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Effect of adjunctive roxithromycin therapy on interleukin‐1β, transforming growth factor‐β1 and vascular endothelial growth factor in gingival crevicular fluid of cyclosporine A ‐treated patients with gingival overgrowth
Author(s) -
Gong Y.,
Lu J.,
Ding X.,
Yu Y.
Publication year - 2014
Publication title -
journal of periodontal research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 83
eISSN - 1600-0765
pISSN - 0022-3484
DOI - 10.1111/jre.12123
Subject(s) - medicine , vascular endothelial growth factor , placebo , roxithromycin , periodontitis , gastroenterology , chronic periodontitis , scaling and root planing , urology , antibiotics , pathology , vegf receptors , erythromycin , microbiology and biotechnology , biology , alternative medicine
Background and Objective Systemic macrolide antibiotic administration has been shown to result in the elimination or reduction cyclosporine A ‐induced gingival overgrowth. R oxithromycin ( ROX ) is known to have anti‐inflammatory, immunomodulatory and tissue reparative effects. This study was to evaluate the effect of adjunctive ROX therapy on cyclosporine A ‐induced gingival overgrowth and interleukin ( IL )‐1β, transforming growth factor ( TGF )‐β 1 and vascular endothelial growth factor ( VEGF ) levels in gingival crevicular fluid of renal transplant patients. Material and Methods Thirty‐one patients with clinically significant overgrowth and 16 periodontally healthy subjects were included in this randomized, double‐blind, placebo‐controlled, parallel‐arm study. Patients received scaling and root planing ( SRP ) at baseline and randomized to take either ROX or placebo for 5 d. The clinical parameters, including plaque index, papillary bleeding index, probing depth and gingival overgrowth scores, were recorded. The amounts of IL ‐1β, TGF ‐β 1 and VEGF in gingival crevicular fluid were detected by ELISA . Periodontal parameters as well as gingival crevicular fluid biomarker levels were evaluated at baseline and at 1 and 4 wk post‐therapy. Results Following SRP plus ROX and SRP plus placebo therapy, significant improvements in clinical periodontal parameters of both study groups were observed ( p < 0.025). In the ROX group, adjunctive ROX therapy resulted in a greater gingival overgrowth scores reduction compared with those in the placebo group at 4 wk ( p < 0.017). Initial amounts of IL ‐1β, TGF ‐β 1 and VEGF for both the ROX and placebo groups were significantly higher than those for healthy subjects ( p < 0.017), with no statistical difference between the two study groups. At 1 and 4 wk post‐therapy, significant decreases in the amounts of IL ‐1β, TGF ‐β 1 and VEGF were observed in both study groups when compared with baseline ( p < 0.025), but there was no difference in the levels of IL ‐1β and VEGF between the two study groups. The amount of decrease in TGF ‐β 1 levels for the ROX group was statistically significant compared to that for the placebo group at 4 wk after treatment ( p < 0.017). Conclusion Our study indicated that combination of ROX with non‐surgical therapy improves gingival overgrowth status and decreases gingival crevicular fluid TGF ‐β 1 levels in patients with severe gingival overgrowth . The reduction of gingival crevicular fluid TGF ‐β 1 following ROX therapy suggests an anti‐inflammatory/immunomodulatory effect of ROX on the treatment of cyclosporine A ‐induced gingival overgrowth .