Preventive effects of an original combination of grape seed polyphenols with amine fluoride on dental biofilm formation and oxidative damage by oral bacteria.

AIMS: To investigate the preventive effects of an original combination of a grape seed extract (GSE) with an amine fluoride (Fluorinol(®) ) on dental plaque formation and oxidative damage caused by oral bacteria. METHODS AND RESULTS: The antibacterial activity of the compounds was assessed using the broth macrodilution method, and their antiplaque activity was evaluated on a multispecies biofilm grown on saliva-coated hydroxyapatite discs. The effect on glucosyltransferases activity was analysed through reductions in the overall reaction and the quantity of insoluble glucan synthesized. The combination of 2000 µg ml(-1) of GSE with 10·2 mg ml(-1) of Fluorinol(®) significantly decreased the biofilm formation (up to 4·76 log10 of reduction) and inhibited by 97·4% the insoluble glucan synthesis by glucosyltransferases. The antioxidant activity of this combination, alone or incorporated into a formulated mouthwash (Eludril daily(®) ), was determined using the Trolox equivalent antioxidant capacity assay (TEAC), and both showed significantly greater antioxidant capacity than vitamin C. CONCLUSIONS: The GSE/Fluorinol(®) combination showed both a significant antiplaque activity and an important antioxidant capacity in vitro, without any bactericidal effects. SIGNIFICANCE AND IMPACT OF THE STUDY: This is, to our knowledge, the first report on the properties of an original combination of a polyphenolic extract with amine fluoride that could be used for the prevention of oral diseases and oxidative damage associated.

Antibacterial activity of probiotic candidates for oral health.

The aim of this study was to determine the probiotic potential of autochthonous oral lactobacilli. For this, 66 strains were screened for antibacterial activity against two cariogenic strains (Streptococcus mutans and Actinomyces viscosus) and two periodontopathogenic strains (Fusobacterium nucleatum and Porphyromonas gingivalis). The inhibitory activity was investigated with the agar overlay technique. Positive results led us to explore some mechanisms of action. The ability to produce H(2)O(2) and the glycerol dehydratase gene were searched among all the strains. The gassericin A gene was checked among the Lactobacillus gasseri. All the tested strains inhibited S. mutans and A. viscosus; only one did not inhibited F. nucleatum and 52 strains inhibited slightly the growth of P. gingivalis. No inactivation of antibacterial activity was observed after treatment with proteinase K. The gene of the gassericin A was not found in any strain. Only one strain showed a 275-bp amplicon corresponding to the Glycerol Dehydratase gene. This strain has been identified by DNA 16S sequencing as a L. gasseri. Among the 66 tested strains, 7 produced hydrogen peroxide. Our findings suggest that in addition to the previous results, some of the autochthonous oral lactobacilli tested could be considered as suitable probiotics.

The in vitro effect of manuka honeys on growth and adherence of oral bacteria.

Honey has been used since ancient times and more recently, for the healing of wounds and against infectious diseases. The aim of our study was to investigate the effect of two manuka honeys showing different potencies of their antibacterial activity, on potentially pathogenic oral bacteria. The antimicrobial activity was examined by determining the MIC and MBC using the macro dilution broth technique. The effect on the adherence was tested on growing cells of Streptococcus mutans on a glass surface and on a multi-species biofilm grown on saliva-coated hydroxyapatite discs. As expected, the antibacterial activity of manuka 1 (with higher potency of antibacterial activity) was the most important. The two tested honeys weakly inhibited the adherence of S.mutans cells to a glass surface at sub-MIC concentration. Manuka 1 showed a total inhibition of multi-species biofilm at the concentration of 200 µg/ml manuka 2 inhibited biofilm formation weakly at the concentration of 200 µg/ml but firmly at the concentration of 500 µg/ml. Our findings suggest that manuka honeys might be able to reduce oral pathogens within dental plaque. These two honeys appear to be able to control dental biofilm deposit.

Adherence capacities of oral lactobacilli for potential probiotic purposes.

