Rapid multiplex real-time PCR assay using a portable device for the detection of oral pathogens.

Colonization by several oral pathogens and the onset of oral diseases, such as dental caries and periodontal diseases, are closely related. Therefore, the analysis of pathogens in oral specimens would be helpful for the risk assessment of oral diseases. We developed a rapid multiplex real-time polymerase chain reaction (PCR) method using a portable device and newly designed probe/primer sets to detect the oral pathogens Streptococcus mutans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. The theoretical minimum detectable cell numbers of S. mutans, P. gingivalis, T. denticola, and T. forsythia were 1, 1, 4, and 3, respectively. The multiplex real-time PCR system simultaneously detected the colonization of S. mutans and P. gingivalis in human saliva. These results suggest that the multiplex real-time PCR system may be useful for the risk assessment of oral diseases.

Effect of advanced periodontal self-care in patients with early-stage periodontal diseases on endothelial function: An open-label, randomized controlled trial.

Although a significant association between periodontal disease and atherosclerotic cardiovascular disease has been reported, their cause-to-effect relationship remains controversial. This randomized controlled clinical trial aimed to investigate the effect of advanced self-care on atherosclerotic cardiovascular disease-related vascular function markers flow-mediated brachial artery dilatation (FMD) and serum asymmetric dimethylarginine (ADMA) level in patients with early-stage periodontal disease. The study was designed as a parallel group, 3-month follow-up, open-label, randomized controlled trial. The control group received standard care for periodontal diseases, whereas the test group additionally applied disinfectant using a custom-fabricated prescription tray for advanced self-care twice a day. Overall, 110 patients provided data for FMD and serum ADMA level. No significant improvements in FMD were observed in the control (mean increase, -0.1%; 95% confidence interval [CI], -1.0-0.8; P = 0.805) or test (mean increase, -0.3%; 95% CI, -1.1-0.4; P = 0.398) group. No significant changes in serum ADMA levels were observed (mean reduction, 0.01 µmol/L; 95% CI, -0.00-0.02; P = 0.366 and mean reduction, 0.00 µmol/L; 95% CI, -0.01-0.01; P = 0.349, respectively). No significant between-group differences were found in FMD (mean difference, -0.2%; 95% CI, -1.4-0.9; p = 0.708) or serum ADMA levels (mean difference, 0.01 nmol/L; 95% CI, -0.00-0.03; p = 0.122). Significant improvements in the average probing pocket depth were observed in the control and test groups. The bleeding on probing score in the test group was significantly reduced, while that in the control group was reduced, although not significantly. Periodontal care for a 3-month duration did not provide better endothelial function although improvements of periodontal status in patients with early-stage periodontal diseases. This trial is registered in UMIN Clinical Trials Registry (www.umin.ac.jp/ctr/; ID: UMIN000023395).

Inhibitory effect of black cumin (Nigella sativa) seed essential oil on Fusobacterium nucleatum L-methionine-γ-lyase (L-methioninase) activity.

The enzyme L-methionine-γ-lyase is commonly found in a wide range of bacteria and catalyzes the α-elimination and γ-elimination of L-methionine to produce methyl mercaptan, α-ketobutyrate and ammonia. Black cumin seed essential oil (BC oil) reportedly exhibits deodorizing activity against methyl mercaptan. Therefore, we hypothesized that BC oil may also suppress methyl mercaptan production. In this study, we aimed to evaluate the inhibitory effect of BC oil on L-methionine-γ-lyase activity in Fusobacterium nucleatum. Recombinant L-methionine-γ-lyase was incubated under appropriate conditions with BC oil and its constituent thymoquinone. To analyze L-methionine-γ-lyase activity, α-ketobutyric acid and ammonia concentrations were determined. The concentrations of α-ketobutyric acid and ammonia were significantly decreased by 10 µg mL-1 of BC oil (P < 0.01) and 16.4 µg/mL of thymoquinone (P < 0.05). An enzyme kinetic assay showed a mixed inhibition pattern between L-methionine-γ-lyase and thymoquinone. In conclusion, BC oil not only had a deodorizing effect against methyl mercaptan but also an inhibitory effect on methyl mercaptan production through the suppression of L-methionine-γ-lyase activity. Thymoquinone may be mainly responsible for these effects of BC oil. Thus, application of natural BC oil may be adapted not only for medical use but also in other areas of life.

