SHUN-FA YANGFU-MEI HUANGYU-CHAO CHANG2026-10-162026-10-162009-08-01Pure ID: 15134785Pure UUID: d628ecc3-17cb-4ea7-b36c-23b6203a0a0a10.1111/j.1600-0765.2008.01147.xhttps://www.scopus.com/pages/publications/67651055784https://scholars.csmu.edu.tw/handle/123456789/34159Background and Objective: Cystatin C is a 13 kDa non-glycosylated, basic protein belonging to the cystatin family. It is consistently and dramatically upregulated in a variety of fibrotic diseases. However, little is known about the correlation between cystatin C and cyclosporine A-induced gingival overgrowth. The aim of this study was to compare cystatin C expression in normal, healthy gingival tissues and cyclosporine A-induced gingival overgrowth specimens and further explore the potential mechanism that may result in cystatin C expression. Material and Methods: Fifteen cyclosporine A-induced gingival overgrowth specimens and five normal gingival tissues were examined by immunohistochemistry. Three human gingival fibroblast (HGF) strains were established from crown-lengthening surgery. The reverse transcriptase-polymerase chain reaction was used to investigate the effects on HGFs exposed to cyclosporine A. In addition, predominant periodontal pathogens (Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis) and proinflammatory cytokines (interleukin-1α and tumor necrosis factor-α) were added to seek the possible regulatory mechanisms of cystatin C expression. Results: The cystatin C staining in gingival tissue was stronger in the cyclosporine A-induced gingival overgrowth group than in the normal gingival group (p < 0.05). Intensive staining for cystatin C expression was observed mainly in the cytoplasm of fibroblasts, epithelial cells and inflammatory cells. Moreover, cystatin C expression was significantly higher in cyclosporine A-induced gingival overgrowth specimens with higher levels of inflammatory infiltrates (p < 0.05). A concentration of 200 ng/mL cyclosporine A was found to increase cystatin C expression in HGFs in a time-dependent manner (p < 0.05). The addition of periodontal pathogens and proinflammatory cytokines significantly increased the expression of cystatin C compared with cyclosporine A alone (p < 0.05). Conclusion: The increased ability of protein accumulation by cystatin C is one of several factors mediating cyclosporine A-induced gingival overgrowth. In addition, cyclosporine A may predispose to gingival overgrowth in inflammatory environments.6enjournal article