Immunohistochemical analysis of estrogen and progesterone receptors expression in gingival lesions

Abstract

ABSTRACT
Background: Some lesions in the oral cavity and mostly on the gingiva have predominant predilection towards
females. Such lesions occur most commonly in the first fourth decades of life when changes in sex hormones levels in
the blood are obvious , for example pyogenic granuloma is a tumor like lesion of oral cavity that is considered to be
non-neoplastic in nature and arises in response to local irritation.
The present study aimed to evaluate the role of female sex steroid hormones in pathogenesis of pyogenic
granuloma (P.G) , peripheral giant cell granuloma (P.G.C.G), and peripheral ossifying fibroma (P.O.F) , on human
gingiva as a target organ .
Materials and Methods: This Study conducted on 40 case of reactive gingival lesions as a study group and 10
specimens of normal gingival tissue as acontrol group. These samples are collected to evaluate the expression of
estrogen and progesterone by using immuinohistochemistry .The study group included 15 case of P.G, 13 case of
P.G.C.G and 12 case of P.O.F. An immunohistochemical staining with estrogen monoclonal antibody marker and
anti progesterone monoclonal antibody were performed. All tests were carried out on 4μm sections from formalin
fixed parraffin embedded tissues.
Results: The age range of the subject in this study is 10 -59 years and the male to female ratio was 14/26 (1:1.85) for
study group while it was 5/5 (1:1) for control group . The cases have been already diagnosed, three subtypes of
gingival lesions were studies . These include 15 case of P.G (37.5 %), 13 case of P.G.C.G (32.5 %) and 12 case of P.O.F
(30 %). After immunohistochemical staining, all subjects in the control group showed negative expression for estrogen
and progesterone, while in the study group, 11 estrogen and progesterone receptors were detected. Eight of these
receptors were ER and three were PR .Estrogen was detected in the three lesions while progesterone was not
detected in P.G. In order of decreasing frequency, the ERs and PRs were found in PG.C.G (n=6), P.G (n=3) and P.O.F.
(n=2). The expression of these receptors was distributed in three site including epithelial, inflammatory and
mesencymal cells. Progesterone expression was much less than that’s of estrogen in both quantity (proportion of
positive cell) and intensity. Significant difference for expression of these receptors was found between the three
types of the lesions. This study showed significant difference in ERs expression between males and females. The
positivity of ERs receptor in females was more than males. On the other hand no significant difference for PRs
expression was found between males and females.
Conclusions : Estrogen and progesterone may play a role in the pathogenesis of the three oral lesions , P.G , P.G.C.G
and P.O.F by mechanism other than hormone receptor interaction , such mechanism may attributed to levels of
circulating hormones .Increase levels of these hormone may induce the release of inflammatory mediators from mast
cell and stimulate the proliferation of fibroblast .
Key word: Gingival lesions, estrogen, progesterone, immunohistochemistry. (J Bagh Coll Dentistry 2011;23(1):34-38).