RESUMEN
The administration of cyclosporine A (CsA) has been associated with significant bone loss and increased bone remodeling. The present investigation was designed to evaluate the effects of CsA on alveolar bone of rats subjected to experimental periodontitis, using histomorphometric and histological analysis. Twenty-four rats were divided into groups with 6 animals each: 1, control; 2, rats with ligature around the lower first molars; 3, rats with ligature around the lower first molars and that were treated with 10 mg CsA/kg of body weight/d; and 4, rats treated with 10 mg CsA/kg of body weight/d. At the end of 30 days, rats were humanely killed and subjected to a histological processing, with analysis of the distance cemento-enamel junction and alveolar bone crest, bone area, eroded bone area, and cemento surface. All of them were assessed at the mesial region of the alveolar bone. The CsA therapy combined with ligature placement decreased bone area and increased the eroded bone area around the tooth surface. The results at the histological analysis showed the same combination and changes. Therefore, in spite of the lack of a direct effect on the alveolar bone height, the CsA therapy intensified the imbalance of the alveolar bone homeostasia in a rat model of experimental periodontitis.
Asunto(s)
Pérdida de Hueso Alveolar/inducido químicamente , Proceso Alveolar/efectos de los fármacos , Remodelación Ósea/efectos de los fármacos , Ciclosporina/toxicidad , Inmunosupresores/toxicidad , Periodontitis/complicaciones , Pérdida de Hueso Alveolar/patología , Proceso Alveolar/patología , Animales , Modelos Animales de Enfermedad , Ligadura , Masculino , Diente Molar/cirugía , Periodontitis/patología , Ratas , Ratas Sprague-Dawley , Factores de TiempoRESUMEN
Cyclosporine (CsA) and tacrolimus (FK 506) exert complex, incompletely understood actions on bone. The objective of the study was to evaluate the effects of long-term tacrolimus therapy on the periodontium. Rats were treated for 60, 120, 180, and 240 days with daily subcutaneous injections of 1 mg/kg body weight of FK 506. After the experimental period, we obtained serum levels of calcium and alkaline phosphatase (ALP). After histological processing, the alveolar bone and cementum, as well as volume densities of bone (V(b)) and osteoclasts (V(o)), were assessed at the regions of the lower first molar. There was a tendency toward a statistically significant decrease in ALP levels with FK 506; however, serum calcium levels increased during the long periods. At 60, 180, and 240 days of treatment with FK 506, we did not observe V(b) and V(o) alterations. At 120 days of treatment, there was an evident decrease in V(b), but it did not show alveolar bone loss. We did not observe any alterations of cementum among rats treated with FK 506. It may be concluded that FK 506 administration did not induce side effects on the periodontium.
Asunto(s)
Cementos para Huesos/uso terapéutico , Densidad Ósea/efectos de los fármacos , Huesos/patología , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico , Animales , Huesos/efectos de los fármacos , Ciclosporina/uso terapéutico , Masculino , Mandíbula/efectos de los fármacos , Mandíbula/fisiología , RatasRESUMEN
BACKGROUND AND OBJECTIVE: Cyclosporine A treatment is important in the therapy of a number of medical conditions; however, alveolar bone loss is an important negative side-effect of this drug. As such, we evaluated whether concomitant administration of simvastatin would minimize cyclosporine A-associated alveolar bone loss in rats subjected, or not, to experimental periodontal disease. MATERIAL AND METHODS: Groups of 10 rats each were treated with cyclosporine A (10 mg/kg/day), simvastatin (20 mg/kg/day), cyclosporine A and simvastatin concurrently (cyclosporine A/simvastatin) or vehicle for 30 days. Four other groups of 10 rats each received a cotton ligature around the lower first molar and were treated similarly with cyclosporine A, simvastatin, cyclosporine A/simvastatin or vehicle. Calcium (Ca(2+)), phosphorus and alkaline phosphatase levels were evaluated in serum. Expression levels of interleukin-1beta, prostaglandin E(2) and inducible nitric oxide synthase were evaluated in the gingivomucosal tissues. Bone volume and numbers of osteoblasts and osteoclasts were also analyzed. RESULTS: Treatment with cyclosporine A in rats, with or without ligature, was associated with bone loss, represented by a lower bone volume and an increase in the number of osteoclasts. Treatment with cyclosporine A was associated with bone resorption, whereas simvastatin treatment improved cyclosporine A-associated alveolar bone loss in all parameters studied. In addition, simvastatin, in the presence of inflammation, can act as an anti-inflammatory agent. CONCLUSION: This study shows that simvastatin therapy leads to a reversal of the cyclosporine A-induced bone loss, which may be mediated by downregulation of interleukin-1beta and prostaglandin E(2) production.
