机制研究进展

环孢素A（cyclosporine A，CsA）作为一种免疫抑制药物，在防治器官移植后排斥反应及自身免疫性疾病方面发挥重要的作用。然而，环孢素的副作用之一是引起牙龈增生（CsA-induced gingival overgrowth）。文献报道，该病的发病率约为30％～50％，个别学者报道高达80％。牙龈增生使正常的牙龈形态发生改变，轻者影响美观，重者可覆盖全部牙冠，使牙齿移位，严重影响咀嚼、发音等口腔功能。     

服用环孢素A和他克莫司的肾移植患者药物性牙龈增生的发病情况调查

目的:调查服用环孢素A(CsA)或他克莫司(Tcr)的肾移植患者中药物性牙龈增生的发病情况.方法:研究对象为107例分别服用CsA或Tcr的肾移植患者,记录2组患者的性别、年龄、服药时间和剂量等临床资料以及牙周指数,比较2组患者中牙龈增生的发生率以及有关危险因素与牙龈增生的关系.采用SPSS13.0软件包对数据进行t检验、X2检验、Mann-Whitney U检验和逐步回归分析.结果:服用CsA的肾移植患者,牙龈增生的发生率(49%)显著高于服用Tcr的患者(16%),CsA组的牙龈增生评分(30.3±15.5)显著高于Tcr组(17.5±9.61,差异均有统计学意义(P＜0.05);CsA组和Tcr组中牙龈增生患者的菌斑指数、龈乳头出血指数均显著高于牙龈未增生患者(P＜0.05).结论:服用CsA的肾移植患者,牙龈增生的发生率高于服用Tcr的患者;菌斑引起的感染与牙龈增生的严重程度密切相关.     

硝苯地平性牙龈增生的临床研究

目的 研究服用硝苯地平患者牙龈增生的发病情况。方法 对75名服用硝苯地平患者作牙周检查。并与134名非服用者作对照。结果 服用硝苯地平患者牙龈增生的发病率和发病严重程度均明显较对照组高。结论 提示服用硝苯地平是导致牙龈增生的重要原因。     

整合素在药物性牙龈增生中的表达研究

目的:检测整合素α1、α2和β1在来源于药物性牙龈增生(drug-induced gingival overgrowth,DIGO)患者的牙龈成纤维细胞中的表达水平变化,探讨其与DIGO胶原聚集的相关性.方法:采用免疫组织化学法和实时定量PCR分别检测整合素α1、α2和β1在来源于DIGO和正常人群牙龈组织和成纤维细胞中的表达水平.结果:整合素α1在DIGO牙龈成纤维细胞中的表达水平显著性低于其在正常牙龈成纤维细胞中的表达水平(P＜0.01).而整合索α2和β1在2组牙龈成纤维细胞中的表达水平无显著性差异.结论:整合素α1在DIGO牙龈成纤维细胞中的低表达可能与胶原聚集相关.     

Gingival Crevicular Fluid and Plasma Levels of Transglutaminase‐2 and Oxidative Stress Markers in Cyclosporin A‐Induced Gingival Overgrowth