The most abundantly used probiotic strains come from the genus Lactobacillus and only a few studies have investigated their role in oral health. Even if a positive correlation has been established between the saliva Lactobacillus count and dental caries, this genus is generally recognized as safe (GRAS). Moreover, lactobacilli could in some cases play a beneficial role by inhibiting the growth of some oral pathogenic bacteria. This activity could justify their use as probiotic. To establish the potential health benefit of probiotic candidates, appropriate in vitro tests are required, particularly on their adhesive capacity. The aim of this work was to investigate the adhesive properties and surface characteristics of 70 oral lactobacilli that could be used as probiotics for oral health. For this, three methods were used: biofilm formation on a glass surface and on saliva-coated hydroxyapatite discs and the microbial adhesion to solvent method. The results of the biofilm formed on glass surface showed 13 strains with an adhesion score equal to or higher than 3. 57/70 (81%) of the tested lactobacilli did not form any biofilm on glass surfaces. All of the 13 strains formed biofilms on HA discs. Among these 13 strains, 10/13 (77%) showed low surface hydrophobicity (0-35%) and 3/13 (23%) showed medium hydrophobicity (36-70%). Some of the selected strains showed potentially useful adhesive capacity. This work paves the way for the selection of probiotics that could be used for oral health purposes with the aim to reduce carious risk.

Effect of antiplaque compounds and mouthrinses on the activity of glucosyltransferases from Streptococcus sobrinus and insoluble glucan production.

INTRODUCTION: The development of therapeutic agents inhibiting the activity of glucosyltransferases (GTF) and their production of glucans is a potential strategy to reduce dental decay. The aim of this study was first to characterize a GTF preparation from Streptococcus sobrinus ATCC 33478 and then to evaluate the effects of select compounds and mouthrinses on insoluble glucan (ISG) formation by combined GTFs. METHODS: The purity of the crude GTF mixture was assessed by electrophoresis. The effects of pH, temperature, sucrose, and dextran T10 concentrations on GTF activity were analyzed and the chemical structure of the products was investigated. Finally, the inhibition of GTF by commercial mouthrinses used in oral hygiene and their active components (chlorhexidine, polyphenolic compounds, fluoride derivatives, polyols, cetylpyridinium chloride, and povidone iodine) was analyzed through the reductions in the overall reaction rate and the quantity of ISG synthesized. RESULTS: The S. sobrinus ATCC 33478 crude GTF preparation obtained contains a mixture of four different GTFs known for this species. For optimal adherent ISG formation, the reaction parameters were 37 degrees C, pH 6.5, sucrose 50 g/l, and dextran T10 2 g/l. Under these conditions, the most effective agents were chlorhexidine, cetylpyridinium chloride, and tannic acid. Eludril, Elmex, and Betadine were the most effective inhibitors of all the mouthrinses tested. CONCLUSION: As the formulation of commercial products considerably influences the efficiency of active components, the fast representative ISG inhibition test developed in this study should be of great interest.

In vitro anti-bacterial and anti-adherence effects of natural polyphenolic compounds on oral bacteria.

AIMS: To investigate the action of different polyphenolic compounds, extracted from red wine, grape marc and pine bark, on oral bacteria. METHODS AND RESULTS: The anti-microbial activity of extracts was examined by determining the Minimal Inhibitory Concentration and Minimal Bactericidal Concentration using the macro dilution broth technique. Their effect on the adherence was tested on growing cells of Streptococcus mutans on a glass surface and on a multi-species biofilm grown on saliva-coated hydroxyapatite discs. The effect on glucosyltransferase activity was analysed through the reductions in the overall reaction rate and the quantity of insoluble glucan (ISG) synthesized. Pine bark and grape marc extracts were the most effective inhibitors of the multi-species biofilm formation and of the ISG synthesis. CONCLUSION: The tested components showed an interesting anti-plaque activity in vitro. SIGNIFICANCE AND IMPACT OF THE STUDY: This is, to our knowledge, the first and the most complete report on the properties of wine and pine bark extracts that could be used for oral disease prevention purpose.

Epistaxis complicating treatment by anti-vitamin K and new oral anticoagulants.