Purification of a High Molecular Mass Protein in Streptococcus mutans.

Elucidation of a gene's function typically involves comparison of phenotypic traits of wild-type strains and strains in which the gene of interest has been disrupted. Loss of function following gene disruption is subsequently restored by exogenous addition of the product of the disrupted gene. This helps to determine the function of the gene. A method previously described involves generating a gtfC gene-disrupted Streptococcus mutans strain. Here, an undemanding method is described for purifying the gtfC gene product from the newly generated S. mutans strain following the gene disruption. It involves the addition of a polyhistidine-coding sequence at the 3' end of the gene of interest, which allows simple purification of the gene product using immobilized metal affinity chromatography. No enzymatic reactions other than PCR are required for the genetic modification in this method. The restoration of the gene product by exogenous addition after gene disruption is an efficient method for determining gene function, which may also be adapted to different species.

Method for functional analysis of a gene of interest in Streptococcus mutans: gene disruption followed by purification of a polyhistidine-tagged gene product.

Typical methods for elucidating the function of a particular gene involve comparative phenotypic analysis of the wild-type strain and a strain in which the gene of interest has been disrupted. We previously described a simple method for the generation of a gene-disrupted strain in Streptococcus mutans by replacing the gene of interest with an antibiotic resistance marker gene. It is also crucial that the function lost following the gene disruption is restored by exogenous addition of the gene product, but purification of this product can be difficult and involve a complex series of steps. In this study, we describe a simple method for the purification of gene products following gene disruption in S. mutans. The method involves the expression of an additional polyhistidine tag at the C-terminus of the gene product. The target protein can be simply purified by immobilized metal affinity chromatography and applied to a restoration assay. This method utilizes the genomes of both the wild-type strain and the gene-disrupted strain as PCR templates to generate the DNA construct. Therefore, generation of the gene-disrupted strain is a prerequisite for the present procedure. The combination of gene disruption and gene product purification results in an efficient method for the analysis of gene function that could be further adapted to various other bacterial species.

Generation of a Gene-disrupted Streptococcus mutans Strain Without Gene Cloning.

Typical methods for the elucidation of the function of a particular gene involve comparative phenotypic analyses of the wild-type strain and a strain in which the gene of interest has been disrupted. A gene-disruption DNA construct containing a suitable antibiotic resistance marker gene is useful for the generation of gene-disrupted strains in bacteria. However, conventional construction methods, which require gene cloning steps, involve complex and time-consuming protocols. Here, a relatively facile, rapid, and cost-effective method for targeted gene disruption in Streptococcus mutans is described. The method utilizes a 2-step fusion polymerase chain reaction (PCR) to generate the disruption construct and electroporation for genetic transformation. This method does not require an enzymatic reaction, other than PCR, and additionally offers greater flexibility in terms of the design of the disruption construct. Employment of electroporation facilitates the preparation of competent cells and improves the transformation efficiency. The present method may be adapted for the generation of gene-disrupted strains of various species.

Contribution of chloride channel permease to fluoride resistance in Streptococcus mutans.

Genes encoding fluoride transporters have been identified in bacterial and archaeal species. The genome sequence of the cariogenic Streptococcus mutans bacteria suggests the presence of a putative fluoride transporter, which is referred to as a chloride channel permease. Two homologues of this gene (GenBank locus tags SMU_1290c and SMU_1289c) reside in tandem in the genome of S. mutans The aim of this study was to determine whether the chloride channel permeases contribute to fluoride resistance. We constructed SMU_1290c- and SMU_1289c-knockout S. mutans UA159 strains. We also constructed a double-knockout strain lacking both genes. SMU_1290c or SMU_1289c was transformed into a fluoride transporter- disrupted Escherichia coli strain. All bacterial strains were cultured under appropriate conditions with or without sodium fluoride, and fluoride resistance was evaluated. All three gene-knockout S. mutans strains showed lower resistance to sodium fluoride than did the wild-type strain. No significant changes in resistance to other sodium halides were recognized between the wild-type and double-knockout strains. Both SMU_1290c and SMU_1289c transformation rescued fluoride transporter-disrupted E. coli cell from fluoride toxicity. We conclude that the chloride channel permeases contribute to fluoride resistance in S. mutans.