Background: Transglutaminase (TGM)‐2 has been shown to contribute to fibrosis by extracellular matrix accumulation in some organs and is activated by intracellular reactive oxygen species. The aim of this study is to investigate levels of gingival crevicular fluid (GCF) and plasma TGM‐2 and oxidative stress markers (OSMs) in cyclosporin A (CsA)‐induced gingival overgrowth (GO). Methods: The study enrolled 20 healthy (H) individuals; 20 patients with gingivitis (G); 20 CsA‐medicated patients with GO (CsA GO+); and 20 CsA‐medicated patients without GO (CsA GO?). GCF and plasma levels of TGM‐2 were analyzed by enzyme‐linked immunosorbent assay. Spectrofluorometry was used to analyze thiobarbituric acid reactive substance (TBARS); ferric‐reducing antioxidant power (FRAP); total oxidant status (TOS); and total antioxidant capacity (TAC). Results: GCF TGM‐2 level was elevated in CsA GO+ compared with G (P = 0.048) and H (P = 0.001) groups. GCF TBARS level was elevated in CsA GO+ compared with other groups (CsA GO? group: P = 0.003; G group: P <0.001; and H group: P <0.001) and was higher in CsA GO? than in H (P = 0.048). GCF FRAP level was lower in CsA GO? than in H (P = 0.04). Both CsA GO+ and CsA GO? groups had lower GCF TOS levels than H (P <0.001 and P = 0.002) and G (P = 0.003 and P = 0.04). GCF TAC was higher in CsA GO+ than in H (P = 0.02). Plasma TGM‐2 level was elevated in CsA GO+ compared with G (P = 0.048) and H (P = 0.002). Plasma FRAP level was higher in H and CsA GO? than in CsA GO+ (P = 0.008 and P = 0.02). Conclusions: CsA use significantly alters GCF and plasma levels of TGM‐2 and OSMs. TGM‐2 may contribute to CsA‐induced GO in CsA‐treated patients by changing GCF and plasma levels of OSMs. Further studies are needed to prove causality and its direction.     

Phenytoin-Induced Gingival Overgrowth Resulting in Delayed Eruption of the Primary Dentition: A Case Report

A case of delayed eruption of the primary dentition secondary to Phenytoin therapy in a 4-year-old child is reported. The patient had been on phenytoin therapy since the first months of life. Radiographs revealed that alveolar but not gingival emergence had occurred. Surgical excision of the excess gingival tissue was accomplished under general anesthesia. Oral hygiene procedures were stressed and parental cooperation solicited. Three- and ninemonth postoperative visits revealed no regrowth of gingival tissue and continued eruption of the primary dentition.     

Gingival Overgrowth Among Patients Medicated With Cyclosporin A and Tacrolimus Undergoing Renal Transplantation: A Prospective Study

Background: The aim of this study is to make a longitudinal evaluation of the incidence and severity of gingival overgrowth (GO) induced by immunosuppressive agents, such as tacrolimus (Tcr) and cyclosporin A (CsA), in the absence of calcium channel blockers in patients undergoing renal transplantation (RT). Methods: This longitudinal study is conducted in 49 patients with RT who were divided into a CsA group (n = 25) and Tcr group (n = 24). The individuals were assessed at four time intervals: before transplant and 30, 90, and 180 days after RTs. Demographic data and periodontal clinical parameters (plaque index, cemento‐enamel junction to the gingival margin, probing depth, clinical attachment level, bleeding on probing [BOP], and GO) were collected at all time intervals. Results: The mean GO index was significantly lower in the Tcr group compared to the CsA group after 30 (P = 0.03), 90 (P = 0.004), and 180 (P = 0.01) days of immunosuppressive therapy. One hundred eighty days after RTs, a clinically significant GO was observed in 20.0% of individuals in the CsA group and 8.3% of individuals in the Tcr group. However, this difference was not statistically significant (P = 0.41). There was a reduction in periodontal clinical parameters regarding the time of immunosuppressive therapy for PI and BOP (P <0.001) in both groups. Conclusion: Although there was no statistical difference in the incidences of clinically significant GO after 180 days of immunosuppressive therapy, it was observed that GO occurred later in the Tcr group, and the severity of GO in this group was lower than in patients who used CsA.     