OBJECTIVES: To assess any differences in severity and management of epistaxis when complicating treatment by anti-vitamin K (AVK) or by new oral anticoagulants (NOAC). MATERIALS AND METHOD: All patients admitted to the ENT department of a University Hospital Center for epistaxis under oral anticoagulation therapy between January 2010 and June 2015 were included in a retrospective study. Severity was assessed in terms of management and of hemoglobin level at admission. Two groups were distinguished: treatment by AVK or by NOAC. RESULTS: One hundred and thirty-four patients were included: 126 under AVK and 8 under NOAC. There was a significant difference in mean hospital stay: 4.5 days for AVK versus 3.5 days for NOAC (P=0.019; 95% CI [0.1921; 0.8907]). There were no significant differences for the other severity criteria. None of the patients died. CONCLUSION: Admission rates for epistaxis complicating NOAC therapy was low, and much lower than in case of AVK. Bleeding severity was equivalent with both treatments. NOACs significantly reduce hospital stay. Contrary to the study hypothesis, epistaxis is less serious when complicating NOAC than AVK therapy.

Sources of carbon for hepatic glycogen synthesis in the conscious dog.

To identify the source(s) of carbon for the indirect pathway of hepatic glycogen synthesis, we studied nine 42-h fasted conscious dogs given a continuous intraduodenal infusion of glucose, labeled with [1-13C]glucose and [3-3H]glucose, at 8 mg.kg-1.min-1 for 240 min. Glycogen formation by the direct pathway was measured by 13C-NMR. Net hepatic balances of glucose, gluconeogenic amino acids, lactate, and glycerol were determined using the arteriovenous difference technique. During the steady-state period (the final hour of the infusion), 81% of the glucose infused was absorbed as glucose. Net gut output of lactate and alanine accounted for 5% and 3% of the glucose infused, respectively. The cumulative net hepatic uptakes were: glucose, 15.5 +/- 3.8 g; gluconeogenic amino acids, 32.2 +/- 2.2 mmol (2.9 +/- 0.2 g of glucose equivalents); and glycerol, 6.1 +/- 0.9 mmol (0.6 +/- 0.1 g of glucose equivalents). The liver produced a net of 29.2 +/- 9.6 mmol of lactate (2.6 +/- 0.8 g of glucose equivalents). Net hepatic glycogen synthesis totaled 9.3 +/- 2.5 g (1.8 +/- 0.4 g/100 g liver), with the direct pathway being responsible for 57 +/- 10%. Thus, net hepatic glucose uptake was sufficient to account for all glycogen formed by both the direct and indirect pathways. Total net hepatic uptake of gluconeogenic precursors (gluconeogenic amino acids, glycerol, and lactate) was able to account for only 20% of net glycogen synthesis by the indirect pathway. In a net sense, our data are consistent with an intrahepatic origin for most of the three-carbon precursors used for indirect glycogen synthesis.

Identification of salivary Lactobacillus rhamnosus species by DNA profiling and a specific probe.

The Lactobacillus genus has been shown to be associated with the dental carious process, but little is known about the species related to the decay, although Lactobacillus rhamnosus is suspected to be the most implicated species. Conventional identification methods based on biochemical criteria lead to ambiguous results, since the Lactobacillus species found in saliva are phenotypically close. To clarify the role of this genus in the evolution of carious disease, this work aimed to find a rapid and reliable method for identifying the L. rhamnosus species. Methods based on hybridization with DNA probes and DNA amplification by PCR were used. The dominant salivary Lactobacillus species (reference strains from the ATCC) were selected for this purpose as well as some wild strains isolated from children's saliva. DNA profiling using semirandom polymorphic DNA amplification (semi-RAPD) generated specific patterns for L. rhamnosus ATCC 7469. The profiles of all L. rhamnosus strains tested were similar and could be grouped; these strains shared four common fragments. Wild strains first identified with classic methods shared common patterns with the L. rhamnosus species and could be reclassified. One fragment of the profile was purified, cloned, used as a probe and found to be specific to the L. rhamnosus species. These results may help to localize this species within its ecological niche and to elucidate the progression of the carious process.

