Treponema denticola dentilisin triggered TLR2/MyD88 activation upregulates a tissue destructive program involving MMPs via Sp1 in human oral cells.

Periodontal disease is driven by dysbiosis in the oral microbiome, resulting in over-representation of species that induce the release of pro-inflammatory cytokines, chemokines, and tissue-remodeling matrix metalloproteinases (MMPs) in the periodontium. These chronic tissue-destructive inflammatory responses result in gradual loss of tooth-supporting alveolar bone. The oral spirochete Treponema denticola, is consistently found at significantly elevated levels in periodontal lesions. Host-expressed Toll-Like Receptor 2 (TLR2) senses a variety of bacterial ligands, including acylated lipopolysaccharides and lipoproteins. T. denticola dentilisin, a surface-expressed protease complex comprised of three lipoproteins has been implicated as a virulence factor in periodontal disease, primarily due to its proteolytic activity. While the role of acylated bacterial components in induction of inflammation is well-studied, little attention has been given to the potential role of the acylated nature of dentilisin. The purpose of this study was to test the hypothesis that T. denticola dentilisin activates a TLR2-dependent mechanism, leading to upregulation of tissue-destructive genes in periodontal tissue. RNA-sequencing of periodontal ligament cells challenged with T. denticola bacteria revealed significant upregulation of genes associated with extracellular matrix organization and degradation including potentially tissue-specific inducible MMPs that may play novel roles in modulating host immune responses that have yet to be characterized within the context of oral disease. The Gram-negative oral commensal, Veillonella parvula, failed to upregulate these same MMPs. Dentilisin-induced upregulation of MMPs was mediated via TLR2 and MyD88 activation, since knockdown of expression of either abrogated these effects. Challenge with purified dentilisin upregulated the same MMPs while a dentilisin-deficient T. denticola mutant had no effect. Finally, T. denticola-mediated activation of TLR2/MyD88 lead to the nuclear translocation of the transcription factor Sp1, which was shown to be a critical regulator of all T. denticola-dependent MMP expression. Taken together, these data suggest that T. denticola dentilisin stimulates tissue-destructive cellular processes in a TLR2/MyD88/Sp1-dependent fashion.

Host-microbe interactions: Profiles in the transcriptome, the proteome, and the metabolome.

Periodontal studies using transcriptomics, proteomics, and metabolomics encompass the collection of mRNA transcripts, proteins, and small-molecule chemicals in the context of periodontal health and disease. The number of studies using these approaches has significantly increased in the last decade and they have provided new insight into the pathogenesis and host-microbe interactions that define periodontal diseases. This review provides an overview of current molecular findings using -omic approaches that underlie periodontal disease, including modulation of the host immune response, tissue homeostasis, and complex metabolic processes of the host and the oral microbiome. Integration of these -omic approaches will broaden our perspective of the molecular mechanisms involved in periodontal disease, advancing and improving the diagnosis and treatment of various stages and forms of periodontal disease.

Monitoring the Curriculum through the Student Perspective.

Student input was deliberately included as part of the curriculum implementation and assessment plan at the University of Minnesota College of Veterinary Medicine. The new curriculum included design features to encourage deeper learning such as a spiral curriculum with cross-course integration, increased open time, and more active learning. Student well-being was seen as a simultaneous need. To gather overall perceptions of workload and well-being, student volunteers from each cohort were surveyed weekly starting in 2013. Survey questions asked about out-of-class work time, level of integration, extracurricular activities, student well-being habits, paid employment, and other factors. Survey questions were combined with course data to get a full picture of week quality, total course work time, extracurricular activities, and the effects of integration. Many of our hypotheses about curricular and extracurricular impacts on week quality were disproven. Week quality was most positively affected by student factors of sleep and exercise, whereas the curricular factors of out-of-class work time, total course work time, and examination hours had the strongest negative effects. A surprising finding was that open time, in-class hours, and paid employment hours had a minimal effect on week quality. Students identified excessively heavy semesters and uneven semester workloads that resulted in early revisions to the new curriculum. Student feedback provided a view of the curriculum that was not otherwise available and resulted in early and significant impacts on the new curriculum, and they provided insight into whether planned changes had occurred and how effective various factors were in reaching the curricular goals.

Challenges & Issues: Evidence-Based Clinical Skills Teaching and Learning: What Do We Really Know?

