Cross-sectional analysis of fibrosis-related gene expression in drug-induced gingival enlargement associated with periodontitis.

Objective: The objective of this study was to characterize the expression patterns of inflammation- and fibrosis-related genes in drug-induced gingival enlargement (DIGE) among patients with periodontitis.

Study design: Gingival tissue samples from 44 patients were categorized into 4 groups: N (healthy controls), P (periodontitis), A (patients with periodontitis receiving amlodipine and valsartan without DIGE), and G (periodontitis patients with DIGE). All specimens were obtained during periodontal flap surgery at least 6 months following initial therapy. Histomorphometric analysis, immunohistochemistry, and immunofluorescence staining were used to assess protein expression levels.

Results: Following initial therapy, no patient exhibited DIGE scores of 2 or 3. The expression levels of inflammation- and fibrosis-related markers, including cluster of differentiation 68, matrix metalloproteinase 12, a disintegrin and metalloproteinase 17, connective tissue growth factor, and cathepsin L, were elevated in group G compared with the other groups. Notably, group A demonstrated the highest expression of sirtuin 1 (SIRT1).

Conclusions: Effective supragingival and subgingival plaque control remains essential for managing DIGE in patients with periodontitis. The observed upregulation of SIRT1 in non-DIGE cases might indicate a potential antifibrotic role for this molecule.