Asunto(s)
Pérdida de Hueso Alveolar/inducido químicamente , Ciclosporina/efectos adversos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Inmunosupresores/efectos adversos , Simvastatina/farmacología , Fosfatasa Alcalina/sangre , Pérdida de Hueso Alveolar/fisiopatología , Proceso Alveolar/efectos de los fármacos , Proceso Alveolar/patología , Animales , Antiinflamatorios/farmacología , Densidad Ósea/efectos de los fármacos , Calcio/sangre , Recuento de Células , Dinoprostona/análisis , Regulación hacia Abajo , Encía/efectos de los fármacos , Encía/patología , Interleucina-1beta/análisis , Masculino , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Óxido Nítrico Sintasa de Tipo II/análisis , Osteoblastos/efectos de los fármacos , Osteoblastos/patología , Osteoclastos/efectos de los fármacos , Osteoclastos/patología , Fósforo/sangre , Distribución Aleatoria , Ratas , Ratas Sprague-DawleyRESUMEN
Recent studies have suggested that tacrolimus monotherapy is a beneficial therapeutic alternative for the normalization of cyclosporin-induced bone loss in animal models and humans. The mechanism accounting for this action is unclear at present. In the present study, we attempted to determine the effect of tacrolimus monotherapy on alveolar bone using histological, histomorphometric and transmission electron microscopy (TEM). Groups of rats (n=10 each) were treated with either tacrolimus (1mg/kg/day, s.c.) or drug vehicle for 60 days. Fragments containing maxillary molars were processed for light microscopy to investigate the alveolar bone volume, trabecular separation, number of osteoclasts and osteoblasts, and transmission electron microscopy to investigate their ultrastructural basic phenotype. Treatment with tacrolimus monotherapy during 60 days may induce increases in alveolar bone volume (BV/TV,%; P<0.05) and a non-significant decrease in trabecular separation (Tb.Sp,mm; P>0.05), represented by a decrease in osteoclast number (N.Oc/BS; P<0.05) and maintenance of osteoblast number (N.Ob/BS; P>0.05). Osteoblasts were often observed as a continuous layer of active cells on the bone surface. Osteoclasts appeared to be detached from the resorbed bone surface, which was often filled by active osteoblasts and collagen-rich matrix. Moreover, osteoclasts in the treated group were frequently observed as inactive cells (without ruffled border, clear zone and detached from the bone surface). Within the limits of the present study, we conclude that tacrolimus leads to an increase in alveolar bone formation, which probably exerts action on osteoclasts. Tacrolimus could, therefore, play a crucial role in the control of both early osteoclast differentiations from precursors, as well as in functional activation.
Asunto(s)
Pérdida de Hueso Alveolar/fisiopatología , Inmunosupresores/farmacología , Maxilar/efectos de los fármacos , Enfermedades Maxilares/fisiopatología , Osteoclastos/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Tacrolimus/farmacología , Pérdida de Hueso Alveolar/patología , Animales , Inmunosupresores/administración & dosificación , Inyecciones Subcutáneas , Masculino , Maxilar/fisiopatología , Maxilar/ultraestructura , Enfermedades Maxilares/patología , Microscopía Electrónica de Transmisión , Osteoblastos/efectos de los fármacos , Osteoblastos/ultraestructura , Osteoclastos/ultraestructura , Ratas , Ratas Sprague-Dawley , Tacrolimus/administración & dosificación , Factores de TiempoRESUMEN
BACKGROUND: Tacrolimus, an immunosuppressive drug used in organ transplantation, has been reported not to induce gingival overgrowth. However, prevalence studies are limited, and the methods used for assessing gingival overgrowth varies among studies. OBJECTIVE: The purpose of this study was to evaluate the effects of up to 240 days of tacrolimus therapy on gingival tissues of rats. MATERIALS AND METHODS: Rats were treated for 60, 120, 180 and 240 days with daily subcutaneous injections of 1 mg/kg body weight of tacrolimus. After histological processing, the oral and connective tissue, volume densities of fibroblasts (Vf), collagen fibers (Vcf) and other structures (Vo) were assessed in the region of the lower first molar. RESULTS: After 60 and 120 days of treatment with tacrolimus, gingival overgrowth was not observed. The gingival epithelium, connective tissue, as well as the values for Vf, Vcf, and Vo were similar to those of the control rats (P>0.05). After 180 and 240 days of the treatment, gingival overgrowth was associated with a significant increase in the gingival epithelium and connective tissue as well as an increase in the Vf and Vcf (P<0.05). CONCLUSIONS: Within the limits of the experimental study, it may be concluded that the deleterious side effects of tacrolimus on the gingival tissues of rats may be time-related.