The recent programmatic focus on skills development in veterinary medicine means that many programs are devoting increased time to formal clinical skills teaching. This expansion makes it essential that we use the time as effectively as possible. This review examines current practices and veterinary training principles using the broader field of evidence-based motor skills learning as a lens. In many areas, current practices may be hindering learning. Proposed practices include using videos and discussions for pre-laboratory training, focusing on a single complex skill at a time, using more near-peer instructors rather than faculty, including assessments in each teaching or practice session, and encouraging supervised distributed practice by incorporating practice sessions into the formal curriculum. Ensuring mastery of a few core skills rather than exposure to many may be the new goal. Further research is urgently needed on block versus spiral curricula, optimum instructor-to-student ratios, learning and practice schedules, hours required for proficiency, and the benefits of exercise on motor skills learning.

Curriculum Review and Revision at the University of Minnesota College of Veterinary Medicine.

Curriculum review is an essential part of ongoing curriculum development, and is a mandate of the American Veterinary Medical Association Council on Education (AVMA COE), the accrediting body of all North American schools and colleges of veterinary medicine. This article describes the steps in curriculum review undertaken by the University of Minnesota College of Veterinary Medicine (UMN CVM) in response to this mandate from the COE and to a recommendation from a recent collegiate review that was part of a larger university-level strategic planning effort. The challenges of reviewing and revising the curriculum within a short time frame were met by appointing a dedicated curriculum review board and by engaging students and faculty groups, both as focus groups and as specific faculty work sections within disciplines. Faculty voting on the process was very valuable as it permitted the curriculum review board and faculty groups to move ahead knowing there was a process in place for reassessment if most faculty did not agree with recommendations. Consistent support from the dean of the college and other administrators was vital in helping maintain momentum for curriculum review.

Creation of a metric for faculty effort in teaching in the veterinary curriculum.

A teaching-effort metric was generated using information from health sciences literature and self-reported data from faculty members. This metric was used to verify faculty effort based on teaching assignments, to equalize teaching between faculty members within disciplines, and to help faculty members understand the ramifications of new teaching opportunities on their overall effort.

Large intra-abdominal abscess treatment by marsupialization in 2 alpacas.

OBJECTIVES: To report the clinical signs, diagnostic findings, surgical treatment, postoperative complications, and long-term outcome in 2 adult alpacas with large intra-abdominal abscesses treated by marsupialization of the abscess to the ventral body wall. STUDY DESIGN: Clinical report. ANIMALS: Alpacas (n = 2). METHODS: Two alpacas each presented with decreased appetite, lethargy, poor body condition, and marked abdominal distension. A complete physical examination, abdominal radiography, and ultrasonography confirmed the presence of large intra-abdominal abscesses. Streptococcus equi ssp. zooepidemicus was cultured from the abscess fluid of alpaca 1, and a Gram-negative bacillus from alpaca 2. RESULTS: Both alpacas had exploratory celiotomy with marsupialization of the abdominal abscess to the ventral body wall. Postoperatively, alpacas were administered systemic antibiotics and non-steroidal anti-inflammatory drugs, and the abscesses were lavaged for several days. Alpaca 2 required a second surgical procedure. The abscesses ultimately resolved in both alpacas, with body wall hernia formation as the only major complication. Both alpacas had good long-term outcomes. CONCLUSION: Marsupialization to the ventral abdominal wall with concurrent antibiotic treatment should be considered as a treatment option for alpacas with large intra-abdominal abscesses in which complete surgical resection of the abscess is not possible. An abdominal wall hernia can result from this procedure, and clients should be informed of this potential complication before surgery.

Tolerability of lomustine in combination with cyclophosphamide in dogs with lymphoma.

This retrospective study describes toxicity associated with a protocol of lomustine (CCNU) and cyclophosphamide (CTX) in dogs with lymphoma. CCNU was administered per os (PO) at a targeted dosage of 60 mg/m(2) body surface area on day 0, CTX was administered PO at a targeted dosage of 250 mg/m(2) divided over days 0 through 4, and all dogs received prophylactic antibiotics. Ninety treatments were given to the 57 dogs included in the study. Neutropenia was the principal toxic effect, and the overall frequency of grade 4 neutropenia after the first treatment of CCNU/CTX was 30% (95% confidence interval, 19-43%). The mean body weight of dogs with grade 4 neutropenia (19.7 kg ± 13.4 kg) was significantly less than the mean body weight of dogs that did not develop grade 4 neutropenia (31.7 kg ± 12.4 kg; P = .005). One dog (3%) developed hematologic changes suggestive of hepatotoxicity. No dogs had evidence of either renal toxicity or hemorrhagic cystitis. Adverse gastrointestinal effects were uncommon. On the basis of the findings reported herein, a dose of 60 mg/m(2) of CCNU combined with 250 mg/m(2) of CTX (divided over 5 days) q 4 wk is tolerable in tumor-bearing dogs.

