Crevicular fluid levels of TGFβ1 in drug-induced gingival overgrowth

Objective: To determine if local, gingival crevicular fluid (GCF) levels of TGFβ1 were altered in drug-induced gingival overgrowth. Patients and methods: GCF samples were collected on Periopaper™ strips from 45 renal transplant recipients who had been medicated with cyclosporin or cyclosporin in combination with other putative overgrowth-inducing drugs for a minimum of 6 months. Twenty-two subjects had gingival overgrowth while the other 23 patients showed no signs of gingival changes and constituted the medicated control group. Non-medicated controls consisted 20 periodontally healthy individuals who had never taken overgrowth-inducing drugs. GCF levels of TGFβ1 and alkaline phosphatase, a marker of inflammation, were determined by enhanced chemiluminescence ELISA and enzyme activity assays, respectively. Results: TGFβ1 levels in GCF from overgrowth and non-overgrowth sites in overgrowth sufferers did not differ. However, there were significant differences in median concentration (P=0.001) and GCF levels of TGFβ1 per sample (P=0.05) between study groups with overgrowth patients having higher amounts per sample and lower concentrations than medicated and healthy controls. Median levels of alkaline phosphatase per GCF sample differed between site (P=0.01) with higher levels present at overgrowth sites. Despite this, the concentration of enzyme in GCF did not differ between site or patient group. Conclusions: GCF TGFβ1 detected in overgrowth patients could reflect a higher level of gingival inflammation because of difficulties in plaque control consequent on the development of overgrowth. However, the higher local levels of total TGFβ1 in overgrowth patients could indicate that it is a risk factor for developing gingival overgrowth.