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Maddeppungeng NM, Syahirah NA, Hidayati N, Rahman FUA, Mansjur KQ, Rieuwpassa IE, Setiawati D, Fadhlullah M, Aziz AYR, Salsabila A, Alsayed AR, Pamornpathomkul B, Permana AD, Hasyim R. Specific delivery of metronidazole using microparticles and thermosensitive in situ hydrogel for intrapocket administration as an alternative in periodontitis treatment. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2024; 35:1726-1749. [PMID: 38769614 DOI: 10.1080/09205063.2024.2349414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/25/2024] [Indexed: 05/22/2024]
Abstract
Periodontitis is a common chronic inflammatory disease primarily caused by the prevalence of bacterial overgrowth resulting in the development of an inflammatory condition that destroys the tooth's supporting tissues and eventual tooth loss. Comparatively, to other treatment methods, it is difficult for topical antibacterial drugs to effectively permeate the biofilm's physical barrier, making conventional therapy for periodontitis more challenging. This novel study combines thermosensitive in situ hydrogel with microparticles (MPs) to enhance the targeted delivery of metronidazole (MET) to the periodontal pocket. Polycaprolactone (PCL) polymer was utilized to produce bacteria-sensitive MPs. Additionally, the study assessed the attributes of MPs and demonstrated an enhancement in the in vitro antibacterial efficacy of MPs towards Staphylococcus aureus (SA) and Escherichia coli (EC). Subsequently, we incorporated MET-MPs into thermosensitive in situ hydrogel formulations using chitosan. The optimized formulations exhibited stability, appropriate gelation temperature, mucoadhesive strength, and viscosity. In vitro permeation tests showed selective and prolonged drug release against SA and EC. Ex vivo experiments demonstrated no significant differences between in situ hydrogel containing pure MET and MET-MPs in biofilm quantity, bacterial counts, and metabolic activity in biofilms. According to in vitro tests and the effectiveness of the antibacterial activity, this study has exhibited a novel methodology for more efficacious therapies for periodontitis. This study aims to utilize MET in MPs to improve its effectiveness, enhance its antibacterial activity, and improve patient treatment outcomes. In further research, the efficacy of the treatment should be investigated in vivo using an appropriate animal model.
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Affiliation(s)
- Nurul Muhlisah Maddeppungeng
- Department of Pharmacy, Faculty of Medicine and Health Sciences, Alauddin Islamic State University, Samata Gowa, Indonesia
| | | | - Nasyrah Hidayati
- Department of Orthodontic, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Fadhlil U A Rahman
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Karima Qurnia Mansjur
- Department of Orthodontic, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Irene E Rieuwpassa
- Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Dian Setiawati
- Department of Periodontology, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Muhammad Fadhlullah
- Veterinary Paramedic Study Program, Faculty of Vocational Study, Hasanuddin University, Makassar, Indonesia
| | | | | | - Ahmad R Alsayed
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | | | | | - Rafikah Hasyim
- Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
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Berto LA, Ettmayer JB, Stutzer D, Nietzsche S, Niederhauser T, Burger J, Sculean A, Eick S, Hofmann M. In-vitro effects of novel periodontal scalers with a planar ultrasonic piezoelectric transducer on periodontal biofilm removal, dentine surface roughness, and periodontal ligament fibroblasts adhesion. Clin Oral Investig 2024; 28:294. [PMID: 38698252 PMCID: PMC11065928 DOI: 10.1007/s00784-024-05671-w] [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: 12/11/2023] [Accepted: 04/21/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES To compare ultrasonic scaler prototypes based on a planar piezoelectric transducer with different working frequencies featuring a titanium (Ti-20, Ti-28, and Ti-40) or stainless steel (SS-28) instrument, with a commercially available scaler (com-29) in terms of biofilm removal and reformation, dentine surface roughness and adhesion of periodontal fibroblasts. MATERIALS AND METHODS A periodontal multi-species biofilm was formed on specimens with dentine slices. Thereafter specimens were instrumented with scalers in a periodontal pocket model or left untreated (control). The remaining biofilms were quantified and allowed to reform on instrumented dentine slices. In addition, fibroblasts were seeded for attachment evaluation after 72 h of incubation. Dentine surface roughness was analyzed before and after instrumentation. RESULTS All tested instruments reduced the colony-forming unit (cfu) counts by about 3 to 4 log10 and the biofilm quantity (each p < 0.01 vs. control), but with no statistically significant difference between the instrumented groups. After 24-hour biofilm reformation, no differences in cfu counts were observed between any groups, but the biofilm quantity was about 50% in all instrumented groups compared to the control. The attachment of fibroblasts on instrumented dentine was significantly higher than on untreated dentine (p < 0.05), with the exception of Ti-20. The dentine surface roughness was not affected by any instrumentation. CONCLUSIONS The planar piezoelectric scaler prototypes are able to efficiently remove biofilm without dentine surface alterations, regardless of the operating frequency or instrument material. CLINICAL RELEVANCE Ultrasonic scalers based on a planar piezoelectric transducer might be an alternative to currently available ultrasonic scalers.