Purification of Native Dentilisin Complex from Treponema denticola by Preparative Continuous Polyacrylamide Gel Electrophoresis and Functional Analysis by Gelatin Zymography.

Periodontal disease is characterized by the destruction of the hard and soft tissues comprising the periodontium. This destruction translates to a degradation of the extracellular matrices (ECM), mediated by bacterial proteases, host-derived matrix metalloproteinases (MMPs), and other proteases released by host tissues and immune cells. Bacterial pathogens interact with host tissue, triggering adverse cellular functions, including a heightened immune response, tissue destruction, and tissue migration. The oral spirochete Treponema denticola is highly associated with periodontal disease. Dentilisin, a T. denticola outer membrane protein complex, contributes to the chronic activation of pro-MMP-2 in periodontal ligament (PDL) cells and triggers increased expression levels of activators and effectors of active MMP-2 in PDL cells. Despite these advances, no mechanism for dentilisin-induced MMP-2 activation or PDL cytopathic behaviors leading to disease is known. Here, we describe a method for purification of large amounts of the dentilisin protease complex from T. denticola and demonstrate its ability to activate MMP-2, a key regulator of periodontal tissue homeostasis. The T. denticola dentilisin and MMP-2 activation model presented here may provide new insights into the dentilisin protein and identify potential therapeutic targets for further research. Key features • This protocol builds upon a method described by Cunningham et al. [1] for selective release of Treponema outer membrane proteins. • We adapted the protocol for the purification of biologically active, detergent-stable outer membrane protein complexes from large batch cultures of T. denticola. • The protocol involves large-scale preparative electrophoresis using a Model 491 Prep Cell. • We then use gelatin zymography to demonstrate the activity of the purified dentilisin complex by its ability to activate matrix metalloproteinase 2 (MMP-2).

Solid Lipid Nanoparticles Loaded with Nisin (SLN-Nisin) are More Effective Than Free Nisin as Antimicrobial, Antibiofilm, and Anticancer Agents.

Bacteriocins are peptides produced by bacteria to inhibit the growth of other prokaryotes. Nisin is a bacteriocin widely used in the food industry and for biomedical applications. However, bacteriocins have some limitations, as they experience mechanisms of resistance, degradation by proteases, and suboptimal intracellular delivery. Combining bacteriocins with nanoscale drug delivery systems (nano-DDS) is an approach that can help overcome these limitations. Among the nano-DDS, solid lipid nanoparticles (SLN) have been described as promising candidates, because of their potential for industrial scale-up and lower toxicity. The objective of this proof-of-concept study was to investigate the use of nisin-loaded SLN (SLN-Nisin) as an antimicrobial and anticancer therapeutic. We show that SLN-Nisin can significantly inhibit the growth of the oral pathogen, Treponema denticola, disrupt oral biofilms, and decrease oral squamous cell carcinoma cell (OSCC) viability compared to free nisin. Further, analysis with scanning electron microscopy (SEM) revealed significant morphological changes in OSCC cells challenged with SLN-Nisin, compared to the empty-nanoparticle or free nisin, indicating that SLN-Nisin likely decreases cell viability by increasing pore formation. This data reveals that nano-DDS are robust tools that can enhance bacteriocin properties.

Cross-sectional study to investigate the association between vitamin D status and cutaneous mast cell tumours in Labrador retrievers.

