Haemolysis of human erythrocytes by the Fusobacterium nucleatum associated with periodontal disease

Serum and salivary ferritin and Hepcidin levels in patients with chronic periodontitis and type 2 diabetes mellitus

BACKGROUND

Iron disorder and abnormal expression of hepcidin play important roles in many diseases, but it is still unclear in chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). We aimed to assess ferritin and hepcidin levels in serum and saliva of CP patients with or without T2DM.

METHODS

Serum and unstimulated whole saliva samples were collected from 88 participants, who were categorized into 4 groups based on the presence or absence of CP or T2DM. Demographics and general health parameters were recorded. Full-mouth clinical periodontal parameters including probing pocket depth, clinical attachment loss, bleeding index, and plaque index were recorded. Chemiluminescence microparticle immunoassay and enzyme-linked immunosorbent assay were used to detect ferritin and hepcidin concentrations, respectively, in serum and saliva.

RESULTS

Serum ferritin and hepcidin levels in the CP and CP with T2DM groups were higher than in the control group (P < 0.05). Serum hepcidin and serum ferritin are linear correlated (P < 0.001). Serum hepcidin/ferritin values in the CP with T2DM group were significantly lower than those in the T2DM and control groups. Moreover, salivary ferritin levels in the CP and T2DM groups were higher than those in the control group (P < 0.05). There was positively correlation between salivary ferritin and serum ferritin (P = 0.017). Hepcidin concentrations were relatively low in saliva.

CONCLUSIONS

These results suggest that iron overload and hepcidin inadequacy existed in CP with T2DM patients. Salivary ferritin might provide a reference for body iron load.

TRIAL REGISTRATION

ChiCTR-ROC-17012780.

Tea polyphenols inhibit the growth and virulence properties of Fusobacterium nucleatum

Fusobacterium nucleatum plays a key role in creating the pathogenic subgingival biofilm that initiates destructive periodontitis. It is also a common resident of the human gastrointestinal tract and has been associated with inflammatory bowel disease. The aim of the present study was to investigate the effects of green and black tea extracts as well as two of their bioactive components, EGCG and theaflavins, on the growth and virulence properties of F. nucleatum. The tea extracts and components displayed various degrees of antibacterial activity that may involve damage to the bacterial cell membrane and the chelation of iron. They also prevented biofilm formation by F. nucleatum at concentrations that did not interfere with bacterial growth. In addition, the treatment of a pre-formed F. nucleatum biofilm with the green tea extract and EGCG caused a time-dependent decrease in biofilm viability. The green and black tea extracts, EGCG, and theaflavins decreased the adherence of F. nucleatum to oral epithelial cells and matrix proteins. Moreover, these tea components also attenuated F. nucleatum-mediated hemolysis and hydrogen sulfide production, two other virulence factors expressed by this bacterium. In summary, this study showed that tea polyphenols may be of interest for treating F. nucleatum-associated disorders.

Association of clinical parameters with periodontal bacterial haemolytic activity

AIMS

To determine whether haemolytic activity of subgingival bacteria is associated with periodontitis clinical parameters and to identify which bacteria produce the haemolysins.

MATERIALS AND METHODS

Subgingival plaque samples from 22 untreated chronic periodontitis patients were investigated by culture and identified with matrix assisted laser desorption/ionisation time-of-flight mass spectrometry.

RESULTS

Total aerobic and anaerobic bacterial viable counts, percentage distribution of α- and β-haemolytic bacteria were significantly elevated in diseased sites in relation to healthy sites (p < 0.001). Periodontal pathogens were more frequently detected at diseased sites: Porphyromonas gingivalis, Tannerella forsythia, Treponema sp., Prevotella sp., Parvimonas micra, Fusobacterium sp., Campylobacter sp., Capnocytophaga sp., and Selenomonas sp. Haemolytic unidentifiable species and Gram-positive anaerobes such as Slackia exigua, Solobacterium moorei, and Bulledia extructa were also more frequently detected at diseased sites. In diseased sites, the presence of different haemolytic characteristics was more strongly correlated with clinical measures of disease than the mere absence or presence of specific species. The strongest correlation with probing pocket depth was observed for overall β-haemolytic toxicity (r = 0.73, p < 0.001).