Adaptation of salivary Lactobacillus strains to xylitol.

OBJECTIVE: Acid production from sugars is one of the virulence factors of cariogenic bacteria. To eliminate this factor, many authors have suggested using sugar substitutes like xylitol, which is not fermented by most oral bacteria. The aim of this work was to investigate whether oral strains of lactobacilli unable to utilise xylitol could become able to utilise this polyol. DESIGN: Twenty-eight oral strains and six ATCC strains of lactobacilli were tested. None was initially able to produce acids from xylitol. Media containing only xylitol was used in order to see if an adaptation was possible. The acid production from xylitol was measured by recording the pH variations of the culture medium. The acids produced were identified by HPLC. RESULTS: After a 15-days culture, 10 strains produced acids. After a 40-days culture, 11 more strains produced acid. When acid production occurred, lactic, formic, acetic, propionic and butyric acids were the organic acids formed by all the strains. CONCLUSIONS: Adaptation of oral strains of lactobacilli to xylitol can occur in vitro.

MRI and CT in a case of pituitary abscess.

We report the case of a woman admitted for hypopituitarism of sudden onset, in whom conventional radiography, CT and MRT suggested a pituitary tumour with supra- and intrasellar extensions. The surgical findings and the clinical course under antibiotic therapy transformed this diagnosis into one of pituitary abscess by a pyogenic micro-organism. Pituitary abscess is an exceptional lesion. Despite the advent of CT and MRI, its preoperative diagnosis remains difficult. However, the presence of an intrasellar expansive process with liquid centre and contrast-enhanced outline should suggest the possibility of an abscess, particularly when the pituitary lesion is associated with a sphenoidal sinus effusion.

[Multiple endocrine neoplasia type 1. Digestive hormones in the screening]. / Néoplasie endocrinienne multiple de type 1. Hormones digestives dans le dépistage.

Detection of subjects from a multiple endocrine neoplasia type 1 family must rest on clinical, biochemical and radiological data, since study of the genome is unable to detect these subjects. In the new family described here, 6 out of the 14 subjects explored were affected. One had a confirmed pancreatic endocrine tumour and in 3 others a pancreatic endocrine tumour was highly probable, since insulin and glucagon levels, as well as ultrasonic exploration of the pancreas were pathological. Measurements of gastrointestinal hormones gave normal results in all cases. We conclude that to detect this endocrine neoplasia in subjects at risk it seems necessary to measure plasma insulin levels and perform an abdominal ultrasonography.

[Pheochromocytoma. Study of a personal series of 85 cases]. / Le phéochromocytome. Enseignements tirés d'une série de 85 cas personnels.

The study of a personal series of 85 cases observed by the same endocrinologist over a period of 40 years shows the modifications of clinical presentation and biological methods of diagnosis and treatment. There is a striking increase in the percentage of patients without any cardiac or vascular manifestations. The methoxyamines assay has the best sensitivity and specificity even in asymptomatic tumors. The recent development of this assay in the blood is very efficient. The tumor may be found with an abdominal CT scan. The use of NMR is not fruitful. The 131I MIBG scintigraphy is necessary if the CT scan is not informative and in malignant forms. The malignancy is more frequent (16.5%) than classical according to the long duration of the disease. The quite good prognosis is improved by the administration of 131I MIBG. The surgery was safer and without mortality over the last 15 years.

Ecology of lactobacilli in the oral cavity: a review of literature.

Lactobacilli appear in the oral cavity during the first years of a child's life. Their presence depends on numerous factors such as the presence of ecological niches e.g. natural anfractuosities of the teeth.A strong correlation has been established between the saliva Lactobacillus count and dental caries, the higher the DMF index, the higher the number of children harbouring a high Lactobacillus count.Among children, the presence of lactobacilli in coronal caries is incontestable. Among adults, lactobacilli are found in root caries. Since 1999, taxonomical revisions make it difficult to interpret the results obtained in the numerous previous studies carried out on the identification of oral lactobacilli, but whatever the sampling method or the identification technique, the carious site or the age of sampled subjects, most species belong to the Lactobacillus casei group.This is important because if a specific correlation can be found between few species of lactobacilli and caries a better understanding of their properties could allow the development of new tools for prevention.