牙龈组织一氧化氮含量与牙龈炎症程度的相关性分析

目的:检测分析牙龈组织NO含量与牙龈炎症程度的相关性,初步探讨NO在牙周病发病机理中的作用。方法:采用酶法检测实验性牙周炎动物牙龈组织中NO2-和NO3-的含量,以间接反映NO水平,分析牙龈指数(G I值)与NO含量的相关性。结果:正常状况下与牙龈炎症状态下NO含量有显著性差异P<0.05。牙龈组织NO含量与牙龈指数呈显著负相关(P相似文献   

Interleukin‐6 Family of Cytokines in Crevicular Fluid of Renal Transplant Recipients With and Without Cyclosporine A–Induced Gingival Overgrowth

Background: Interleukin (IL)‐6 family of cytokines, including IL‐6, oncostatin M (OSM), leukemia inhibitory factor (LIF), and IL‐11, have fibrogenic features. The current study determines gingival crevicular fluid (GCF) levels of fibrosis‐related IL‐6–type cytokines in cyclosporine A (CsA)–induced gingival overgrowth (GO). Methods: Eighty non‐smokers were included (40 CsA‐medicated renal transplant patients with GO [GO + ; n = 20] or without GO [GO?; n = 20], 20 individuals with gingivitis, and 20 healthy participants). Probing depth and plaque, papilla bleeding, and hyperplastic index scores were recorded. GCF samples were obtained from the mesio‐buccal aspects of two teeth. GCF IL‐6, IL‐1β, OSM, LIF, and IL‐11 levels were analyzed by enzyme‐linked immunosorbent assay. Results: The GO+ and GO? groups had higher IL‐6 total amounts than the healthy group (P <0.008). IL‐1β total amounts in the GO+ group were significantly higher than in both the healthy and GO? groups (P <0.008). OSM total amount was elevated in the GO+ and GO? groups compared with both the gingivitis and healthy groups (P <0.008). All groups had similar LIF and IL‐11 total amounts (P >0.008). Moderate positive correlations were detected among IL‐6, IL‐1β, OSM, and IL‐11 total amount in GCF and clinical parameters (P <0.05). Conclusions: IL‐6 and OSM increases in GCF as a result of CsA usage or an immunosuppressed state irrespective of the severity of inflammation and the presence of GO. The IL‐6 family of cytokines might not be directly involved in biologic mechanisms associated with CsA‐induced GO. Lack of an association between assessed IL‐6 cytokines and CsA‐induced GO might indicate distinct effects of these cytokines on fibrotic changes of different tissues.     

舌鳞癌组织中CHK1和RAD51的表达及其临床病理意义

目的:研究舌鳞状细胞癌和癌旁正常上皮组织中,细胞周期检测点激酶1(checkpoint kinase 1,CHK1)和DNA双链断裂修复蛋白(RAD51)的表达水平及其临床病理意义。方法 :45例舌鳞状细胞癌和10例癌旁正常上皮组织常规制作石蜡包埋切片,CHK1和RAD51染色方法为EnVisionTM免疫组织化学法;应用统计软件SPSS 13.0行χ2检验。结果:舌鳞状细胞癌中CHK1和RAD51表达阳性率明显高于癌旁正常上皮(χ2=3.67,P=0.05)。组织学分级I～II级、临床分期I～II期及无颈部淋巴结转移的病例,其CHK1和RAD51表达阳性率,明显低于组织学分级III～IV级、临床分期III～IV期及颈部淋巴结转移的病例(P<0.05)。结论:CHK1和RAD51的表达水平,对舌鳞状细胞癌的发生、进展、临床生物学行为等方面可能有重要影响,CHK1和(或)RAD51阳性表达者预后不良。     

颌外动脉重要毗邻关系及临床意义

目的：研究颌外动脉的重要毗邻关系,方法：逐层解剖６０具完整的头颈标本（每具仅解剖一侧）,观察颌外动脉与颌下腺、面前静脉,面神经下颌缘支及颌下淋巴结之间的毗邻关系。结果：（１）颌外动脉位于２下腺深面者占６０％,穿越腺实质者占３８．３％,行走于腺体表面者占１．７％。（２）颌外动脉位于颌缘支深面者占９０％,位于浅面者占５％,下颌缘支环孢或夹持颌外动脉者５％。（３）颌外动脉一面前静脉伴行者占１１．７％,不