Lysozyme concentrations in the gingival crevice and at other oral sites in human subjects with and without gingivitis

Potential oral probiotic Lactobacillus pentosus MJM60383 inhibits Streptococcus mutans biofilm formation by inhibiting sucrose decomposition

Streptococcus mutans is known as a contributor to dental caries. In this work, Lactobacillus pentosus MJM60383 was selected for its strong antagonistic activity against S. mutans and was characterized by good oral probiotic properties including lysozyme tolerance, adhesive ability to oral cells, good aggregation (auto-aggregation, co-aggregation) ability, hydrogen peroxide production and inhibition of biofilm formation of S. mutans. L. pentosus MJM60383 also exhibited safety as a probiotic characterized by no hemolytic activity, no D-lactate production, no biogenic amine production, and susceptibility to antibiotics. Furthermore, the biofilm formation of S. mutans was also significantly inhibited by the supernatant of L. pentosus MJM60383. An anti-biofilm mechanism study revealed that sucrose decomposition and the production of water-insoluble exopolysaccharides by S. mutans were inhibited by the treatment with L. pentosus MJM60383 supernatant. Real-time PCR analysis indicated that the supernatant of L. pentosus MJM60383 significantly inhibited the mRNA expression of S. mutans glycosyltransferases, which synthesize glucan to construct biofilm architecture and mediate bacterial adherence. Our study demonstrated L. pentosus MJM60383 as a potential oral probiotic and revealed its anti-biofilm mechanism.

Fibulin-1 regulates the pathogenesis of tissue remodeling in respiratory diseases

Airway and/or lung remodeling, involving exaggerated extracellular matrix (ECM) protein deposition, is a critical feature common to pulmonary diseases including chronic obstructive pulmonary disease (COPD), asthma, and idiopathic pulmonary fibrosis (IPF). Fibulin-1 (Fbln1), an important ECM protein involved in matrix organization, may be involved in the pathogenesis of these diseases. We found that Fbln1 was increased in COPD patients and in cigarette smoke-induced (CS-induced) experimental COPD in mice. Genetic or therapeutic inhibition of Fbln1c protected against CS-induced airway fibrosis and emphysema-like alveolar enlargement. In experimental COPD, this occurred through disrupted collagen organization and interactions with fibronectin, periostin, and tenascin-c. Genetic inhibition of Fbln1c also reduced levels of pulmonary inflammatory cells and proinflammatory cytokines/chemokines (TNF-α, IL-33, and CXCL1) in experimental COPD. Fbln1c^-/- mice also had reduced airway remodeling in experimental chronic asthma and pulmonary fibrosis. Our data show that Fbln1c may be a therapeutic target in chronic respiratory diseases.

Does variability in salivary protein concentrations influence oral microbial ecology and oral health?

Salivary protein interactions with oral microbes in vitro include aggregation, adherence, cell-killing, inhibition of metabolism, and nutrition. Such interactions might be expected to influence oral ecology. However, inconsistent results have been obtained from in vivo tests of the hypothesis that quantitative variation in salivary protein concentrations will affect oral disease prevalence. Results may have been influenced by choices made during study design, including saliva source, stimulation status, control for flow rate, and assay methods. Salivary protein concentrations also may be subject to circadian variation. Values for saliva collected at the same time of day tend to remain consistent within subjects, but events such as stress, inflammation, infection, menstruation, or pregnancy may induce short-term changes. Long-term factors such as aging, systemic disease, or medication likewise may influence salivary protein concentrations. Such sources of variation may increase the sample size needed to find statistically significant differences. Clinical studies also must consider factors such as human population variation, strain and species differences in protein-microbe interactions, protein polymorphism, and synergistic or antagonistic interaction between proteins. Salivary proteins may form heterotypic complexes with unique effects, and different proteins may exert redundant effects. Patterns of protein-microbe interaction also may differ between oral sites. Future clinical studies must take those factors into account. Promising approaches might involve meta-analysis or multi-center studies, retrospective and prospective longitudinal designs, short-term measurement of salivary protein effects, and consideration of individual variation in multiple protein effects such as aggregation, adherence, and cell-killing.