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Affiliation(s)
- Luciana Aranha Berto
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, CH-3010, Switzerland
| | - Johanna Blanda Ettmayer
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, CH-3010, Switzerland
| | - Diego Stutzer
- Institute for Human Centered Engineering, Bern University of Applied Sciences, Quellgasse 21, Biel, CH-2501, Switzerland
| | - Sandor Nietzsche
- Center of Electron Microscopy, University Hospital Jena, Ziegelmühlenweg 1, D-07743, Jena, Germany
| | - Thomas Niederhauser
- Institute for Human Centered Engineering, Bern University of Applied Sciences, Quellgasse 21, Biel, CH-2501, Switzerland
| | - Juergen Burger
- School of Biomedical and Precision Engineering, University of Bern, Gueterstrasse 24/26, Bern, CH-3008, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, CH-3010, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, CH-3010, Switzerland.
| | - Martin Hofmann
- School of Biomedical and Precision Engineering, University of Bern, Gueterstrasse 24/26, Bern, CH-3008, Switzerland
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Borov S, Baldauf B, Henke J, Pavaci H, Perani A, Zrenner B, Dietl J, Mehilli J, Lau EW, Vonthein R, Bonnemeier H. Use of a taurolidine containing antimicrobial wash to reduce cardiac implantable electronic device infection. Europace 2023; 25:euad306. [PMID: 37831737 PMCID: PMC10616572 DOI: 10.1093/europace/euad306] [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: 07/24/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
AIMS TauroPace (Tauropharm, Bavaria Germany), a taurolidine solution for combating cardiac implantable electronic device (CIED) infection, was compared with a historical control of 3% hydrogen peroxide (H2O2) in a prospective observational study. METHODS AND RESULTS The device pocket was irrigated, and all hardware accessible within (leads, suture sleeves, pulse generator) was wiped with H2O2, TauroPace, or taurolidine in a galenic formulation during any invasive CIED procedure at the study centre. Only CIED procedures covered by TauroPace or H2O2 from 1 January 2017 to 28 February 2022 were included for analysis. Patients who underwent >1 procedure were censored for the last treatment group and reassigned at the next procedure. The primary endpoint was major CIED infection within 3 months. The secondary endpoints were CIED infection beyond 3 months, adverse events potentially related to the antimicrobial solutions, CIED system, procedure, and death, till the end of follow-up. TauroPace covered 654 procedures on 631 patients, and H2O2 covered 551 procedures on 532 patients. The TauroPace group had more patient risk factors for infection than the H2O2 group (P = 0.0058) but similar device and procedure-specific risk factors (P = 0.17). Cardiac implantable electronic device infection occurred in 0/654 (0%) of the TauroPace group and 6/551 (1.1%) of the H2O2 group (P = 0.0075). Death occurred in 23/654 (3.5%) of the TauroPace group and 14/551 (2.5%) of the H2O2 group (P = 0.33). Non-infection related adverse events were rarer in the TauroPace (3.8%) than the H2O2 (6.0%) group (P = 0.0802). CONCLUSION TauroPace is safe but more effective than H2O2 in reducing CIED infection. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05576194.