CONCLUSION

A strong association was observed between subgingival bacterial haemolytic activity and clinical parameters in patients with chronic periodontitis. Further investigations are warranted to delineate the role of haemolysins in the pathogenesis of periodontitis.

Heme acquisition mechanisms of Porphyromonas gingivalis - strategies used in a polymicrobial community in a heme-limited host environment

Porphyromonas gingivalis, a main etiologic agent and key pathogen responsible for initiation and progression of chronic periodontitis requires heme as a source of iron and protoporphyrin IX for its survival and the ability to establish an infection. Porphyromonas gingivalis is able to accumulate a defensive cell-surface heme-containing pigment in the form of μ-oxo bisheme. The main sources of heme for P. gingivalis in vivo are hemoproteins present in saliva, gingival crevicular fluid, and erythrocytes. To acquire heme, P. gingivalis uses several mechanisms. Among them, the best characterized are those employing hemagglutinins, hemolysins, and gingipains (Kgp, RgpA, RgpB), TonB-dependent outer-membrane receptors (HmuR, HusB, IhtA), and hemophore-like proteins (HmuY, HusA). Proteins involved in intracellular heme transport, storage, and processing are less well characterized (e.g. PgDps). Importantly, P. gingivalis may also use the heme acquisition systems of other bacteria to fulfill its own heme requirements. Porphyromonas gingivalis displays a novel paradigm for heme acquisition from hemoglobin, whereby the Fe(II)-containing oxyhemoglobin molecule must first be oxidized to methemoglobin to facilitate heme release. This process not only involves P. gingivalis arginine- and lysine-specific gingipains, but other proteases (e.g. interpain A from Prevotella intermedia) or pyocyanin produced by Pseudomonas aeruginosa. Porphyromonas gingivalis is then able to fully proteolyze the more susceptible methemoglobin substrate to release free heme or to wrest heme from it directly through the use of the HmuY hemophore.

Periodontal bacterial DNA suppresses the immune response to mutans streptococcal glucosyltransferase

Certain CpG motifs found in bacterial DNA enhance immune responses through Toll-like receptor 9 (TLR-9) and may also demonstrate adjuvant properties. Our objective was to determine if DNA from bacteria associated with periodontal disease could affect the immune response to other bacterial antigens in the oral cavity. Streptococcus sobrinus glucosyltransferase (GTF), an enzyme involved in dental caries pathogenesis, was used as a test antigen. Rowett rats were injected with aluminum hydroxide (alum) with buffer, alum-GTF, or alum-GTF together with either Escherichia coli DNA, Fusobacterium nucleatum DNA, or Porphyromonas gingivalis DNA. Contrary to expectation, animals receiving alum-GTF plus bacterial DNA (P. gingivalis in particular) demonstrated significantly reduced serum immunoglobulin G (IgG) antibody, salivary IgA antibody, and T-cell proliferation to GTF compared to animals immunized with alum-GTF alone. A diminished antibody response was also observed after administration of alum-GTF with the P. gingivalis DNA either together or separately, indicating that physical complexing of antigen and DNA was not responsible for the reduction in antibody. Since TLR triggering by DNA induces synthesis of prospective suppressive factors (e.g., suppressor of cytokine signaling [SOCS]), the effects of P. gingivalis DNA and GTF exposure on rat splenocyte production of SOCS family molecules and inflammatory cytokines were investigated in vitro. P. gingivalis DNA significantly up-regulated SOCS1 and SOCS5 expression and down-regulated interleukin-10 expression by cultured splenocytes. These results suggested that DNA from periodontal disease-associated bacteria did not enhance, but in fact suppressed, the immune response to a protein antigen from cariogenic streptococci, potentially through suppressive SOCS components triggered by innate mechanisms.