Epidemiological data indicate that low serum vitamin D concentrations are associated with an increased risk of a variety of human tumours. Cutaneous mast cell tumours (MCT) occur more frequently in dogs than in any other species. Canine MCT express the vitamin D receptor, and vitamin D derivatives have in vitro and in vivo anti-tumour activity. We sought to examine the association between vitamin D serum level and MCT in Labrador retrievers, a dog breed predisposed to MCT development. To examine this association, serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations were examined in eighty-seven Labrador retrievers, including thirty-three with MCT and fifty-four unaffected controls. The relationship between cases and controls and 25(OH)D3 level, age and body condition score were evaluated using univariate and multivariate analyses. Potential differences in vitamin D oral intake, calculated on the basis of a dietary questionnaire, were also evaluated between groups. Mean 25(OH)D3 concentration (104 (SD 30) nmol/l) in dogs with MCT was significantly lower than that of unaffected dogs (120 (SD 35) nmol/l; P = 0.027). The mean calculated vitamin D intake per kg body weight in Labrador retrievers with MCT was not statistically different from that of unaffected Labrador retrievers (0.38 (SD 0.25) and 0.31 (SD 0.22) µg/kg body weight, respectively; P = 0.13). These findings suggest that low levels of 25(OH)D3 might be a risk factor for MCT in Labrador retrievers. Prospective cohort studies are warranted.

Blastomycotic osteomyelitis associated with severe lameness in a horse.

A 12-year-old Quarter horse gelding was presented for evaluation of severe right forelimb lameness, 2 draining tracts over the lateral aspect of the right proximal antebrachium, and weight loss. A presumptive diagnosis of blastomycotic osteomyelitis was established based on radiographs and cytology of the exudate. This diagnosis was confirmed at necropsy.

Treponema denticola-Induced RASA4 Upregulation Mediates Cytoskeletal Dysfunction and MMP-2 Activity in Periodontal Fibroblasts.

The periodontal complex consists of the periodontal ligament (PDL), alveolar bone, and cementum, which work together to turn mechanical load into biological responses that are responsible for maintaining a homeostatic environment. However oral microbes, under conditions of dysbiosis, may challenge the actin dynamic properties of the PDL in the context of periodontal disease. To study this process, we examined host-microbial interactions in the context of the periodontium via molecular and functional cell assays and showed that human PDL cell interactions with Treponema denticola induce actin depolymerization through a novel actin reorganization signaling mechanism. This actin reorganization mechanism and loss of cell adhesion is a pathological response characterized by an initial upregulation of RASA4 mRNA expression resulting in an increase in matrix metalloproteinase-2 activity. This mechanism is specific to the T. denticola effector protein, dentilisin, thereby uncovering a novel effect for Treponema denticola-mediated RASA4 transcriptional activation and actin depolymerization in primary human PDL cells.

Survival time for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone: the Canine Lymphoma Steroid Only trial.

OBJECTIVE: To evaluate survival times for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone. ANIMALS: 109 client-owned dogs recruited from 15 institutions in the United States. PROCEDURES: Dogs were treated with prednisone at a dosage of 40 mg/m2, PO, once daily for 7 days and at a dosage of 20 mg/m2, PO, once daily thereafter. Quality of life (QOL) was assessed by owners with a visual analog scale when treatment was started (day 0), 1 and 2 weeks after treatment was started, and every 4 weeks thereafter. The primary outcome of interest was survival time as determined by the Kaplan-Meier method. Factors potentially associated with survival time were examined. RESULTS: Median overall survival time was 50 days (95% CI, 41 to 59 days). Factors associated with survival time included substage (a vs b) and immunophenotype (B cell vs T cell). Owner-assigned QOL scores on days 0 and 14 were significantly positively correlated with survival time. When QOL score was dichotomized, dogs with day 0 or day 14 QOL scores ≥ 50 had significantly longer survival times, compared with dogs with day 0 or day 14 QOL scores < 50. No variables were predictive of long-term (> 120 days) survival. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that survival times were short for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone. Owner-perceived QOL and clinician-assigned substage were both associated with survival time. Findings provide potentially important information for clinicians to discuss with owners of dogs with lymphoma at the time treatment decisions are made.

Evaluation of diffusion of triamcinolone acetonide from the distal interphalangeal joint into the navicular bursa in horses.

