Gingival Tissue and Apoptosis

Abstract

Background: Several factors can influence gingival tissues. Among them: disrupting tissue homeostasis and occurrence of pathological conditions. The aim of our study was to investigate and compare the presence of apoptosis in patients treated with immunosuppressive therapy, patients with periodontitis and on the other hand, healthy patients, as well as to better understand the role of apoptosis in the these processes.   Methods: The first objective group consisted of 21 patients (10 males and 11 females; mean age 37.4 ± 10.2 years old) with neither kidney diseases nor treated with cyclosporine A (CsA) therapy, who had a verified periodontal disease. The second group consisted of 21 kidney-transplant patients (9 males and 12 females; mean age 36.2 ± 9.5 years old), with diagnosed gingival overgrowth (GO) subjected to continuous immunosuppressive therapy. The control group consisted of the same number of patients, clinically healthy subjects (15 males and 6 females; mean age 29 ± 14.0 years old) with plaque-induced gingivitis. The following indexes were analyzed: plaque index (PI) Sillnes-Loe, index of gingival inflammation (GI) according to Loe-Sillnes, and gingival overgrowth index (GOI) according to MacGaw et al. The determination of CsA in blood was performed by a fluorescence polarised immunoassay (FPIA).The tissue samples were estimated by semiquantitative analysis in order to determine the presence of apoptotic cells and immunohistochemical expression of the bcl-2 and p53 proteins.   Results: We found statistical differences in bcl-2 and apoptotic index, among the groups: greatest expression of bcl-2 and apoptotic index was registered in the group treated with CsA, and the lowest expression was noted in the gingivitis group(p 0,05 ; r = 0.187).   Conclusion: Our findings suggest that increased apoptosis may have a role in the pathogenesis of CsA-induced gingival overgrowth in the cases of patients on high dose of CsA.