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Xiang Y, Wang S, Huang H, Li X, Wei Y, Li H, Ji X. A novel endolysin from an Enterococcus faecalis phage and application. Microb Pathog 2024; 192:106689. [PMID: 38750777 DOI: 10.1016/j.micpath.2024.106689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/03/2024] [Accepted: 05/12/2024] [Indexed: 05/26/2024]
Abstract
Enterococcus faecalis is the primary species detected in cases of secondary persistent infection resulting from root canal therapy failure. Due to the overuse of antibacterial agents, E. faecalis has developed resistance to these drugs, making it challenging to treat clinical diseases caused by E. faecalis infection. Therefore, there is an urgent need to explore new alternative drugs for treating E. faecalis infections. We aimed to clone and express the genes of phage endolysins, purify the recombinant proteins, and analyze their antibacterial activity, lysis profile, and ability to remove biofilm. The crude enzyme of phage endolysin pEF51 (0.715 mg/mL), derived from phage PEf771 infecting E. faecalis, exhibited superior bacterial inhibitory activity and a broader bactericidal spectrum than its parental phage PEf771. Furthermore, pEF51 demonstrated high efficacy in eliminating E. faecalis biofilm. Therapeutic results of the infected Sprague-Dawley (SD) rat model indicated that among 10 SD rats, only one developed a thoracic peritoneal abscess and splenic peritoneal abscess after 72 h of treatment with pEF51. This suggests that pEF51 could provide protection against E. faecalis infection in SD rats. Based on the 16S rDNA metagenomic data of the intestinal microbial community of SD rats, endolysin pEF51 exerted a certain influence on the diversity of intestinal microorganisms at the genus level. Thus, pEF51 may serve as a promising alternative to antibiotics in the management of E. faecalis infection.
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Affiliation(s)
- Yingying Xiang
- -Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Suping Wang
- -Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, 650500, China
| | - Hao Huang
- -Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Xuelin Li
- -Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Yunlin Wei
- -Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, 650500, China
| | - Haiyan Li
- -Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, 650500, China
| | - Xiuling Ji
- -Life Science and Technology & Medical Faculty, Kunming University of Science and Technology, Kunming, 650500, China.
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2
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Manoil D, Parga A, Bostanci N, Belibasakis GN. Microbial diagnostics in periodontal diseases. Periodontol 2000 2024; 95:176-193. [PMID: 38797888 DOI: 10.1111/prd.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
Microbial analytical methods have been instrumental in elucidating the complex microbial etiology of periodontal diseases, by shaping our understanding of subgingival community dynamics. Certain pathobionts can orchestrate the establishment of dysbiotic communities that can subvert the host immune system, triggering inflammation and tissue destruction. Yet, diagnosis and management of periodontal conditions still rely on clinical and radiographic examinations, overlooking the well-established microbial etiology. This review summarizes the chronological emergence of periodontal etiological models and the co-evolution with technological advances in microbial detection. We additionally review the microbial analytical approaches currently accessible to clinicians, highlighting their value in broadening the periodontal assessment. The epidemiological importance of obtaining culture-based antimicrobial susceptibility profiles of periodontal taxa for antibiotic resistance surveillance is also underscored, together with clinically relevant analytical approaches to guide antibiotherapy choices, when necessary. Furthermore, the importance of 16S-based community and shotgun metagenomic profiling is discussed in outlining dysbiotic microbial signatures. Because dysbiosis precedes periodontal damage, biomarker identification offers early diagnostic possibilities to forestall disease relapses during maintenance. Altogether, this review highlights the underutilized potential of clinical microbiology in periodontology, spotlighting the clinical areas most conductive to its diagnostic implementation for enhancing prevention, treatment predictability, and addressing global antibiotic resistance.