Malignant pheochromocytoma: a series of 14 cases observed between 1966 and 1990.

We report 14 patients (9 males, 5 females) aged 15-59 years, treated for malignant pheochromocytoma. These patients were observed during the 1966-1990 period along with 68 other patients presenting benign pheochromocytomas. From the initial general presentation of the 14 patients, two groups could be individualized. In seven patients, the initial presentation seemed benign. After the excision, the recovery was complete, but patients recurred on average 7.8 yr later (range 1-22 yr). Tumors were intraadrenal in six cases (5 single, 1 bilateral) and extraadrenal in one case. In the seven remaining patients, malignancy was evident from the first examination. The tumors were intraadrenal in 2 cases, extraadrenal in 5 cases. Frequency of extraadrenal locations (6/14) was in this series significantly higher than in benign forms (9/68). Diagnosis of malignancy was based on metastases in 12 cases (lymph nodes in 5, bones in 5, liver in 4, lung in 2, brain in 1) and on peritumoral extension in 2 cases. No biological specificity was detected in urinary excretion of catecholamines or its metabolites. In 6 patients so far studied, an uptake of 131I MIBG was found in the tumor and/or metastases. Four patients received therapeutic doses of 131I MIBG and in three of them, this treatment led to a good result within a follow-up range of 12 to 66 months.(ABSTRACT TRUNCATED AT 250 WORDS)

[Plasma methoxyamines assay: a practical advance for the diagnosis of pheochromocytoma]. / Le dosage des méthoxyamines plasmatiques: une avancée pratique dans le diagnostic du phéochromocytome.

Measurement of plasma methoxyamines is aimed to provide a reliable plasma marker readily available for any patient suspected of having a pheochromocytoma. The present HPLC method is able to detect methoxyamine amounts as low as 0.2 nmoles/l and allows the determination of both free or conjugated methoxyamines (metanephrine MN and normetanephrine NMN) in normal subjects, treated or untreated patients and a fortiori in pheochromocytoma. The analytical specificity is excellent. Among most usual antihypertensive drugs, only conversion enzyme inhibitors and diuretics induce in some patients a moderate increase of NMN with minor consequence in values interpretation. The kidney plays a major role in the blood clearance of methoxyamines and any alteration of renal function is associated to the increase of plasma methoxyamine levels. Plasma methoxyamines have a long half-life and are long-lasting integrated markers of catecholamine secretion; at variance with plasma free catecholamines, they are able to afford the presence of a secreting pheochromocytoma whatever the clinical presentation--asymptomatic or paroxysmal form between the crisis. The diagnostic sensitivity (at least 98%) is equal to that of urinary methoxyamines, far higher than plasma or urine catecholamines or urine VMA (60 to 70%).

[An orodental epidemiologic survey conducted in the school environment in the Great Southwest of France]. / Enquête épidémiologique bucco-dentaire menée en milieu scolaire dans le Grand Sud-Ouest.

Within the framework of a national epidemiological study, a regional study of the oral conditions of a representative survey of 1174 schoolchildren aged 6 to 15 years, was conducted in the south-west Region of France. This Region studied by the Dental School of Bordeaux comprised the departments of Dordogne, Gironde, Landes, Lot-et-Garonne, Pyrénées-Atlantiques, Charente and Charente-Maritime. Only 8.8% of the 15 years old children were caries free. The mean DMFT was 4.3 at age 12 years whereas the mean DMFS at the same age was 6.6. At the age of 15, these indices reached respectively the values of 6.5 and 11.4. The most affected sites were the pits and fissures, followed by the approximal and smooth surfaces (respectively 59.3%, 25.4% and 15.3% at age 15). The plaque index varied only slightly around 0.9, whereas the calculus index increased regularly from 0.0 to 0.4 between the ages of 6 to 15 years. The gingival index, which was 0.1 at age 6, remained stable around 0.3 between 8 and 15 years of age.