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Affiliation(s)
- Stefan Borov
- Department of Cardiology, Klinikum Freising, Alois-Steinecker-Straße 18, Freising 85354, Germany
- Medical Faculty, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
| | - Benito Baldauf
- Medical Faculty, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
- Institute of Life Science, Hochschule Bremerhaven, An der Karlstadt 8, Bremerhaven 27568, Germany
| | - Jana Henke
- Medical Faculty, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
| | - Herribert Pavaci
- Krankenhaus Landshut Achdorf, Achdorfer Weg 3, Landshut 84036, Germany
| | - Arben Perani
- Krankenhaus Landshut Achdorf, Achdorfer Weg 3, Landshut 84036, Germany
| | - Bernhard Zrenner
- Krankenhaus Landshut Achdorf, Achdorfer Weg 3, Landshut 84036, Germany
| | - Josef Dietl
- Krankenhaus Landshut Achdorf, Achdorfer Weg 3, Landshut 84036, Germany
| | - Julinda Mehilli
- Krankenhaus Landshut Achdorf, Achdorfer Weg 3, Landshut 84036, Germany
| | - Ernest W Lau
- Department of Cardiology, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK
| | - Reinhard Vonthein
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - Hendrik Bonnemeier
- Medical Faculty, Christian-Albrechts University, Christian-Albrechts-Platz 4, Kiel 24118, Germany
- Institute of Life Science, Hochschule Bremerhaven, An der Karlstadt 8, Bremerhaven 27568, Germany
- Department of Cardiology, Helios Klinikum Cuxhaven, Altenwalder Ch 10, Cuxhaven 27474, Germany
- Department of Cardiology, Helios Klinikum Wesermarsch, Mildred-Scheel-Straße 1, Nordenham 26954, Germany
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Su Y, Yrastorza JT, Matis M, Cusick J, Zhao S, Wang G, Xie J. Biofilms: Formation, Research Models, Potential Targets, and Methods for Prevention and Treatment. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2203291. [PMID: 36031384 PMCID: PMC9561771 DOI: 10.1002/advs.202203291] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/31/2022] [Indexed: 05/28/2023]
Abstract
Due to the continuous rise in biofilm-related infections, biofilms seriously threaten human health. The formation of biofilms makes conventional antibiotics ineffective and dampens immune clearance. Therefore, it is important to understand the mechanisms of biofilm formation and develop novel strategies to treat biofilms more effectively. This review article begins with an introduction to biofilm formation in various clinical scenarios and their corresponding therapy. Established biofilm models used in research are then summarized. The potential targets which may assist in the development of new strategies for combating biofilms are further discussed. The novel technologies developed recently for the prevention and treatment of biofilms including antimicrobial surface coatings, physical removal of biofilms, development of new antimicrobial molecules, and delivery of antimicrobial agents are subsequently presented. Finally, directions for future studies are pointed out.
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Affiliation(s)
- Yajuan Su
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Jaime T. Yrastorza
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Mitchell Matis
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Jenna Cusick
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Siwei Zhao
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Guangshun Wang
- Department of Pathology and MicrobiologyCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
| | - Jingwei Xie
- Department of Surgery‐Transplant and Mary & Dick Holland Regenerative Medicine ProgramCollege of MedicineUniversity of Nebraska Medical CenterOmahaNE68198USA
- Department of Mechanical and Materials EngineeringCollege of EngineeringUniversity of Nebraska‐LincolnLincolnNE68588USA
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The In-Vitro Activity of a Cold Atmospheric Plasma Device Utilizing Ambient Air against Bacteria and Biofilms Associated with Periodontal or Peri-Implant Diseases. Antibiotics (Basel) 2022; 11:antibiotics11060752. [PMID: 35740158 PMCID: PMC9219831 DOI: 10.3390/antibiotics11060752] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/15/2022] Open
Abstract
Due to its antimicrobial and healing-promoting effects, the application of cold atmospheric plasma (CAP) appears to be a promising modality in various fields of general medicine and dentistry. The aim of the present study was to evaluate the antibacterial and anti-biofilm activity of a handheld device utilizing ambient air for plasma generation. Suspensions of 11 oral bacteria (among them Fusobacterium nucleatum, Porphyromonas gingivalis, Parvimonas micra, Streptococcus gordonii, and Tannerella forsythia) were exposed to CAP for 10, 30, 60, and 120 s. Before and after treatment, colony forming unit (CFU) counts were determined. Then, 12-species biofilms were cultured on dentin and titanium specimens, and CAP was applied for 30, 60, and 120 s before quantifying CFU counts, biofilm mass, and metabolic activity. A reduction of ≥3 log10 CFU, was found for ten out of the eleven tested species at 30 s (except for T. forsythia) and for all species at 60 s. For biofilm grown on dentin and titanium specimens, the log10 reductions were 2.43 log10 CFU/specimen and by about 4 log10 CFU/specimen after 120 s of CAP. The CAP application did not reduce the biomass significantly, the metabolic activity of the biofilms on dentin and titanium decreased by 98% and 95% after 120 s of CAP. An application of 120 s of CAP had no cytotoxic effect on gingival fibroblasts and significantly increased the adhesion of gingival fibroblasts to the titanium surface. These results are promising and underline the potential of CAP for implementation in periodontal and peri-implantitis therapy.