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Affiliation(s)
- Daniel Manoil
- Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Ana Parga
- Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
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3
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Yang D, Xiang Y, Song F, Li H, Ji X. Phage therapy: A renewed approach against oral diseases caused by Enterococcus faecalis infections. Microb Pathog 2024; 189:106574. [PMID: 38354990 DOI: 10.1016/j.micpath.2024.106574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/16/2024]
Abstract
Antibiotics play an important role in the treatment of infectious diseases. Long-term overuse or misuse of antibiotics, however, has triggered the global crisis of antibiotic resistance, bringing challenges to treating clinical infection. Bacteriophages (phages) are the viruses infecting bacterial cells. Due to high host specificity, high bactericidal activity, and good biosafety, phages have been used as natural alternative antibacterial agents to fight against multiple drug-resistant bacteria. Enterococcus faecalis is the main species detected in secondary persistent infection caused by failure of root canal therapy. Due to strong tolerance and the formation of biofilm, E. faecalis can survive the changes in pH, temperature, and osmotic pressure in the mouth and thus is one of the main causes of periapical lesions. This paper summarizes the advantages of phage therapy, its applications in treating oral diseases caused by E. faecalis infections, and the challenges it faces. It offers a new perspective on phage therapy in oral diseases.
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Affiliation(s)
- Dan Yang
- Medical School, Kunming University of Science and Technology, Kunming, 650500, China
| | - Yingying Xiang
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Fei Song
- Department of Minimally Invasive Intervention, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, China
| | - Haiyan Li
- Medical School, Kunming University of Science and Technology, Kunming, 650500, China
| | - Xiuling Ji
- Medical School, Kunming University of Science and Technology, Kunming, 650500, China.
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Liu X, Jiang S, Zhang T, Xu Z, Liu L, Zhang Z, Pan S, Li Y. "Magnet" Based on Activated Silver Nanoparticles Adsorbed Bacteria to Predict Refractory Apical Periodontitis Via Surface-Enhanced Raman Scattering. ACS APPLIED MATERIALS & INTERFACES 2024; 16:8499-8508. [PMID: 38335515 DOI: 10.1021/acsami.3c16677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Refractory apical periodontitis (RAP) is an endodontic apical inflammatory disease caused by Enterococcus faecalis (E. faecalis). Bacterial detection using surface-enhanced Raman scattering (SERS) technology is a hot research topic, but the specific and direct detection of oral bacteria is a challenge, especially in real clinical samples. In this paper, we develop a novel SERS-based green platform for label-free detection of oral bacteria. The platform was built on silver nanoparticles with a two-step enhancement way using NaBH4 and sodium (Na+) to form "hot spots," which resulted in an enhanced SERS fingerprint of E. faecalis with fast, quantitative, lower-limit, reproducibility, and stability. In combination with machine learning, four different oral bacteria (E. faecalis, Porphyromonas gingivalis, Streptococcus mutans, and Escherichia coli) could be intelligently distinguished. The unlabeled detection method emphasized the specificity of E. faecalis in simulated saliva, serum, and even real samples from patients with clinical root periapical disease. In addition, the assay has been shown to be environmentally friendly and without secondary contamination through antimicrobial assays. The proposed label-free, rapid, safe, and green SERS detection strategy for oral bacteria provided an innovative solution for the early diagnosis and prevention of RAP and other perioral diseases.