Application of chimeric glucanase comprising mutanase and dextranase for prevention of dental biofilm formation.

Water-insoluble glucan (WIG) produced by mutans streptococci, an important cariogenic pathogen, plays an important role in the formation of dental biofilm and adhesion of biofilm to tooth surfaces. Glucanohydrolases, such as mutanase (α-1,3-glucanase) and dextranase (α-1,6-glucanase), are able to hydrolyze WIG. The purposes of this study were to construct bi-functional chimeric glucanase, composed of mutanase and dextranase, and to examine the effects of this chimeric glucanase on the formation and decomposition of biofilm. The mutanase gene from Paenibacillus humicus NA1123 and the dextranase gene from Streptococcus mutans ATCC 25175 were cloned and ligated into a pE-SUMOstar Amp plasmid vector. The resultant his-tagged fusion chimeric glucanase was expressed in Escherichia coli BL21 (DE3) and partially purified. The effects of chimeric glucanase on the formation and decomposition of biofilm formed on a glass surface by Streptococcus sobrinus 6715 glucosyltransferases were then examined. This biofilm was fractionated into firmly adherent, loosely adherent, and non-adherent WIG fractions. Amounts of WIG in each fraction were determined by a phenol-sulfuric acid method, and reducing sugars were quantified by the Somogyi-Nelson method. Chimeric glucanase reduced the formation of the total amount of WIG in a dose-dependent manner, and significant reductions of WIG in the adherent fraction were observed. Moreover, the chimeric glucanase was able to decompose biofilm, being 4.1 times more effective at glucan inhibition of biofilm formation than a mixture of dextranase and mutanase. These results suggest that the chimeric glucanase is useful for prevention of dental biofilm formation.

Differential susceptibility to hydrogen sulfide-induced apoptosis between PHLDA1-overexpressing oral cancer cell lines and oral keratinocytes: role of PHLDA1 as an apoptosis suppressor.

Hydrogen sulfide (H2S) is a novel gasotransmitter that plays multiple biological roles in various body systems. In addition to its endogenous production, H2S is produced by bacteria colonizing digestive organs, including the oral cavity. H2S was previously shown to enhance pro-apoptotic effects in cancer cell lines, although the mechanisms involved remain unclear. To properly assess the anti-cancer effects of H2S, however, investigations of apoptotic effects in normal cells are also necessary. The aims of this study were (1) to compare the susceptibility to H2S-induced apoptosis between the oral cancer cell line Ca9-22 and oral keratinocytes that were derived from healthy gingiva, and (2) to identify candidate genes involved in the induction of apoptosis by H2S. The susceptibility to H2S-induced apoptosis in Ca9-22 cells was significantly higher than that in keratinocytes. H2S exposure in Ca9-22 cells, but not keratinocytes, enhanced the expression of pleckstrin homology-like domain, family A, member 1 (PHLDA1), which was identified through a differential display method. In addition, PHLDA1 expression increased during actinomycin D-induced apoptosis in Ca9-22 cells. Knockdown of PHLDA1 expression by small interfering RNA in Ca9-22 cells led to expression of active caspase 3, thus indicating apoptosis induction. The tongue cancer cell line SCC-25, which expresses PHLDA1 at a high level, showed similar effects. Our data indicate that H2S is an anti-cancer compound that may contribute to the low incidence of oral cancer. Furthermore, we demonstrated the role of PHLDA1 as an apoptosis suppressor.

Effects of a composition containing lactoferrin and lactoperoxidase on oral malodor and salivary bacteria: a randomized, double-blind, crossover, placebo-controlled clinical trial.