Host enzymes in gingival crevicular fluid as diagnostic indicators of periodontitis

Host responses to periodontal infections include the production of several families of enzymes that are released by stromal, epithelial or inflammatory cells. Study of these enzymes in gingival crevicular fluid may lead to insights into pathogenesis and may provide a rational basis for the development of novel diagnostic tests. However, analogous to other diagnostic interventions in dentistry and medicine, validation of host enzymes as diagnostic indicators is dependent on clear-cut demonstrations of the identity of the enzyme, reproducibility, diagnostic accuracy and clinical utility. The enzyme of interest should be readily measured over a broad range of disease severity and in varied clinical settings. Ideally, the enzyme should also be an essential component of proposed pathogenic mechanisms. In this context, the connective tissue matrix degrading enzymes elastase, collagenase and gelatinase are promising because of their apparently central role in periodontal attachment loss and disease progression. Sensitive and specific assays are also available to quantify these enzymes. Other work on enzymes associated with cell death (aspartate aminotransferase, lactate dehydrogenase) and several neutrophil lysosomal enzymes (beta glucuronidase, arylsulphatase, cathepsins) has demonstrated positive associations between enzyme levels and attachment loss and inflammation. While numerous cross-sectional studies have indicated that the levels of hydrolytic enzymes in gingival crevicular fluid parallel the severity of periodontal lesions, there are much less data on reproducibility, diagnostic accuracy and clinical utility in longitudinal studies. As appropriate study design is an essential prerequisite for establishing the efficacy of host enzymes as diagnostic tests, future clinical investigations should include: (1) individuals who would most likely benefit by early diagnosis, i.e., rapidly progressive and recurrent periodontitis cases; (2) longitudinal, cohort study designs to show that attachment loss is temporally linked with large increases in enzyme activity; (3) the use of a battery of tests to overcome intrinsic problems of low predictive values when prevalence of active disease is low. In the final analysis, the utility of host enzymes as diagnostic indicators will need to be examined in randomized controlled trials in which the question is asked: are patients better off as a result of testing?

Effect of lysozyme on glucose fermentation, cytoplasmic pH, and intracellular potassium concentrations in Streptococcus mutans 10449

Several previous findings have suggested that the cationic nature of lysozyme is a major factor in its bactericidal activity. Since a number of cationic proteins or peptides have been reported to cause membrane damage in bacteria, we investigated the effect of lysozyme on glucose fermentation and intracellular pH and K+ in Streptococcus mutans under conditions in which lysis does not occur. Results showed that lysozyme and poly-D-lysine (PDL) cause inhibition of glucose fermentation at pH 5.5 in a dose-dependent manner. Human placental lysozyme and hen egg-white lysozyme exhibited similar inhibitory potency on glucose fermentation. Both lysozyme and PDL caused a marked acidification of the cytoplasm of S. mutans. However, when cytoplasmic pH was examined as a function of fermentation rate, the relationship was similar regardless of the presence or absence of lysozyme or PDL. Therefore, acidification of the cytoplasm appeared to not depend specifically on lysozyme or PDL. In contrast, the same relationship between the profound loss of intracellular K+, when fermenting cells were exposed to either lysozyme or PDL, and the fermentation rate was not exhibited in the controls. These results indicate that lysozyme and PDL specifically affected the ability of the cells to maintain intracellular K+. We concluded that lysozyme and PDL indeed perturb membrane function, perhaps in a selective manner. Furthermore, the similarity in action of lysozyme and the cationic homopolypeptide PDL supports the notion that the cationic property of lysozyme indeed plays a significant role in its antibacterial activity.

Gingival fluid, beta 2-microglobulin and protein levels as indicators of periodontal disease

beta 2-microglobulin (beta 2-m), lysozyme and protein concentrations in gingival fluid were analyzed in 19 patients with severe periodontitis and in 19 controls devoid of any clinical signs of inflammation. A significant increase of the total protein and beta 2-m levels was found in periodontal subjects. In contrast, lysozyme concentration did not reflect the inflammatory status of the periodontium. Statistical analyses showed significant correlations between beta 2-m and protein concentrations in both groups. Furthermore, the values obtained by Periotron 600 closely correlated with the protein and beta 2-m contents, indicating that this method is a reliable aid in assessment of the quantity and quality of crevicular exudate and thus the severity of periodontal disease.