Two distinct hemolysins in Trichomonas tenax ATCC 30207

An oral protist Trichomonas tenax ATCC 30207 was investigated for the ability to lyse erythrocytes of sheep, rabbits, horses and humans. Five fractions, including intact cells, culture supernatant, culture filtrate, cell debris and lipid-enriched fractions, were prepared from the protozoan cells, and their hemolytic activities were assayed under various conditions. All the samples except culture supernatant had hemolytic activities, which were due to two different kinds of hemolysins. One hemolysin was protein-like and mainly found in cell-free fractions: culture supernatant and culture filtrate. It was heat-labile and inhibited by various cysteine-proteinase inhibitors. The other hemolysin was lipid-like and found in cell-associated fractions: intact cells, cell-debris and lipid-enriched fractions. It was heat-stable, organic solvent-tolerant and unaffected by various proteinase inhibitors and stimulators. These results suggested that T. tenax ATCC 30207 possessed two distinct hemolysins, protein and lipid.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

Some binding properties of the envelope of Porphyromonas gingivalis to hemoglobin

Porphyromonas gingivalis was found to bind to hemoproteins (hemoglobin, myoglobin, catalase, cytochrome c) and the binding properties of the envelope of P. gingivalis to hemoglobin were investigated. Maximum amount of hemoglobin bound to 1 mg of the envelope was 58 micrograms. No significant binding was observed at 4 degrees C and the binding was inhibited strongly by tosyl-L-lysine chloromethyl ketone, Leupeptin, EDTA and partially by meta-periodate. Heating of the envelope at 70 degrees C for 15 min resulted in complete loss of the binding activity. The binding activity of the envelope was not influenced by the treatment with the endogenous proteases. The envelope saturated with hemoglobin could no longer bind to other hemoproteins tested, indicating that binding site for these hemoproteins are common.

Studies on the factors affecting the hemolytic activity of Fusobacterium necrophorum

The in vitro activity of the hemolysin of Fusobacterium necrophorum was determined using the hemolysis of horse erythrocytes as an assay. The effects of medium composition and pH on hemolysin production were investigated. Calf serum and casitone stimulated a comparatively higher hemolytic activity in F. necrophorum subsp. necrophorum and F. necrophorum subsp. funduliforme, respectively. However, sugars, such as glucose, galactose and fructose were inhibitors of hemolytic activity. The spectrum of erythrocyte sensitivity to the hemolysin indicated that horse and quail erythrocytes were more sensitive to the hemolysin of both F. necrophorum subsp. necrophorum and subsp. funduliforme, than were cat, dog, rabbit, pigeon and human erythrocytes. Cat erythrocytes were however insensitive to the hemolysin of subsp. funduliforme. Cattle, sheep and chicken erythrocytes were insensitive to the hemolysin of the two subspecies. Medium pH near neutral were more effective in enhancing hemolytic activity, and hemolytic activity was positively correlated with growth. In general, F. necrophorum subsp. necrophorum was more hemolytic than subsp. funduliforme.

Binding of hemin and congo red by oral hemolytic spirochetes

Colony-forming units or cells in suspension of oral anaerobic spirochetes (Treponema denticola, Treponema vincentii and Treponema socranskii) bind hemin and Congo red. Hemin or Congo red binds to a hydrophobic polypeptide receptor that is located in the outer membrane of the bacterial cells and it has a relative molecular mass of 47 kDa. These oral spirochetes also lyse sheep erythrocytes to produce beta-hemolytic zones around colony-forming units. The oral spirochetes may acquire iron for growth when they lyse erythrocytes and bind heme from which they may sequester and transport iron into the cells.