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Affiliation(s)
- Xin Liu
- The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
| | - Shen Jiang
- College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
| | - Ting Zhang
- College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Department of Inorganic Chemistry and Physical Chemistry, College of Pharmacy, Harbin Medical University, Heilongjiang 150081, P. R. China
| | - Ziming Xu
- The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
| | - Ling Liu
- College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
| | - Zhe Zhang
- College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- College of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
| | - Shuang Pan
- The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
- Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, Heilongjiang 150001, P. R. China
| | - Yang Li
- College of Pharmacy, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Research Center for Innovative Technology of Pharmaceutical Analysis, Harbin Medical University, Harbin, Heilongjiang 150081, P. R. China
- Research Unit of Health Sciences and Technology (HST), Faculty of Medicine University of Oulu, 2125B, Aapistie 5A, Oulu 90220, Finland
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Xiang Y, Yang R, Li X, Huang H, Duan K, Song F. Phage PEf771 for the Treatment of Periapical Periodontitis Induced by Enterococcus faecalis YN771. Crit Rev Immunol 2024; 44:41-53. [PMID: 37947071 DOI: 10.1615/critrevimmunol.2023050313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Enterococcus faecalis was the main causative bacteria of refractory periapical periodontitis (PP), there is a pressing need to explore effective methods for eradicating E. faecalis in patients with refractory PP. This study aimed to assess the anti-infective effectiveness of phage PEf771 in treating periapical inflammation in rats. We developed a rat model of PP through E. faecalis YN771 induction. Micro-computed tomography and hematoxylin-eosin staining were utilized to evaluate bone destruction and inflammation in experimental teeth for seven consecutive weeks. Subsequently, rats with PP caused by E. faecalis YN771 were treated with phage PEf771, calcium hydroxide preparation, and 2% chlorhexidine gel. The healing progress of bone defects and inflammation in the apical region was monitored over three consecutive weeks using imaging and histopathology assessments. The PP rat model was successfully developed, and bone destruction and inflammatory cell infiltration in the apical region of the experimental tooth peaked at 4 weeks. The area of bone destruction in rats treated with phage PEf771, calcium hydroxide preparation, and 2% chlorhexidine gel was significantly smaller than that in the untreated group. Phage PEf771, calcium hydroxide preparation, and 2% chlorhexi-dine gel all have the effect of promoting the healing of apical lesions. Therapeutic effects of phage PEf771 on periapical inflammation infected by E. faecalis YN771 enhanced with time. Phage PEf771 promoted the healing of apical lesions, presenting a promising new approach for the treatment of refractory PP using bacteriophages.
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Affiliation(s)
- Yingying Xiang
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Rongyu Yang
- Department of Clinical Medicine, First Affiliated Hospital of Dali University, Dali, Yunnan, China
| | - Xuelin Li
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Hao Huang
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Kaiwen Duan
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Fei Song
- Department of Minimally Invasive Intervention, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Xiang Y, Wang S, Huang H, Li X, Li H, Tu Y, Wei Y, Song F, Ji X. A novel holin from an Enterococcus faecalis phage and application in vitro and in vivo. Microb Pathog 2024; 186:106471. [PMID: 38048838 DOI: 10.1016/j.micpath.2023.106471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
Enterococcus faecalis, a conditional pathogenic bacterium, is prevalent in the intestinal, oral, and reproductive tracts of humans and animals, causing a variety of infectious diseases. E. faecalis is the main species detected in secondary persistent infection from root canal therapy failure. Due to the abuse of antibacterial agents, E. faecalis has evolved its resistant ability. Therefore, it is difficult to treat clinical diseases infected by E. faecalis. Exploring new alternative drugs for treating E. faecalis infection is urgent. We cloned and expressed the gene of phage holin, purified the recombinant protein, and analyzed the antibacterial activity, lysis profile, and ability to remove bacterial biofilm. It showed that the crude enzyme of phage holin pEF191 exhibited superior bacterial inhibiting activity and a broader lysis host range compared to the parent phage PEf771. In addition, pEF191 demonstrated high efficacy in eliminating E. faecalis biofilm. The therapeutic results of the Sprague-Dawley (SD) rats model infected showed that pEf191 did not affect SD rats, indicating that pEF191 provided greater protection against E. faecalis infection in SD rats. Based on the 16 S rDNA data of SD rats intestinal microorganism population, holin pEF191 exhibited no impact on the diversity of intestinal microorganisms at the phylum and genus levels and improved the relative abundance of favorable bacteria. Thus, pEF191 may serve as a promising alternative to antibiotics in the management of E. faecalis infection.
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Affiliation(s)
- Yingying Xiang
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Suping Wang
- Facculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Hao Huang
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Xuelin Li
- Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650031, China
| | - Haiyan Li
- Medical School, Kunming University of Science and Technology, 650500, Kunming, China
| | - Yungui Tu
- Anning First People's Hospital Affiliated to Kunming University of Science and Technology, China
| | - Yunlin Wei
- Facculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Fei Song
- Department of Minimally invasive intervention, the Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, China.
| | - Xiuling Ji
- Medical School, Kunming University of Science and Technology, 650500, Kunming, China.
