Influence of endogenous catalase activity on the sensitivity of the oral bacterium Actinobacillus actinomycetemcomitans and the oral haemophili to the bactericidal properties of hydrogen peroxide

Role of hydrogen peroxide in competition and cooperation between Streptococcus gordonii and Actinomyces naeslundii

In dental plaque alpha-haemolytic streptococci, including Streptococcus gordonii, are considered beneficial for oral health. These organisms produce hydrogen peroxide (H(2)O(2)) at concentrations sufficient to kill many oral bacteria. Streptococci do not produce catalase yet tolerate H(2)O(2). We recently demonstrated that coaggregation with Actinomyces naeslundii stabilizes arginine biosynthesis in S. gordonii. Protein arginine residues are sensitive to oxidation by H(2)O(2). Here, the ability of A. naeslundii to protect S. gordonii against self-produced H(2)O(2) was investigated. Coaggregation with A. naeslundii enabled S. gordonii to grow in the absence of arginine, and promoted survival of S. gordonii following growth with or without added arginine. Arginine-replete S. gordonii monocultures contained 20-30 microM H(2)O(2) throughout exponential growth. Actinomyces naeslundii did not produce H(2)O(2) but synthesized catalase, removed H(2)O(2) from coaggregate cultures and decreased protein oxidation in S. gordonii. On solid medium, S. gordonii inhibited growth of A. naeslundii; exogenous catalase overcame this inhibition. In coaggregate cultures, A. naeslundii cell numbers were >90% lower than in monocultures after 24 h. These results indicate that coaggregation with A. naeslundii protects S. gordonii from oxidative damage. However, high cell densities of S. gordonii inhibit A. naeslundii. Therefore, H(2)O(2) may drive these organisms towards an ecologically balanced community in natural dental plaque.

Influence of environmental conditions on hydrogen peroxide formation by Streptococcus gordonii

Hydrogen peroxide generated by viridans group streptococci has an antagonistic effect on many bacterial species, including a number of pathogens, in the oral environment. This study examines the influence of a variety of environmental conditions on rates of hydrogen peroxide synthesis by Streptococcus gordonii. Hydrogen peroxide was synthesized at every concentration of glucose and sucrose tested from 10 microM to 1 M, with the highest rates occurring at 0.1 mM sucrose and 1 mM glucose. S. gordonii appeared to have an intracellular store of polysaccharide which supported hydrogen peroxide formation even when the assay buffer contained no carbohydrate. Most heavy metal ions inhibited peroxidogenesis, and anaerobic conditions induced adaptive down-regulation of hydrogen peroxide synthesis; however, peroxidogenesis was generally insensitive to moderate increases in salt concentration, alteration of the mineral content of the assay solution, and changes in pH between 5.0 and 7.5. In contrast, stimulation of peroxidogenesis occurred in 1 mM Mg(2+) and 10 to 50 mM potassium L-lactate. Maximum peroxidogenesis occurred during the mid-logarithmic and late-logarithmic phases of bacterial growth. These bacterial responses may have significant implications for oral ecology and oral health.

Sensitivity of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus to oxidative killing

We examined the killing of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus by oxygen metabolites generated by the xanthine-xanthine oxidase (X-XO) system. This system generates a mixture of oxidants, including superoxide radical, hydrogen peroxide, hydroxyl radical, and possibly singlet oxygen. Differential sensitivity to the X-XO system was observed among strains of A. actinomycetemcomitans; notably, 2 catalase-deficient strains and 2 strains representative of serotypes b and c were the most susceptible. H. aphrophilus was not sensitive. The amount of oxidants produced by the X-XO system more closely correlated with killing than the ratio of oxidant production. Cytochrome c, superoxide dismutase, catalase, dimethyl sulfoxide, and desferrioxamine were used to determine the role of superoxide radical, hydrogen peroxide and hydroxyl radical in the bactericidal process. Hydrogen peroxide was the major bactericidal agent against A. actinomycetemcomitans. Superoxide anion participated in killing of A. actinomycetemcomitans to varying but lesser degrees. The intracellular generation of hydroxyl radical was implicated in the killing of several strains. We conclude that (i) strains of A. actinomycetemcomitans are differentially sensitive to the bactericidal effects of the X-XO system and (ii) of the oxidants produced by the X-XO system, hydrogen peroxide is the most bactericidal against A. actinomycetemcomitans.