We report a clinical trial of the effects of test tablets containing bovine lactoferrin and lactoperoxidase on oral malodor and salivary bacteria. Fifteen subjects with volatile sulfur compounds (VSCs) in mouth air above the olfactory threshold (H(2)S >1.5 or CH(3)SH >0.5 ng/10 ml) as detected by gas chromatography were enrolled in the trial. Either a test or a placebo tablet was ingested twice at 1-h intervals in two crossover phases. Mouth air was monitored for VSC levels at the baseline before ingestion of a tablet, 10 min after the first ingestion, 1 h (just before the second ingestion), and 2 h after the first ingestion. Whole saliva was analyzed at the baseline and at 2 h for bacterial numbers. At 10 min, the level of CH(3)SH was significantly lower in the test group (median [interquartile range] = 0.28 [0.00-0.68] ng/10 ml) compared to that in the placebo group (0.73 [0.47-1.00] ng/10 ml; P = 0.011). The median concentration of CH(3)SH in the test group was below the olfactory threshold after 10 min until 2 h, whereas the level in the placebo group was above the threshold during the experimental period. No difference in the numbers of salivary bacteria was detected by culturing or quantitative PCR, but terminal restriction fragment length polymorphism detected one fragment with a significantly lower copy number at 2 h in the test group (mean ± standard error, 4.89 ± 0.11 log(10) copies/10 µl) compared to that in the placebo group (5.38 ± 0.15 log(10) copies/10 µl; P = 0.033). These results indicate a suppressive effect of the test composition on oral malodor and suggest an influence on oral bacteria.

Oral malodorous compound activates mitochondrial pathway inducing apoptosis in human gingival fibroblasts.

Hydrogen sulfide (H(2)S) is a main cause of physiologic halitosis. H(2)S induces apoptosis in human gingival cells, which may play an important role in periodontal pathology. Recently, it has been reported that H(2)S induced apoptosis and DNA damage in human gingival fibroblasts (HGFs) by increasing the levels of reactive oxygen species. However, the mechanisms of H(2)S-induced apoptosis have not been clarified in HGFs. The objective of this study was to determine the apoptotic pathway activated by H(2)S in HGFs. The HGFs were exposed to 50 ng/mL H(2)S, resulting in 18 ng/mL in the culture medium, which is lower than the concentration in periodontal pockets. The number of apoptotic cells after 24 and 48 h incubation was significantly higher than that in the control cultures (p < 0.05). Mitochondrial membrane depolarization and the release of cytochrome c, and caspase-3, and caspase-9 were also significantly increased after both 24- and 48-h incubation (p < 0.05), whereas caspase-8, a key enzyme in the receptor ligand-mediated pathway causing apoptosis, was not activated. The present study shows that H(2)S triggered the mitochondrial pathway causing apoptosis in HGFs but did not activate the receptor ligand-mediated pathway.

Oral malodorous compound inhibits osteoblast proliferation.

BACKGROUND: Oral malodorous compounds including hydrogen sulfide (H2S) are causative agents of periodontitis because the toxicities are similar to that of cyanate. Previous studies demonstrated that volatile sulfur compounds (VSCs) were highly toxic to periodontal tissues, causing a large reduction in the amount of collagen in human gingival fibroblasts and extracellular matrix as well as, for example, apoptosis, immunologic responses, and matrix metalloproteinase production. The objective of this study was to determine the effect of H2S on the proliferation of osteoblasts and a signaling transduction pathway through the mitogen-activated protein kinase (MAPK). METHODS: Normal human osteoblasts (NHOst) and murine osteoblasts (cell line MC3T3-E1) were incubated with H2S. Cell proliferation was assessed by measuring [3H]thymidine incorporation. The effects of H2S on the signal transduction pathways, the MAPK cascade, that control cell proliferation were evaluated in NHOst by determining extracellular signal-regulated kinase (ERK)1/2 and p38 phosphorylation with a Western blot analysis. RESULTS: After incubating NHOst with H2S for 24 hours, [3H]thymidine incorporation into the DNA significantly decreased dose-dependently with H(2)S. At a concentration of 100 ng/ml H2S, [3H]thymidine incorporation decreased 79% compared to the control. Similar results were obtained from MC3T3-E1. The phosphorylation of ERK1/2 and p38 was increased by H2S at 10 minutes after starting the treatment and then decreased time dependently. The activation of ERK1/2 and p38 induced by H2S was inhibited by the specific inhibitor of MAPK/ERK kinase ([MEK]; U0126) or p38 (SB203580). CONCLUSION: H2S inhibited the proliferation of human osteoblastic cells through the MAPK pathway.