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Elashiry MM, Bergeron BE, Tay FR. Enterococcus faecalis in secondary apical periodontitis: Mechanisms of bacterial survival and disease persistence. Microb Pathog 2023; 183:106337. [PMID: 37683835 DOI: 10.1016/j.micpath.2023.106337] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Enterococcus faecalis is a commensal bacterium commonly found in the human gastrointestinal tract. However, in individuals with compromised immune systems, the pathogen can lead to severe illness. This opportunistic pathogen is associated with secondary apical diseases and is adept at resisting antibiotics and other forms of treatment because of its numerous virulence factors. Enterococcus faecalis is capable of disrupting the normal functions of immune cells, thereby hindering the body's ability to eradicate the infection. However, intensive research is needed in further understanding the adverse immunomodulatory effects of E. faecalis. Potential strategies specific for eradicating E. faecalis have proven beneficial in the treatment of persistent secondary apical periodontitis.
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Affiliation(s)
- Mohamed M Elashiry
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA; Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Brian E Bergeron
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA
| | - Franklin R Tay
- Department of Endodontics, Dental College of Georgia, Augusta University, Georgia, USA
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In Vitro Evaluation of Five Newly Isolated Bacteriophages against E. faecalis Biofilm for Their Potential Use against Post-Treatment Apical Periodontitis. Pharmaceutics 2022; 14:pharmaceutics14091779. [PMID: 36145527 PMCID: PMC9503355 DOI: 10.3390/pharmaceutics14091779] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
State-of-the-art treatment of root canal infection includes the use of mechanical debridement and chemical agents. This disinfection method is limited, and microorganisms can remain in the canal system. Enterococcus faecalis appears with a high prevalence in secondary and persistent root canal infections and can be linked to endodontic treatment failure due to its various resistance mechanisms. Here, we evaluated the activity of newly isolated bacteriophages against clinical isolates of E. faecalis (including one vancomycin- and gentamicin-resistant strain) as a single treatment or in combination with gentamicin and vancomycin. For the resistant strain, daptomycin and fosfomycin were tested. Sixteen E. faecalis strains were used to screen for the presence of bacteriophages in sewage. Five different bacteriophages were characterized in terms of virion morphology, host range and killing-kinetics against each E. faecalis host strain. To investigate the antibiofilm effect of antibiotic and phages, E. faecalis biofilm was grown on porous glass beads and treated with different antibiotic concentrations and with isolated bacteriophages alone or in staggered combinations. A strong biofilm reduction was observed when phages were combined with antibiotic, where combinations with gentamicin showed a better outcome compared to vancomycin. Regarding the resistant strain, daptomycin had a superior antibiofilm effect than fosfomycin.
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Luo X, Wan Q, Cheng L, Xu R. Mechanisms of bone remodeling and therapeutic strategies in chronic apical periodontitis. Front Cell Infect Microbiol 2022; 12:908859. [PMID: 35937695 PMCID: PMC9353524 DOI: 10.3389/fcimb.2022.908859] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 12/19/2022] Open
Abstract
Chronic periapical periodontitis (CAP) is a typical oral disease in which periodontal inflammation caused by an odontogenic infection eventually leads to bone loss. Uncontrolled infections often lead to extensive bone loss around the root tip, which ultimately leads to tooth loss. The main clinical issue in the treatment of periapical periodontitis is the repair of jawbone defects, and infection control is the first priority. However, the oral cavity is an open environment, and the distribution of microorganisms through the mouth in jawbone defects is inevitable. The subversion of host cell metabolism by oral microorganisms initiates disease. The presence of microorganisms stimulates a series of immune responses, which in turn stimulates bone healing. Given the above background, we intended to examine the paradoxes and connections between microorganisms and jaw defect repair in anticipation of new ideas for jaw defect repair. To this end, we reviewed the microbial factors, human signaling pathways, immune cells, and cytokines involved in the development of CAP, as well as concentrated growth factor (CGF) and stem cells in bone defect repair, with the aim of understanding the impact of microbial factors on host cell metabolism to inform the etiology and clinical management of CAP.
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Affiliation(s)
| | | | - Lei Cheng
- *Correspondence: Lei Cheng, ; Ruoshi Xu,
| | - Ruoshi Xu
- *Correspondence: Lei Cheng, ; Ruoshi Xu,
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