The neutrophil: mechanisms of controlling periodontal bacteria

The control of potentially periodontopathic microorganisms by host neutrophils is crucial to periodontal health. Neutrophils may use oxidative or nonoxidative mechanisms and either kill bacteria, influence bacterial growth, or modify bacterial colonization in the periodontium. Delivery of antimicrobial substances by neutrophils involves respiratory burst activity, phagocytosis, secretion, or cytolysis/apoptosis. Neutrophils contain a number of antimicrobial components including calprotectin complex, lysozyme, defensins, cofactor-binding proteins, neutral serine proteases, bactericidal/permeability increasing protein, myeloperoxidase, and a NADPH oxidase system. Many of these components are multifunctional and exhibit several mechanisms of antimicrobial activity. When comparisons are made among periodontal bacteria, differences in sensitivity to different components are observed. A hypothesis of specific defense is presented: That specific periodontal diseases can result from the failure of specific aspects of the host immune system (the neutrophil, in particular) in its interaction with specific periodontal pathogens. Failure may be due to phenotypic variation (pleomorphism) within the host or bacterial evasive strategies.

Killing of oral, gram-negative, facultative bacteria by the rabbit defensin, NP-1

Oral, gram-negative, facultative bacteria, including Actinobacillus actinomycetemcomitans, Eikenella corrodens, and Capnocytophaga spp. have been associated with destructive periodontal infection. Neutrophils play a critical role in defending the periodontium against destructive infection. Defensins are antimicrobial peptides that have been isolated in human, rabbit, guinea pig, and rat leukocytes that may constitute an important nonoxidative mechanism of killing. The purpose of this study was to examine the sensitivity of a battery of oral, gram-negative, facultative bacteria to the bactericidal effects of the isolated rabbit peptide NP-1. All species tested were killed by NP-1; however, there was strain-to-strain variation in sensitivity. The bactericidal effect was not dependent on net bacterial growth, although metabolic activity was evident as assessed by bacterial oxygen consumption. We conclude that bacteria are sensitive to the cidal mechanism involved in defensin-mediated bacterial killing and that the conditions of this assay system support the killing of bacteria by the defensin peptides.

pH-dependent fluoride inhibition of catalase activity

The inhibitory effects of fluoride on several catalases were examined over a range of pH conditions. Preparations of bovine-liver catalase were sensitive to fluoride under acidic conditions. Catalase activity associated with whole-cell preparations of Actinomyces viscosus NP 311A remained relatively constant between pH 3.0 and 8.0 and was inhibited by fluoride in a pH-dependent manner. Fluoride was also observed to enhance hydrogen peroxide killing of A. viscosus NP 311A under acidic pH conditions. Results suggest that some catalase enzymes, including those associated with common plaque bacteria, may be inhibited by fluoride in a pH-dependent manner.

Effects on gingivitis of daily rinsing with 1.5% H2O2

The purpose of this study was to compare 2 groups of adolescents undergoing orthodontic treatment with fixed appliances to determine whether once daily use of a mouthrinse containing 1.5% H2O2 along with toothbrushing would be better than toothbrushing alone in maintaining their periodontal health. The 2 groups of subjects were selected non-randomly but were matched for age and sex. The control group (N = 34) used toothbrushing and a mint-flavored 0.05% NaF mouthrinse once daily, while the treatment group (N = 25) used toothbrushing and a once daily rinse with a preparation containing 0.05% NaF and 1.5% H2O2 (Orthoflur). 2 calibrated clinical examiners made single-blind clinical assessments of the plaque index, gingival index, and bleeding tendency in 6 standard sites per subject. They also noted any generalized mucosal irritations or staining of the teeth or tongue. Assessments were made before appliances were placed (baseline) and 1, 3, 6, 9, 12 and 18 months after appliances were placed. Results indicated that although there were no significant differences at baseline, the Orthoflur group had significantly fewer study sites with gingival indes or bleeding tendency scores greater than 1 than the control group from the 1-month through the 18-month examinations (P less than 0.01), and significantly fewer sites with plaque index greater than 1 and bleeding tendency scores of 2 or more from the 3-month through the 18-month examinations (P less than 0.02 and 0.01, respectively). No generalized mucosal irritations or clinically significant staining of the tongue or teeth were noted in either group during the study.

