Ultrastructural changes in Langerhans cells in gingival overgrowth in cyclosporin A-treated renal transplant patients

Aim: Our research was focused on the ultrastructural features of gingival epithelium in kidney transplant patients and, in particular, on Langerhans cells, with the aim of verifying whether ultrastructural modifications might explain gingival overgrowth. Methods: Using electron microscopy and immunohistochemical S100 staining at optical microscopy, we examined gingival samples obtained from 18 kidney transplant patients who presented with gingival overgrowth following cyclosporin A treatment. Results: The hyperkeratosis shown by the epithelium, and especially the absence of Birbeck granules in the Langerhans cells observed in serial sections, lead us to correlate these data to an immunodeficiency which affects the epithelium in the complex mechanism determining overgrowth. Conclusions: In our previous studies we attributed the responsibility of overgrowth to the connective tissue alone. However, in the light of the present results, we cannot exclude a contribution of the epithelium to gingival overgrowth.