Adhesive properties of strains of Fusobacterium nucleatum of the subspecies nucleatum, vincentii and polymorphum

This study surveyed some adhesive properties of strains of Fusobacterium nucleatum representative of the 3 recently defined groups or subspecies that could relate to their colonization and virulence. With one exception, F. nucleatum strains agglutinated sheep erythrocytes, but the quantity of bacteria required and the sensitivity of the hemagglutination reactions to inhibition by 0.05 M galactose or arginine varied between strains, and did not exhibit clear-cut correlations with subspecies. Neuraminidase treatment of erythrocytes generally enhanced the hemagglutinating activity of most strains, but trypsin treatment had no effect. Strains of F. nucleatum also attached in moderate numbers to buccal epithelial cells. Treatment of the epithelial cells with neuraminidase or with trypsin increased the numbers of all Fusobacterium strains that attached. Treatment of hydroxyapatite (HA) beads with submandibular or parotid saliva also promoted the adhesion of all strains of F. nucleatum studied. Treatment of HA with human serum or albumin produced a selective effect. Adhesion of some strains was promoted by serum and albumin treatment, and that of other strains was unaffected. Adhesion of all strains of F. nucleatum was enhanced to statherin-treated HA, whereas HA treated with salivary proline-rich protein-1 did not foster F. nucleatum attachment. Three of 4 strains of the subspecies vincentii, and each of 2 polymorphum strains studied exhibited strong adhesion to HA treated with either human type I or type IV collagen. However, only 1 of 5 strains of the subspecies nucleatum bound well to collagen-treated HA.(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristics of hemolytic and hemagglutinating activities of Treponema denticola

Treponema denticola, a suspected periodontal pathogen, was shown to agglutinate and lyse human red blood cells. Both activities were cell-associated, heat-labile, and produced during the exponential growth phase. Hemolytic activity was time-dependent and required incubation at 37 degrees C; further incubation at 4 degrees C increased the hemolysis. Hemagglutination was reduced in the presence of D-glucosamine, EDTA or sodium salicylate, whereas hemolytic activity was affected by calcium chloride, magnesium chloride, EDTA or sodium salicylate. These biological activities may favor a higher concentration of hemin-containing compounds in periodontal sites, and therefore represent additional potential virulence mechanisms.

Hemolytic activity in the periodontopathogen Porphyromonas gingivalis: kinetics of enzyme release and localization

Porphyromonas gingivalis W50, W83, A7A1-28, and ATCC 33277 were investigated for their abilities to lyse sheep, human, and rabbit erythrocytes. All of the P. gingivalis strains studied produced an active hemolytic activity during growth, with maximum activity occurring in late-exponential-early-stationary growth phase. The enzyme was cell bound and associated with the outer membrane. Fractionation of P. gingivalis W50 localized the putative hemolysin almost exclusively in the outer membrane fraction, with significant hemolytic activity concentrated in the outer membrane vesicles. Ca2+ and Mg2+ ions significantly increased the expression of hemolytic activity. Hemolytic activity was inhibited by proteinase K, trypsin, the proteinase inhibitors Na-P-tosyl-L-lysine chloromethyl ketone and benzamidine, the metabolic inhibitor M-chlorophenyl-hydrazone, and iodoacetate. KCN and sodium azide (NaN3) only partially inhibited P. gingivalis hemolytic activity, while antiserum to whole cells of each of the P. gingivalis strains had a significant inhibitory effect on hemolytic activity. The P. gingivalis W50 hemolysin was inhibited by cysteine, dithiothreitol, and glutathione at concentrations of at least 10 mM; at low concentrations (i.e., 2 mM), dithiothreitol did not completely inhibit hemolytic activity. Heating to temperatures above 55 degrees C resulted in an almost complete inhibition of hemolytic activity. The effect of heme limitation (i.e., iron) on hemolysin production indicated that either limitation or starvation for heme resulted in significantly increased hemolysin production compared with that of P. gingivalis grown in the presence of excess heme.