Asunto(s)
Encía/efectos de los fármacos , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico , Animales , Recuento de Células , Colágeno/efectos de los fármacos , Tejido Conectivo/efectos de los fármacos , Tejido Conectivo/patología , Epitelio/efectos de los fármacos , Epitelio/patología , Fibroblastos/efectos de los fármacos , Encía/patología , Hiperplasia Gingival/inducido químicamente , Hiperplasia Gingival/patología , Sobrecrecimiento Gingival/inducido químicamente , Sobrecrecimiento Gingival/patología , Inmunosupresores/administración & dosificación , Inyecciones Subcutáneas , Masculino , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Tacrolimus/administración & dosificación , Factores de TiempoRESUMEN
BACKGROUND AND OBJECTIVE: Cyclosporine A is an immunosuppressive drug that is widely used in organ transplant patients as well as to treat a number of autoimmune conditions. Bone loss is reported as a significant side-effect of cyclosporine A use because this can result in serious morbidity of the patients. As we have shown that cyclosporine A-associated bone loss can also affect the alveolar bone, the purpose of this study was to evaluate the effect of the concomitant administration of alendronate on alveolar bone loss in a rat model. MATERIAL AND METHODS: Forty Wistar rats (10 per group) were given cyclosporine A (10 mg/kg, daily), alendronate (0.3 mg/kg, weekly), or both cyclosporine A and alendronate, for 60 d. The control group received daily injections of sterile saline. The expression of proteins associated with bone turnover, including osteocalcin, alkaline phosphatase and tartrate-resistant acid phosphatase (TRAP), and also the calcium levels, were evaluated in the serum. Analysis of the bone volume, alveolar bone surface, the number of osteoblasts per bone surface and the number of osteoclasts per bone surface around the lower first molars was also performed. RESULTS: The results indicate that cyclosporine A treatment was associated with bone resorption, represented by a decrease in the bone volume, alveolar bone surface and the number of osteoblasts per bone surface and by an increase in the number of osteoclasts per bone surface and TRAP-5b. These effects were effectively counteracted by concomitant alendronate administration. CONCLUSION: It is concluded that concomitant administration of alendronate can prevent cyclosporine A-associated alveolar bone loss.
Asunto(s)
Alendronato/uso terapéutico , Pérdida de Hueso Alveolar/inducido químicamente , Conservadores de la Densidad Ósea/uso terapéutico , Ciclosporina/efectos adversos , Inmunosupresores/efectos adversos , Fosfatasa Ácida/sangre , Alendronato/administración & dosificación , Fosfatasa Alcalina/sangre , Pérdida de Hueso Alveolar/patología , Pérdida de Hueso Alveolar/prevención & control , Proceso Alveolar/efectos de los fármacos , Proceso Alveolar/patología , Animales , Biomarcadores/sangre , Densidad Ósea/efectos de los fármacos , Conservadores de la Densidad Ósea/administración & dosificación , Calcio/sangre , Recuento de Células , Modelos Animales de Enfermedad , Isoenzimas/sangre , Masculino , Osteoblastos/efectos de los fármacos , Osteoblastos/patología , Osteocalcina/sangre , Osteoclastos/efectos de los fármacos , Osteoclastos/patología , Distribución Aleatoria , Ratas , Ratas Wistar , Fosfatasa Ácida TartratorresistenteRESUMEN
OBJECTIVE: Periodontitis is a well-appreciated example of leukocyte-mediated bone loss and inflammation with pathogenic features similar to those observed in other inflammatory diseases, such as arthritis. Since Tacrolimus, is an immunomodulatory drug used for the treatment of some cases of arthritis, we hypothesized that it may modulate periodontal disease. DESIGN: Using a murine model of ligature-induced periodontal disease, we assessed the effects of daily administrations of Tacrolimus (1mg/kg body weight) on bone loss, enzymatic (myeloperoxidase) analysis, differential white blood cells counts, airpouch exudate and cytokine expression for 5-30 days. RESULTS: Radiographic, enzymatic (myeloperoxidase) and histological analysis revealed that Tacrolimus reduced the severity of periodontitis. More specifically, Tacrolimus suppressed the expression of serum interleukin (IL-1beta), tumour necrosis factor (TNF-alpha), IL-6, airpouch exudate PGE(2) and leukocytosis usually observed after the induction of periodontitis. Tacrolimus treatment in periodontitis-induced rats conferred protection against the inflammation-induced tissue and bone loss associated with periodontitis, through a mechanism involving IL-1beta, TNF-alpha and IL-6. CONCLUSIONS: The effects of Tacrolimus on periodontal disease pathogenesis may provide clues to a novel approach to host modulation therapy in destructive periodontal disease.
