Calcium antagonists such as nifedipine are used for the treatment of hypertension but are known to elicit gingival overgrowth. The enhanced proliferation of gingival fibroblasts, the increase of bFGF (basic fibroblast growth factor) production and the decrease of phagocytosis of collagen by fibroblasts are proposed to be the mechanism for drug-induced gingival overgrowth. Plaque control and gingivectomy in severe case are necessary for the treatment of gingival overgrowth, but gingival overgrowth recurs in cases of poor plaque control. Moreover, it is difficult to stop drug administration because treatment of hypertension is preferred.
Sai-rei-to is a Japanese traditional medicine used for the treatment of acute gastroenteritis and edema. Sai-rei-to has an inhibitory effect on cell proliferation such as rat mesangial cells and fibroblasts in idiopathic retroperitoneal fibrosis. Sai-rei-to has also an anti-inflammatory effect and is used for the treatment of rheumatoid arthritis, lupus erythematosus and glomerulonephritis. From these effects, we assumed that Sai-rei-to is effective for the treatment of drug-induced gingival overgrowth. We investigated the effects of Sa-rei-to on nifedipine-induced fibroblast proliferation and production of bFGF and type I collagen using an in vitro gingival overgrowth model in which human gingival fibroblasts, Gin-1, were treated with nifedipine.
Sai-rei-to decreased nifedipine-induced cell proliferation and productions of bFGF and type I collagen in a dose-dependent manner. These results suggest that Sai-re-to may be effective for the prevention and treatment of drug-induced gingival overgrowth.