Cleavage action of a trypsin-like protease from Bacteroides gingivalis 381 on reduced egg-white lysozyme

Soluble reduced lysozyme was extensively digested by a trypsin-like protease purified from the culture supernatant of the bacterium. The digestion peptides were separated and purified by reversed-phase high-performance liquid chromatography, and were subjected to amino acid analysis. The fragments were identified by their amino acid composition, and the cleavage sites in the lysozyme chain were determined. Like mammalian trypsin, the enzyme from B. gingivalis split peptide bonds non-specifically at carboxyl sides of internal arginine and lysine residues, but the lysine present at the amino terminus of the lysozyme chain was not released. In addition, the enzyme cleaved the peptide linkage at the amino side of lysine and bonds between leucine-glycine, alanine-leucine and leucine-serine. Thus the trypsin-like protease from B. gingivalis has some cleavage actions on lysozyme different from those of mammalian trypsin.

Detection of high-risk groups and individuals for periodontal diseases: laboratory markers from analysis of gingival crevicular fluid

Gingival crevicular fluid is regarded as a promising medium for the detection of markers of periodontal diseases activity. The collection protocols are straight forward and non-invasive and can be performed at specific sites of interest in the periodontium. Because the fluid accumulates at the gingival margin, it will contain potential markers derived not only from the host tissues and serum but also the subgingival microbial plaque, and thus an extremely broad range of candidate molecules may be investigated. However, the ability to successfully describe indicators of current disease activity and predictors of future disease is dependent not only upon the choice of the biochemical marker but also on the accurate description of the health status of the sample sites using currently available clinical and radiographic methods. Areas of study which currently show the most promise involve the analysis of host enzyme activities directed against components of the extracellular matrix, the nature of the glycosaminoglycans released into the sulcus and the concentration in gingival crevicular fluid of certain mediators of the inflammatory process, most notably prostaglandin E2.

Indicators of periodontal disease activity: an evaluation

It is becoming increasingly apparent that the traditional clinical criteria are inadequate for: determining active disease sites in periodontitis, monitoring quantitatively the response to therapy or measuring the degree of susceptibility to future breakdown. In an attempt to develop objective measures, a wide variety of studies have been undertaken using saliva, blood, plaque and gingival crevicular fluid (GCF) as the specimen source. Examination has included: specific bacteria and their products; host cells and their products (enzymatic and antibacterial, both immunologic and non-immunologic); products of tissue injury derived from local epithelial and connective tissues and bone. Although most of the work to date has failed to provide reliable aids to the clinician, refinements in techniques for sampling and the availability of more sophisticated analytic techniques give cause for optimism. Methods proposed for detection of disease-associated bacteria in subgingival plaque vary in their sensitivity and specificity. Dark field microscopy shows some correlation with existing disease; however, the limited specificity of this method imposes severe restrictions on its usefulness. Highly specific polyclonal and monoclonal antisera to suspected pathogens Bacteroides gingivalis and Actinobacillus actinomycetemcomitans have been developed and improved methods of identification of these microbes in plaque by ELISA immunofluorescence and flow cytometry are under development. With respect to the host response, a strong correlation between antibody patterns to specific bacteria and periodontal disease categories appears to be emerging. Although most studies have focused on serum antibody derived from peripheral blood, a shift to detection of local antibody response appears to be likely. Techniques of measurement that are exquisitely sensitive have been developed for detection of major immune recognition proteins such as antibody and complement in crevicular fluid. Research efforts attempting to correlate local antibody response to local disease activity are underway. Measurement of GCF flow rate, endotoxin, H2S, butyrate and a variety of enzymes (e.g., collagenase, arylsulfatase, B-glucuronidase) show good correlation with levels of gingivitis. In periodontitis, the most promising markers of tissue breakdown are prostaglandins of the E series, the enzymes collagenase and aspartate aminotransferase, sulfated glycosaminoglycans, osteoclastic activating factor and bone resorptive capacity of crevicular cells. Assay of the migration of crevicular leucocytes in vivo can serve as an indicator of a defect in host resistance.(ABSTRACT TRUNCATED AT 400 WORDS)