Hop polyphenols suppress production of water-insoluble glucan by Streptococcus mutans and dental plaque growth in vivo.

OBJECTIVE: This study determined the effect of Hop polyphenols (HPP) on water-insoluble glucan (WIG), which is a major component of dental plaque along with microorganisms, and the effect of HPP-containing tablets on the growth of dental plaque. METHODS: The effects of HPP on Streptococcus mutans MT8148 were determined. HPP concentrations employed in this study were 0% (as the HPP control), 0.001%, 0.01%, 0.1%, and 0.5%. The average result of six independent experiments was obtained at each concentration of HPP. Suppression of plaque formation in vivo was examined by a clinical trial that was designed as a randomized, single-blind, three-treatment study using 28 healthy subjects. The subjects used either 20 mg or seven mg HPP-containing tablets representing high and low dosages, respectively. The composition of each tablet was similar, except for the level of HPP; the control tablet had none. For the treatment period, subjects took one tablet seven times a day (before breakfast, after each meal, between meals, and at bedtime) for three days. The tablets were dissolved in the mouth and naturally swallowed. Plaque levels were then assessed for the subjects in the three groups. RESULTS: In vitro, after 24-hour incubation, 0.5% HPP significantly reduced the growth of S. mutans compared to the control (p < 0.01). After 18-hour incubation, HPP at 0.1% and 0.5% significantly reduced lactic acid production (p < 0.05 and p < 0.001, respectively), and HPP at 0.01%, 0.1%, and 0.5% also suppressed WIG production (p < 0.01, p < 0.001 and p < 0.001, respectively). In vivo, the effect of HPP-containing tablets (seven times a day) on three-day dental plaque regrowth was assessed by the plaque scoring system (PSS). The high-dosage group using 20 mg HPP tablets exhibited a reduction in PSS (1.37 +/- 0.48 vs. 2.41 +/- 1.15 in the control group, p < 0.05). CONCLUSION: It was concluded that HPP tablets might be a significant means of delivering HPP onto tooth surfaces to prevent dental plaque formation.

Diurnal changes in oral malodour among dental-office workers.

PURPOSE: Dentistry is a major resource for the treatment of halitosis, therefore dental professionals must also pay attention to their own oral malodour for professional courtesy. However, oral malodour among dental professionals has not yet been investigated. In this study, the diurnal changes in oral malodour in dental-office workers were determined, and preventative measures were assessed. METHODS: Diurnal changes in the levels of volatile sulphur compounds (VSCs), which are the main cause of oral malodour, in mouth air were determined with a gas chromatograph specially designed for such analysis and the effects of several preventive measures were evaluated. RESULTS: High concentrations of VSCs in mouth air persisted during the morning and decreased after lunch. Tongue-cleaning followed by tooth brushing decreased VSCs dramatically. Further measures such as eating breakfast, drinking tea or using zinc mouthwash significantly decreased VSCs, but the effects were limited in dental hygienists who suffered from persistent oral malodour, especially in the afternoon. CONCLUSION: Eating breakfast, cleaning the tongue followed by brushing the teeth and zinc chloride mouthwash were very effective in preventing oral malodour in dental-office workers; however, the effectiveness of these preventive measures was limited in dental hygienists.

Neither hollow-fibre membrane filters nor activated-charcoal filters remove fluoride from fluoridated tap water.