Asunto(s)
Inhibidores de la Calcineurina , Inmunosupresores/uso terapéutico , Periodontitis/prevención & control , Tacrolimus/uso terapéutico , Pérdida de Hueso Alveolar/prevención & control , Animales , Dinoprostona/análisis , Modelos Animales de Enfermedad , Encía/efectos de los fármacos , Encía/enzimología , Factores Inmunológicos/uso terapéutico , Interleucina-1beta/sangre , Interleucina-1beta/efectos de los fármacos , Interleucina-6/sangre , Recuento de Leucocitos , Leucocitosis/prevención & control , Masculino , Periodontitis/enzimología , Peroxidasa/análisis , Ratas , Ratas Wistar , Factores de Tiempo , Factor de Necrosis Tumoral alfa/análisis , Factor de Necrosis Tumoral alfa/efectos de los fármacosRESUMEN
OBJECTIVES: The administration of cyclosporin A has been associated with significant bone loss and increased bone remodeling. The present investigation was designed to evaluate the effects of cyclosporin A on alveolar bone of rats subjected to experimental periodontitis, using serum, stereometric and radiographic analysis. METHODS: Twenty-four rats were divided into one of the following groups with six animals each: group I, control rats; group II, in which the animals received a cotton ligature around the lower first molars; group III, in which the rats received a cotton ligature around the lower first molars and were treated with 10 mg/(kg body weight day) of cyclosporin A; group IV, in which the rats were treated with 10 mg/(kg body weight day) of cyclosporin A. At the end of experimental period, at 30 days, animals were killed and the serum calcium and alkaline phosphatase levels were measured in all groups. The distance from the alveolar bone crest to the cemento-enamel junction was measured radiographically for each mesial surface of the lower first molars of each rat. After histological processing, the stereological parameters: volume densities of multinucleated osteoclasts (V(o)), alveolar bone (V(b)), marrow (V(m)), and relation of eroded surface/bone surface (Es/Bs) were assessed at the mesial region of the alveolar bone. RESULTS: Significant decreases in serum calcium were observed in those groups that received cyclosporin A therapy. No significant changes in serum alkaline phosphatase were observed. The therapy with cyclosporin A combined with the ligature placement decreased the V(b) and increased the V(o), V(m) and Es/Bs at the mesial surface of lower first molars. On the other hand, the radiographic data showed that cyclosporin A therapy diminished the alveolar bone loss at the mesial surface of the lower first molars. CONCLUSIONS: Therefore, within the limits of this study, we suggest that cyclosporin A at immunosuppressive levels can bring about an imbalance in the alveolar bone homeostasis in rats. However, in the presence of inflammatory stimulation, the inhibition of the immune system by cyclosporin A may decrease the initial periodontal breakdown.
Asunto(s)
Pérdida de Hueso Alveolar/inducido químicamente , Remodelación Ósea/efectos de los fármacos , Ciclosporina/administración & dosificación , Inmunosupresores/administración & dosificación , Periodontitis , Fosfatasa Alcalina/sangre , Pérdida de Hueso Alveolar/sangre , Pérdida de Hueso Alveolar/diagnóstico por imagen , Análisis de Varianza , Animales , Densidad Ósea/efectos de los fármacos , Calcio/sangre , Ciclosporina/efectos adversos , Modelos Animales de Enfermedad , Inmunosupresores/efectos adversos , Ligadura , Periodontitis/tratamiento farmacológico , Radiografía , Ratas , Ratas Sprague-Dawley , Estadísticas no ParamétricasRESUMEN
BACKGROUND: There is some evidence showing that cyclosporin A (CsA) and nifedipine (NIF) affect bone metabolism. The purpose of this work was to study the effects of CsA and NIF, given alone or concurrently, on alveolar bone of rats of different ages. METHODS: Rats 15, 30, 60, and 90 days old were treated daily with 10 mg/kg body weight of CsA subcutaneously injected and/or 50 mg/kg body weight of NIF/day given orally for 60 days. Alveolar bone of the first lower molars was morphologically and stereologically evaluated in serial 5 microm bucco-lingual paraffin sections, stained with hematoxylin and eosin. Serum calcium and alkaline phosphatase levels were measured in all animals at the end of the experimental period. RESULTS: Rats treated with CsA or NIF alone or CsA and NIF concurrently showed decreased alveolar bone density. CsA was more effective than NIF. A significant decrease in serum calcium was found only in animals treated with CsA or CsA/NIF. The results were similar regardless of age. CONCLUSIONS: These results indicate that the decrease in the alveolar bone volume in rats caused by CsA and NIF alone or concurrently is not age dependent. Furthermore, NIF (50 mg/kg) did not further increase the loss of alveolar bone volume induced by CsA (10 mg/kg).