Salivary IgA, lysozyme and beta 2-microglobulin in periodontal disease

The concentrations of IgA, lysozyme and beta 2-microglobulin (beta 2-m) were quantitated in wax-stimulated mixed saliva from 28 patients with severe periodontitis and from 28 healthy controls. The mutual correlations between IgA, lysozyme and beta 2-m were determined. In patients with periodontitis decreased lysozyme concentrations were detected when compared with controls (P less than 0.05). The correlation between IgA and beta 2-m concentrations was highly significant in both groups studied (P less than 0.0001, and P less than 0.002), whereas beta 2-m and lysozyme concentrations were positively correlated in patients but not in controls. In addition, a significant correlation between IgA and lysozyme was found only in periodontal patients (P less than 0.001).

Immunohistochemical distribution of immunoglobulins, lactoferrin, and lysozyme in human minor salivary glands

The immunofluorescence technique was used to examine the distribution of immunoglobulin A and its subclasses, secretory component (SC), J chain, lactoferrin and lysozyme in labial and lingual (von Ebner's) glands. IgA-containing plasma cells were found in the connective tissue around intercalated or intralobular ducts and a few were noted around acini of both glands. IgA was detected in the apical cytoplasm of intercalated and intralobular duct cells and in acini of von Ebner's glands and in demilunes of labial glands. Most IgA-containing cells also stained for J chain. The ratio of IgA1:IgA2-containing cells was approximately equal in von Ebner's and labial glands. Cytoplasmic and surface membrane-related staining for SC was detected in epithelial cells of the intercalated and intralobular ducts in both glands, in the serous acini of von Ebner's gland, and in the demilunes of labial glands. Lactoferrin was found in serous acini, demilunes, intercalated and intralobular ducts. Lysozyme was found in acinar and intercalated ducts, but was rarely seen in intralobular ducts. These results disclose the presence of cells (plasma cells and epithelial cells) and their products (IgA and secretory component) that indicate the local production of secretory IgA in minor salivary glands.

Lysozyme and lactoferrin quantitation in the crevicular fluid

This study was designed to determine if quantitation of lysosomal products in crevicular fluid may be useful as a diagnostic test to evaluate clinical status in periodontal disease. Levels of lysozyme and lactoferrin were quantitated in crevicular fluid from patients with gingivitis, generalized adult periodontitis, localized juvenile periodontitis and normals. Crevicular fluid (CF) was collected from each patient by standardized filter paper strips and evaluated for lysozyme and lactoferrin by rocket immunoelectrophoresis. Levels of lysozyme (micrograms of protein per microliter of CF) were significantly higher in localized juvenile periodontitis patients as compared to gingivitis and adult periodontitis. On the other hand, levels of lactoferrin (micrograms of protein per microliter of CF) did not show significant differences between gingivitis, adult periodontitis and localized juvenile periodontitis. These results indicate that a lysozyme to lactoferrin ratio could be of value as a diagnostic test for localized juvenile periodontitis patients.

Studies of immunologic and inflammatory factors in saliva in patients with asthma and in patients with periodontitis

To study the salivary response in asthma and periodontitis, calcium and phosphorus concentrations were determined from parotid and whole saliva. The IgE and histamine concentrations and the activities of lysozyme and arginine aminopeptidases were assayed from whole saliva. The values were compared with those obtained from matched healthy controls (n = 20 in each group). In whole saliva the phosphorus concentrations were elevated in the asthma group and the calcium concentrations in the periodontitis group. Regarding parotid saliva no significant differences between the groups were observed. The results indicate that in patients with asthma the IgE concentrations in whole saliva were elevated, while in patients with periodontitis and in healthy controls no detectable values were obtained. Both histamine and lysozyme concentrations seemed to increase in the asthma and periodontitis groups. A slight increase was also observed in the arginine aminopeptidase activities in the saliva of patients with asthma and patients with periodontitis.