OBJECTIVE: To determine whether triamcinolone acetonide diffuses from the distal interphalangeal joint (DIPJ) to the navicular bursa, diffusion is direct or systemic, and addition of sodium hyaluronan has an effect on diffusion in horses. ANIMALS: 11 adult horses without forelimb lameness. PROCEDURES: 1 randomly chosen forelimb DIPJ of each horse received an injection of 10 mg of triamcinolone acetonide plus 20 mg of sodium hyaluronan (group 1), and the contralateral forelimb DIPJ received an injection of 10 mg of triamcinolone acetonide plus 2 mL of lactated Ringer's solution (group 2). Synovial fluid samples were taken from both forelimb navicular bursae and 1 hind limb navicular bursa (systemic control group) at 6 hours. Triamcinolone acetonide concentrations in synovial fluid were quantified by use of high-performance liquid chromatography plus tandem mass spectrometry. Data were logarithmically transformed, and contrast analysis was performed on the 3 groups. RESULTS: Triamcinolone acetonide was detected in navicular bursal samples in all groups. Groups 1 and 2 had significantly greater concentrations of triamcinolone acetonide than the systemic control group. There was no significant difference between groups 1 and 2. CONCLUSIONS AND CLINICAL RELEVANCE: Triamcinolone acetonide diffused directly from the DIPJ into the navicular bursa in clinically normal horses, and diffusion was not affected by addition of hyaluronan. Injection into the DIPJ with triamcinolone acetonide or a triamcinolone acetonide-hyaluronan combination can potentially be used for treatment of navicular syndrome, but further studies are needed to determine whether triamcinolone acetonide diffuses similarly in horses with navicular syndrome.

The efficacy of imiquimod 5% cream (Aldara® in the treatment of aural plaque in horses: a pilot open-label clinical trial.

Aural plaques affect at least 22% of horses and can be asymptomatic or cause ear sensitivity. Immunohistochemical and electron microscopy studies have shown a strong association between aural plaques and papilloma virus. The purpose of this study was to investigate the efficacy of imiquimod 5% cream, an immune response modifier with potent antiviral activity, in the treatment of equine aural plaques. Twenty-one horses were enrolled and 16 completed the study. Imiquimod 5% cream was applied three times a week, every other week. When both ears were affected only the worst affected ear was treated. Adverse effects in all horses included marked local inflammation, exudation and thick crust formation at the site of treatment and the adjacent skin. Removal of the crust before treatment was painful and required sedation in most horses. Complete resolution of lesions was noted in all horses immediately post-treatment and the long-term resolution rate was 87.5%. Duration of therapy ranged from 1.5 to 8 months (median: 2.9 mean: 3.5). All horses were followed-up for 12-22 months after treatment was discontinued and only two horses had a recurrence of lesions. Clinical signs related to the aural plaques prior to treatment were reported in 11 of 16 (68.8%) horses and included resistance to touching the ears and bridling. Complete resolution of these signs was reported by the owners in all of the horses followed-up for at least 12 months. In conclusion, the topical application of imiquimod 5% cream is an efficacious treatment for aural plaques in horses.

Modulation of pathogenic oral biofilms towards health with nisin probiotic.

BACKGROUND: Oral dysbiosis is an imbalance in the oral microbiome and is associated with a variety of oral and systemic diseases, including periodontal disease, caries, and head and neck/oral cancer. Although antibiotics can be used to control this dysbiosis, they can lead to adverse side effects and superinfections. Thus, novel strategies have been proposed to address these shortcomings. One strategy is the use of probiotics as antimicrobial agents, since they are considered safe for humans and the environment. Specifically, the Gram-positive Lactococcus lactis, a species present in the oral and gut microbiota, is able to produce nisin, which has been used worldwide for food preservation. OBJECTIVE: The objective of this study was to test whether a nisin probiotic can promote a healthier oral microbiome in pathogen-spiked oral biofilms. RESULTS: We found that L. lactis can prevent oral biofilm formation and disrupt 24-h and 48-h pre-formed biofilms. Finally, we demonstrate that both treatments, a nisin-producing L. lactis probiotic and nisin can decrease the levels of pathogens in the biofilms and return the diversity levels back to control or 'healthy' levels. CONCLUSION: A nisin-producing probiotic, can be used to treat 'disease-altered' biofilms and promote healthier oral biofilms, which may be useful for improving patient oral health.

Identification of normal parameters for ultrasonographic examination of the equine large colon and cecum.

Six healthy horses were examined by using transabdominal ultrasonography, as described (1-3), to evaluate activity and size of the large colon and cecum at various locations. Using size and number of sacculations, activity patterns and contractile frequency; significant differences that would allow ultrasonographic identification of dorsal versus ventral colons, if they were displaced, were not found. The cecum had significantly greater activity than the colon, and a trend was seen towards smaller sacculations in the cecum than in the large colon.

Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder.

A 6-month-old female alpaca was presented for stranguria. Based on the history, physical examination findings, and radiographic studies, the alpaca was diagnosed with bladder outlet obstruction, secondary to pelvic displacement of the bladder, a condition previously unreported in camelids. Cystopexy was performed and the alpaca recovered unremarkably.