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Jiang M, Liu L, Liu R, Lam KS, Lane NE, Yao W. A new anabolic compound, LLP2A-Ale, reserves periodontal bone loss in mice through augmentation of bone formation. BMC Pharmacol Toxicol 2020; 21:76. [PMID: 33187558 PMCID: PMC7664094 DOI: 10.1186/s40360-020-00454-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/27/2020] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Currently, there are no effective medications to reverse periodontal disease (PD)-induced bone loss. The objective of this study was to test a new anabolic compound, LLP2A-Ale, or with the combination treatment of mesenchymal stromal cell (MSC), in the treatment of bone loss secondary to PD. METHODS PD was induced in mice by placing a ligature around the second right molar. At one week after disease induction, the mice were treated with placebo, LLP2A-Ale, MSCs, or combination of LLP2A-Ale + MSCs, and euthanized at week 4. RESULTS We found that PD induced alveolar bone loss that was associated with reduced bone formation. LLP2A-Ale alone or in combination with MSCs sustained alveolar bone formation and reversed alveolar bone loss. Additionally, PD alone caused systemic inflammation and increased the circulating levels of G-CSF, IP-10, MIP-1a, and MIP2, which were suppressed by LLP2A-Ale +/- MSCs. LLP2A-Ale +/- MSCs increased bone formation at the peripheral skeletal site (distal femur), which was otherwise suppressed by PD. CONCLUSION Our findings indicated that LLP2A-Ale treatment rescued alveolar bone loss caused by PD, primarily by increasing bone formation. LLP2A-Ale also attenuated the circulating levels of a series of inflammatory cytokines and reversed the PD-induced suppression of systemic bone formation.
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Affiliation(s)
- Min Jiang
- Department of Internal Medicine, University of California, Davis Medical Center, 4625 2nd Avenue, Sacramento, CA, 95817, USA
- Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Lixian Liu
- Department of Internal Medicine, University of California, Davis Medical Center, 4625 2nd Avenue, Sacramento, CA, 95817, USA
- Yunan Vocational and Technical College of Agriculture, Kunming, 650031, Yunan, China
| | - Ruiwu Liu
- Department of Biochemistry & Molecular Medicine, University of California Davis, Sacramento, CA, 95817, USA
| | - Kit S Lam
- Department of Biochemistry & Molecular Medicine, University of California Davis, Sacramento, CA, 95817, USA
| | - Nancy E Lane
- Department of Internal Medicine, University of California, Davis Medical Center, 4625 2nd Avenue, Sacramento, CA, 95817, USA
| | - Wei Yao
- Department of Internal Medicine, University of California, Davis Medical Center, 4625 2nd Avenue, Sacramento, CA, 95817, USA.
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Isola G, Matarese G, Ramaglia L, Pedullà E, Rapisarda E, Iorio-Siciliano V. Association between periodontitis and glycosylated haemoglobin before diabetes onset: a cross-sectional study. Clin Oral Investig 2020; 24:2799-2808. [PMID: 31776665 DOI: 10.1007/s00784-019-03143-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of the present cross-sectional study was to investigate the association between serum glycosylated haemoglobin (HbA1c) levels and periodontal status in patients with periodontitis (CP) and periodontally healthy controls. Furthermore, the objectives were to determine if the periodontitis influenced the serum HbA1c levels. MATERIALS AND METHODS A total of 93 patients with CP and 95 periodontally healthy subjects were enrolled in the present study using a cross-sectional design. At baseline, patients were examined and characterized on a regular basis for blood serum parameters and non-fasting blood samples levels. In all patients, a full periodontal examination was performed and clinical attachment loss (CAL) was the primary outcome variable chosen. The spearman correlation, a stepwise multivariable linear regression, and Jonckheere-Terpstra tests were applied in order to assess the relationship between HbA1c levels and periodontitis. RESULTS Patients in the CP group presented a significantly higher median serum level of HbA1c [40.9 (31.2; 45.6) mmol/mol)] compared to patients in the healthy control group [35.3 (29.6; 38.6) mmol/mol)] (p < 0.001). HbA1c levels were negatively correlated with the number of teeth and positively correlated with C-reactive protein levels and all periodontal parameters (p < 0.001). Moreover, there was a significant decrease in the number of teeth when HbA1c levels increased (P-trend < 0.001), while there was a significant increase in periodontal parameters (CAL, p = 0.002); PD, p = 0.008; BOP, p < 0.001) when levels of HbA1c increased. CONCLUSIONS Patients with CP and undiagnosed diabetes presented significantly higher serum levels of HbA1c compared to periodontally healthy controls. Moreover, the presence of periodontitis was positively correlated with serum HbA1c levels before diabetes onset. CLINICAL RELEVANCE HbA1c levels were positively correlated with the severity of periodontitis before diabetes onset.