BACKGROUND AND OBJECTIVE: Previous reports of the reduction of fluoride concentrations in fluoridated water by domestic water treatment systems have indicated that further supplementation with fluoride is required. However, the absorption of fluoride by filters has not yet been directly identified. If these filters do not absorb fluoride, further fluoride supplementation may increase fluorosis. In this study, we determined whether filtering systems absorb fluoride ions. MATERIALS AND METHODS: We directly measured the amounts of fluoride absorbed by activated-carbon filters or hollow-fibre membrane filters using pyrohydrolysis of the filters and flow-injection analysis, the sensitivity of which is more than 100 times greater than that of conventional methods. We made fluoride solutions of pure or tap water and determined changes in fluoride concentration as a result of filtering with a fluoride electrode. RESULTS: Hollow-fibre membrane filters did not affect fluoride concentrations in the fluoridated water, but activated-carbon filters removed some fluoride, especially from the pure-water solution. Filtering a pure-water solution with a fluoride concentration of 0.8 mg F/L reduced the fluoride concentration until 210 L of the solution had been filtered. However, filtering a tap-water solution of 0.8 mg F/L reduced the fluoride concentration only until 8 L had been filtered. The concentration of absorbed fluoride in the filter at 10 L of filtration was 4.7 mg/kg activated carbon. CONCLUSION: Further fluoride supplementation of fluoridated water should not be necessary, regardless of whether an activated-carbon or hollow-fibre membrane filter is installed on a domestic water treatment system.

Effect of green tea on volatile sulfur compounds in mouth air.

Many food products are claimed to be effective in controlling halitosis. Halitosis is caused mainly by volatile sulfur compounds (VSCs) such as H(2)S and CH(3)SH produced in the oral cavity. Oral microorganisms degrade proteinaceous substrates to cysteine and methionine, which are then converted to VSCs. Most treatments for halitosis focus on controlling the number of microorganisms in the oral cavity. Since tea polyphenols have been shown to have antimicrobial and deodorant effects, we have investigated whether green tea powder reduces VSCs in mouth air, and compared its effectiveness with that of other foods which are claimed to control halitosis. Immediately after administering the products, green tea showed the largest reduction in concentration of both H(2)S and CH(3)SH gases, especially CH(3)SH which also demonstrated a better correlation with odor strength than H(2)S; however, no reduction was observed at 1, 2 and 3 h after administration. Chewing gum, mints and parsley-seed oil product did not reduce the concentration of VSCs in mouth air at any time. Toothpaste, mints and green tea strongly inhibited VSCs production in a saliva-putrefaction system, but chewing gum and parsley-seed oil product could not inhibit saliva putrefaction. Toothpaste and green tea also demonstrated strong deodorant activities in vitro, but no significant deodorant activity of mints, chewing gum or parsley-seed oil product were observed. We concluded that green tea was very effective in reducing oral malodor temporarily because of its disinfectant and deodorant activities, whereas other foods were not effective.

Development of a compact and simple gas chromatography for oral malodor measurement.

BACKGROUND: Volatile sulfur compounds (VSCs) in oral air are the only type of gases correlated with the strength of oral malodor. We developed a compact and simple gas chromatograph (GC) equipped with a newly invented indium oxide semiconductor gas sensor (SCS) for measuring the concentrations of VSCs in mouth air. We have assessed the correlation between measurements with a GC-SCS and those with a regular GC. METHODS: Oral air samples from randomly selected volunteers were analyzed with both a GC-SCS and a GC with a flame photometric detector (FPD), which is specific to VSCs, and GC-SCS measurements were compared to those obtained by GC-FPD. Subsequently, oral air samples before and after mouthrinsing with 5% ethanol mouthwash were analyzed to determine the effect of ethanol on VSC measurements by GC-SCS. RESULTS: There were strong correlations between VSC concentrations determined using these two gas chromatography methods (hydrogen sulfide, R=0.821, P<0.0001; methyl mercaptan, R=0.870, P<0.0001; and dimethyl sulfide, R=0.770, P<0.0001). Although GC-SCS can differentiate ethanol and VSCs in oral air samples after mouthrinsing, GC-SCS measurements demonstrated higher values than those obtained by GC-FPD; however, this discrepancy improved over time due to the reduced effect of ethanol. CONCLUSION: The results suggest that GC-SCS may be useful for the diagnosis of halitosis.