Determination of periodontal disease activity

The determination of disease activity has a direct impact on therapeutic measures in periodontics. Evaluations that may indicate disease activity have been reviewed under the topics of traditional evaluations, gingival crevicular fluid contents, tissue changes, circulating factors, and sulcular microbiota. The traditional methods, such as probing, radiographs, and clinical indices, were static evaluations that had limited validity in determining disease activity. When used in longitudinal tests, these methods may be used retrospectively to detect disease activity. Evaluation of the contents of gingival crevicular fluid has promise as a noninvasive method of determining tissue changes in the periodontium. To date, none of the crevicular fluid constituents has been a reliable indicator of disease activity. Tissue changes in the periodontium are important in understanding the disease processes but have had limited value as indicators of disease activity. The ability to determine disease activity through identification of substances or changes in the systemic circulation would prove quite useful to the clinician. Although some reports found lymphocyte transformation indicative of active disease, others had conflicting results. Finally, examinations of sulcular microbiota provided evidence suggesting that active periodontal disease was associated with specific groups of pathogens and with elevated counts of motile organisms. The evaluation of such pathogens and motile organisms currently shows the most promise for determining periodontal disease activity. However, long-term assessments and further clinical trials are necessary before this type of evaluation can be widely accepted. It is hoped that such studies will enable the clinician to predict the natural history of active and inactive periodontal disease.

Affinity chromatography of human saliva lysozyme and effect of pH and ionic strength on lytic activity

Lysozyme from human saliva was purified in one step by affinity chromatography on chitin. The recovery, however, was always very low, typically 25-40%. When the cationic exchanger BioRex 70 was used, the enzyme was isolated from saliva with only minor loss of activity, and the product appeared to be 60-70% pure. This partially purified enzyme bound completely and reversibly to chitin and was thereby purified to homogeneity with little loss of activity (< 10%). Both saliva lysozyme and the chicken egg white lysozyme were found to exhibit their highest lytic activity at high pH/low ionic strength (pH 9.0, I = 0.03), and both enzymes required higher ionic strength) it was found, however, that the ratio of the specific activity of saliva lysozyme to that of chicken lysozyme varied considerably depending on the assay conditions used. We argue strongly, therefore, against the frequent use of chicken lysozyme as a standard of reference in work on human lysozyme.

Bacteriolytic activity of human gingival exudate

We investigated the bacteriolytic activity of gingival crevicular fluid (CF) on 14C-labeled Streptococcus faecalis, Streptococcus mutans, Staphylococcus aureus, and on whole dental plaque. CF was collected from 100 healthy donors pooled and centrifuged at 200 g. CF supernate and a frozen and thawed extract of the pellet were interacted with the different bacterial strains, while Streptococcus faecalis and Staphylococcus aureus released 60% and 75% of the radioactive label, only 38% of it was solubilized from Streptococcus mutans, following their incubation with the CF supernate. The findings agreed with results obtained by interacting bacteria with a frozen and thawed lysate of human peripheral blood leukocytes. On the other hand, extracts from frozen and thawed CF pellet were inactive. Further, lipoteichoic acid and lipopolysaccharide were released by CF from Gram-positive and Gram-negative bacteria, respectively. The role of bacteriolytic factors, present in CF, as a result of the interaction between microorganisms and leukocytes at inflammatory sites is discussed.

Lysozyme activity and flow rate of mixed saliva in children, adolescents and adults

Reports of lysozyme activity in mixed saliva differ greatly from lysozyme determination in pure form. In this study lysozyme activity of mixed saliva was determined by turbidimetric method in healthy children, adolescents, and adults, 111 subjects altogether. The salivary flow rate was estimated. The lysozyme activity of mixed saliva in 24 children was 129.4 +/- 42.4, in 21 adolescents 160.9 +/- 58.2, and in 66 adults 165.7 +/- 36.7 (mug/ml hen's egg white lysozyme). The flow rate of mixed saliva was similar in different groups. No statistically significant linear dependence between saliva lysozyme and flow rate was found. The lysozyme activities obtained correspond with the results of saliva lysozyme in pure form.