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Affiliation(s)
- Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia n° 78, 95125, Catania, Italy.
| | - Giovanni Matarese
- Department of Biomedical, Odontostomatological, Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy
| | - Luca Ramaglia
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia n° 78, 95125, Catania, Italy
| | - Ernesto Rapisarda
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia n° 78, 95125, Catania, Italy
| | - Vincenzo Iorio-Siciliano
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
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Schmid JL, Kirchberg M, Sarembe S, Kiesow A, Sculean A, Mäder K, Buchholz M, Eick S. In Vitro Evaluation of Antimicrobial Activity of Minocycline Formulations for Topical Application in Periodontal Therapy. Pharmaceutics 2020; 12:pharmaceutics12040352. [PMID: 32295046 PMCID: PMC7238147 DOI: 10.3390/pharmaceutics12040352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 12/12/2022] Open
Abstract
Periodontal therapy using antimicrobials that are topically applied requires slow or controlled release devices. The in vitro antimicrobial activity of biodegradable polymer formulations that contain a new minocycline lipid complex (P-MLC) was evaluated. The new P-MLC formulations that contained 11.5% minocycline were compared with pure minocycline or an existing commercial formulation, which included determination of minimal inhibitory concentration (MIC) values against two oral bacteria and activity on six-species periodontal biofilm. Moreover, the flow of gingival crevicular fluid (GCF) was modeled up to 42 d and the obtained eluates were tested both for MIC values and inhibiting biofilm formation. In general, MICs of the P-MLC formulations were slightly increased as compared with pure minocycline. Biofilm formation was clearly inhibited by all tested formulations containing minocycline with no clear difference between them. In 3.5 d old biofilms, all formulations with 250 µg/mL minocycline decreased bacterial counts by 3 log10 and metabolic activity with no difference to pure antimicrobials. Eluates of experimental formulations showed superiority in antimicrobial activity. Eluates of one experimental formulation (P503-MLC) still inhibited biofilm formation at 28 d, with a reduction by 1.87 log10 colony forming units (CFU) vs. the untreated control. The new experimental formulations can easily be instilled in periodontal pockets and represent alternatives in local antimicrobials, and thus warrant further testing.
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Affiliation(s)
- Jan-Luca Schmid
- Laboratory of Oral Microbiology, Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
| | - Martin Kirchberg
- Institute of Pharmacy, Martin-Luther University Halle, D-06120 Halle (Saale), Germany; (M.K.); (K.M.)
| | - Sandra Sarembe
- Characterization of Medical and Cosmetic Care Products, Fraunhofer Institute for Microstructures and Materials IMWS, D-06120 Halle/Saale, Germany; (S.S.); (A.K.)
| | - Andreas Kiesow
- Characterization of Medical and Cosmetic Care Products, Fraunhofer Institute for Microstructures and Materials IMWS, D-06120 Halle/Saale, Germany; (S.S.); (A.K.)
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
| | - Karsten Mäder
- Institute of Pharmacy, Martin-Luther University Halle, D-06120 Halle (Saale), Germany; (M.K.); (K.M.)
