Multidrug resistance 1 gene polymorphism in amlodipine-induced gingival enlargement. 2015

Kumaraswamy Naik Lambani Rama Naik, and Kapil Jhajharia, and Roopam Chaudhary, and Aravind Tatikonda, and Aprinderpal Singh Dhaliwal, and Rose Kanwaljeet Kaur
Department of Oral and Maxillofacial Pathology, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India.

Gingival enlargement comprises any clinical condition in which an increase in the size of the gingiva is observed. It is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Among calcium channel blockers, nifedipine causes gingival enlargement in about 10% of patients, whereas the incidence of amlodipine, a third-generation calcium channel blocker, induced gingival enlargement is very limited. Because the calcium antagonists, albeit to a variable degree, act as inhibitors of P-glycoprotein (P-gp), the gene product of multidrug resistance 1 (MDR1), and inflammation may modify P-gp expression. We hereby, report a case of amlodipine-induced gingival enlargement with MDR1 3435C/T polymorphism, associated with inflammatory changes due to plaque accumulation, in a 50-year-old hypertensive male patient. The genotype obtained for the polymorphism was a heteromutant genotype, thus supporting the contention that the MDR1 polymorphism may alter the inflammatory response to the drug.

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