Altered Cytokine Expression in Amlodipine Induced Gingival Overgrowth
Objectives: Amlodipine is a calcium channel blocker and used to treat high blood pressure. Studies reported that Amlodipine can induce gingival overgrowth. However, the underlying mechanism is not described yet. There are subtypes of T helper cells with different cytokine expressions. It was shown that Th1/Th2 and Th17 cells may cause fibrotic changes in different tissues. We aim to show cytokine profiles in amlodipine induced gingival overgrowth by using immunohistochemistry (IHC) and ELISA techniques.
Methods: Samples from 27 donors were included in this study: Amlodipine group (8), inflammatory group (11) and control (8). Clinical periodontal parameters, blood and gingival crevicular fluid samples (GCF) were collected. Gingivectomy procedures were performed to obtain tissues samples. To detect the expression levels of IL-17, IL-10, IL-13 and IFN-gamma, samples were stained by IHC. Quantitative analysis was done by counting the total number of positively stained T cells and normalized to total number of T cells and results expressed as the percent positive stained cells. ELISA protocols are still being worked to detect cytokines in blood and GCF.
Results: Immunohistochemistry results showed that IL-17 expression was increased in amlodipine samples (%80.69) compared to control samples (%42.42) (p<0.001). There was an increase in inflammatory group (%66) which is significantly less then amlodipine group (p<0.05). The highest IFN-gamma expression was detected on control tissues (%70.6). IFN-gamma in amlodipine and inflammatory group was %67 and % 51, respectively. In terms of IL-10 and IL-13 expression, there was no significant change within the groups.
Conclusions: IL-17 is known to promote inflammation. Increased IL-17 expression might exacerbate inflammation in gingiva and contribute to amlodipine induced gingival overgrowth. ELISA results will enlighten possible role of IL-17 in amlodipine induced gingival fibrosis.