| | - Mirko Buchholz
- Drug Design and Target Validation, Fraunhofer Institute for Cell Therapy and Immunology IZI-MWT and PerioTrap Pharmaceuticals GmbH, D-06120 Halle/Saale, Germany;
| | - Sigrun Eick
- Laboratory of Oral Microbiology, Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
- Correspondence:
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Radakovic S, Andreoli N, Schmid S, Nietzsche S, Zumbrunn J, Sculean A, Eick S. Taurolidine Acts on Bacterial Virulence Factors and Does Not Induce Resistance in Periodontitis-Associated Bacteria-An In-Vitro Study. Antibiotics (Basel) 2020; 9:antibiotics9040166. [PMID: 32272629 PMCID: PMC7235838 DOI: 10.3390/antibiotics9040166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 11/16/2022] Open
Abstract
The aims of the present study were: (a) to determine the mechanism of action of taurolidine against bacterial species associated with periodontal disease, and (b) to evaluate the potential development of resistance against taurolidine as compared with minocycline. After visualizing the mode of action of taurolidine by transmission electron micrographs, the interaction with most important virulence factors (lipopolysaccharide (LPS), Porphyromonas gingivalis gingipains, Aggregatibacter actinomycetemcomitans leukotoxin), was analyzed. Then, 14 clinical isolates from subgingival biofilm samples were transferred on agar plates containing subinhibitory concentrations of taurolidine or minocycline up to 50 passages. Before and after each 10 passages, minimal inhibitory concentrations (MICs) were determined. Increasing MICs were screened for efflux mechanism. Taurolidine inhibited in a concentration-dependent manner the activities of LPS and of the arginine-specific gingipains; however, an effect on A. actinomycetemcomitans leukotoxin was not detected. One P. gingivalis strain developed a resistance against taurolidine, which was probably linked with efflux mechanisms. An increase of MIC values of minocycline occurred in five of the 14 included strains after exposure to subinhibitory concentrations of the antibiotic. The present results indicate that: (a) taurolidine interacts with LPS and gingipains, and (b) development of resistance seems to be a rare event when using taurolidine.
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Affiliation(s)
- Sabrina Radakovic
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.R.); (N.A.); (S.S.); (A.S.)
| | - Nicola Andreoli
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.R.); (N.A.); (S.S.); (A.S.)
| | - Simon Schmid
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.R.); (N.A.); (S.S.); (A.S.)
| | - Sandor Nietzsche
- Center for Electron Microscopy, Jena University Hospital, D-07743 Jena, Germany;
| | - Jürg Zumbrunn
- Department of Clinical Affairs R& D, Geistlich Pharma Ag, CH-6110 Wolhusen, Switzerland;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.R.); (N.A.); (S.S.); (A.S.)
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (S.R.); (N.A.); (S.S.); (A.S.)
- Correspondence:
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Wang HH, Lee HM, Raja V, Hou W, Iacono VJ, Scaduto J, Johnson F, Golub LM, Gu Y. Enhanced efficacy of chemically modified curcumin in experimental periodontitis: systemic implications. J Exp Pharmacol 2019; 11:1-14. [PMID: 30774454 PMCID: PMC6350653 DOI: 10.2147/jep.s171119] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction Dental microbial biofilm initiates gingival inflammation, and its suppression is the current dominant strategy for treating periodontitis. However, the host response to the biofilm is largely responsible for the connective tissue breakdown including alveolar bone loss, which is mediated by proinflammatory cytokines and matrix metalloproteinases (MMPs). Methods The current study compared the efficacy of a novel host-modulation compound, a chemically modified curcumin (CMC 2.24), to that of its parent compound (natural curcumin), in both lipopolysaccharide (LPS) (a bacterial endotoxin)-induced cell culture and in vivo models of periodontitis. Results In cell culture, both CMC 2.24 and curcumin appeared similarly effective in suppressing LPS-induced cytokine (IL-1β and TNF-α) secretion by mononuclear inflammatory cells; however, CMC 2.24 significantly reduced MMP-9 secretion by 78% (P<0.05) whereas curcumin was ineffective. In vivo, CMC 2.24 administration was more effective than curcumin in suppressing (a) IL-1β in gingival tissue and (b) MMP-9 in both gingiva and plasma, the latter indicating a reduced severity of systemic inflammation. The difference in primary clinical outcome between the two treatments was that CMC 2.24 reduced the pathologically excessive alveolar bone loss, assessed morphometrically at multiple sites, by 80%-90% (P<0.01), whereas curcumin, surprisingly, either increased (P<0.05) or had no effect on alveolar bone loss at these sites. Conclusion These data, plus that from previous studies, support the therapeutic potential of CMC 2.24 in the management of inflammatory periodontal disease and its ability to reduce the risk of associated systemic diseases. The current study also indicates that the MMP-9 inhibitor efficacy is associated with the ability of CMC 2.24 (but not curcumin) to inhibit alveolar bone loss in this rat model of periodontitis.
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Affiliation(s)
- Howard H Wang
- Department of Periodontology and Endodontology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Hsi-Ming Lee
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Veena Raja
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Wei Hou
- Department of Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Vincent J Iacono
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | | | - Francis Johnson
- Department of Chemistry, Stony Brook University, Stony Brook, NY, USA.,Department of Pharmacological Sciences, Stony Brook University, Stony Brook, NY, USA
| | - Lorne M Golub
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ying Gu
- Department of General Dentistry, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA,
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