EVALUATION OF THE FREQUENCY OF HLA DETERMINANTS IN PATIENTS WITH GINGIVAL OVERGROWTH INDUCED BY CYCLOSPORINE-A

This study has been designed to investigate the immunogenetic suscepti bility of Cyclosporine-A (CsA) immunosuppressed renal transplant patie nts to development of gingival overgrowth, and the amplifying effect o f calcium channel blockers on the severity of this clinical entity. 52 renal transplant recipients were selected and initially grouped as fo llows: group (Gp)1: CsA (n=7); Gp 2: CsA+verapamil (n=26); Gp 3: CsA+d iltiazem (n=6); Gp 4: CsA+nifedipine (n=13). These groups were not fou nd to be significantly different in age, sex, plaque index (PII), ging ival index (GI), calculus index, periodontal probing depth, serum CsA level, or duration of CsA therapy (p>0.05). No significant (p>0.05) ad ditive effect of the calcium channel blockers on the gingival overgrow th (GO) was assessed. The main group (n=52) was evaluated for the corr elations between the clinical and the pharmacological variables and th e GO. GI (rs=0.60) and the periodontal probing depth (rs=0.71) were fo und to be moderately correlated with the GO. The patients were regroup ed based on the severity of overgrowth and recognized as responders (n =26) and nonresponders (n=26). Age, sex, calculus index, serum CsA lev el, duration of the CsA therapy, were not statistically different amon g these groups (p>0.05). P1I, GI, periodontal probing depth, and GO we re significantly higher in the responder group (p>0.05). Analysis of H LA distribution of the responders and the nonresponders and comparison with the controls (n=3731) revealed that a statistically significant (p<0.001) % of the nonresponders were positive for HLA-DR1. These data would indicate that an immunogenetic predisposition should be suspect ed in the pathogenesis of the entity, and that HLA-DE 1 would have a p rotective role against gingival overgrowth induced by CsA.