Distribution and frequency of Fusobacterium nucleatum subspecies in the human oral cavity

Three reference strains of Fusobacterium nucleatum and 32 human oral isolates were compared by a variety of physiological tests, enzyme electrophoretic profiles, SDS-PAGE patterns, DNA base composition and hybridization to test their possible site specificity and frequency of the recently described subspecies of F. nucleatum. Nine of the 11 isolates assigned to F. nucleatum subspecies nucleatum were from diseased sites, whereas isolates from healthy sites were all identified as F. nucleatum subspecies polymorphum or F. nucleatum subspecies fusiforme. Strains of the latter subspecies were the least frequently isolated (2 of 32). These results, although still inconclusive because of the relatively small sample size, nevertheless confirmed the heterogeneity of F. nucleatum and indicate that most human oral isolates from subgingival sites probably belong to F. nucleatum subspecies nucleatum.

Haemagglutinating and haemolytic activity of the extracellular vesicles of Bacteroides gingivalis W50

The extracellular vesicles (ECV) and extracellular protein (EP) fractions of Bacteroides gingivalis W50 showed haemagglutinating (HA) activity towards sheep erythrocytes. Similar fractions from the nonpathogenic strain W50/BE1 did not haemagglutinate. W50 ECV HA activity was not inhibited by various glycosidase, phospholipase or protease pretreatments, sugars or amino acids, including arginine or lysine. The haemagglutinating activity of ECV was associated only with the extracellular vesicle membrane. The EP and ECV of both strains displayed haemolytic activity. This activity was apparently depressed in the presence of 10 mM dithiothreitol (DTT). All EP and ECV fractions degraded certain structural sheep erythrocyte membrane proteins. The greatest activity was displayed by W50 ECV and W50/BE1 EP and was enhanced by DTT. In the presence of DTT, the ECV of both strains degraded purified human haemoglobin but this activity was greatly reduced in its absence.

Amino acid-dependent transport of sugars by Fusobacterium nucleatum ATCC 10953

Resting cells of Fusobacterium nucleatum 10953 (grown previously in a medium containing glucose) failed to accumulate glucose under aerobic or anaerobic conditions. However, the addition of glutamic acid, lysine, or histidine to anaerobic suspensions of cells caused the immediate and rapid accumulation of glucose. Except for the amino acid-dependent transport of galactose and fructose (the latter being transported at approximately one-third the rate of glucose), no other sugars tested were accumulated by the resting cells. Amino acid-dependent uptake of sugar(s) by F. nucleatum was abolished by exposure of cells to air, and under aerobic conditions the rates of fermentation of glutamic acid and lysine were less than 15% of the rates determined anaerobically. The energy necessary for active transport of the sugars (acetyl phosphate and ATP) is derived from the anaerobic fermentation of glutamic acid, lysine, or histidine. Competition studies revealed that glucose and galactose were mutual and exclusive inhibitors of transport, and it is suggested that the two sugars (Km = 14 microM) are translocated via a common carrier. The products of amino acid-dependent sugar transport were recovered from resting cells as ethanol-precipitable, high-molecular-weight polymers. Polymer formation by F. nucleatum, during growth in medium containing glucose or galactose, was confirmed by electron microscopy.

Desulfuration of cysteine and methionine by Fusobacterium nucleatum

Fusobacterium nucleatum is a Gram-negative anaerobic rod-shaped bacterium frequently isolated from human dental plaque. It is capable of the desulfuration of cysteine and methionine, resulting in the formation of sulfide and thiol volatiles, respectively. Intact cells, as well as cell-free extracts produced by French pressure cell lysis of F. nucleatum, hydrolyzed radiolabeled cysteine to produce sulfide, pyruvic acid, and ammonia. The hydrolysis products of radiolabeled methionine were a volatile thiol, ketobutyrate, and ammonia. Both activities were associated with the cytoplasmic component, not the membrane. The desulfuration mechanisms are heat-labile, inhibited by the presence of excess substrate, and rates are dependent upon substrate concentration. These dissimilar pathways by F. nucleatum can account in part for the presence of sulfur-containing volatile products that occur in the mouth.