Plasma TGF-β1 as a risk factor for gingival overgrowth

Background and Aims: Induction of the pro-fibrotic growth factor TGF-β1 has been suggested as a possible mechanism through which immunosuppressant drugs may induce gingival overgrowth. This study aims to investigate plasma levels of TGF-β1 and relate them to the development and severity of gingival overgrowth in immunosuppressed transplant patients.

Materials and Methods: One hundred and thirty-two ciclosporin-treated and 13 tacrolimus-treated transplant patients and 24 drug-free control subjects underwent a full periodontal examination including a determination of the presence and severity of gingival overgrowth.

Results: Plasma TGF-β1 concentrations were determined by ELISA, and were found to be significantly elevated in samples from the transplant patients (mean=29.1 ng/ml) as compared with controls (mean=6.1 ng/ml, p<0.0001). There was no significant difference between the levels of plasma TGF-β1 in the ciclosporin- and tacrolimus-treated patient groups.

Conclusions: Furthermore, concomitant treatment with calcium channel blockers did not influence the levels of plasma TGF-β1 in the patients group. The relationship between gingival overgrowth, independent periodontal variables and TGF-β1 plasma concentrations was examined using univariate and multivariate regression analyses; low TGF-β1 plasma concentrations were found to be a risk factor for gingival overgrowth in immunosuppressed patients concomitantly receiving a calcium channel blocker.