Glucosyltransferases of Streptococcus sobrinus C211 are both stimulated and inhibited by hydrogen peroxide

There are 2 glucosyltransferases (GTF) produced by Streptococcus sobrinus C211. One enzyme, GTF-S, produces a water-soluble glucan that is a-1,6-linked, with short a-1,3 branches, and the other enzyme, GTF-I, produces a water-insoluble glucan that is a-1,3-linked with a-1,6 branches. Hydrogen peroxide was found not only to be a potent inhibitor of GTF activity, but also a stimulator of GTF activity when employed at relatively low concentrations. At 0.88 M, H2O2 completely inhibited insoluble glucan synthesis, whereas at a 0.29 M concentration, H2O2 enhanced synthesis of the same glucan. Soluble glucan synthesis was also inhibited by H2O2 at 1.47 M. Low concentrations of hydrogen peroxide with GTF-S, however, caused the enzyme to convert from soluble glucan production to insoluble glucan production. 13C-Nuclear magnetic resonance spectra of glucans produced by peroxide-treated GTF confirmed that the production of a-1,3 linked glucans was increased with H2O2-treated GTF-S.

The role of antibody, complement and neutrophils in host defense against Actinobacillus actinomycetemcomitans

A. actinomycetemcomitans is a facultative Gram-negative coccobacillus which has been implicated in the etiology and pathogenesis of localized juvenile periodontitis and has also been recognized for its potential to cause serious extraoral infections, particularly endocarditis. The polymorphonuclear neutrophil has been suggested to play a key role in host resistance to periodontopathic organisms, as indicated by the association between defective production or function of these phagocytic cells and severe periodontal disease. This association has engendered interest in the study of the interaction between neutrophils and A. actinomycetemcomitans, as well as the role of immunoglobulin and complement in facilitating this interaction. The objective of this review is to summarize current knowledge of the nature and consequences of the interaction between A. actinomycetemcomitans and the host defense triad consisting of neutrophils, complement and immunoglobulin.

Interaction between wild-type, mutant and revertant forms of the bacterium Streptococcus sanguis and the bacterium Actinobacillus actinomycetemcomitans in vitro and in the gnotobiotic rat

In vitro, Streptococcus sanguis inhibits the growth of Actinobacillus actinomycetemcomitans, a presumed aetiological agent of localized juvenile periodontitis. When provided with glucose and good aeration, a growing culture of Strep. sanguis was found to produce hydrogen peroxide at concentrations in excess of the maximum LD50 reported for strains of A. actinomycetemcomitans. This concentration of hydrogen peroxide also inhibits the growth of the producer organism. A mutant of Strep. sanguis was isolated that lacked the ability to produce alpha-haemolysis on blood agar. This mutant had less than 3 per cent of its parent's level of pyruvate-oxidase activity, and made no detectable hydrogen peroxide. In vitro, the mutant had also lost the ability to inhibit the growth of A. actinomycetemcomitans. A spontaneous revertant, isolated by its ability to produce alpha-haemolysis, was found to have regained parental levels of pyruvate-oxidase activity and hydrogen-peroxide production and could inhibit the growth of A. actinomycetemcomitans in vitro. A gnotobiotic rat model was used to demonstrate that Strep. sanguis and A. actinomycetemcomitans interact in vivo and that this interaction depends on hydrogen-peroxide production by Strep. sanguis.

Role of high-avidity binding of human neutrophil myeloperoxidase in the killing of Actinobacillus actinomycetemcomitans

The binding of the neutrophil enzyme myeloperoxidase (MPO) to microbial surfaces is believed to be the first step in its microbicidal activity. The MPO-H2O2-Cl- system is responsible for most oxidative killing of Actinobacillus actinomycetemcomitans by human neutrophils. There appear to be three forms of MPO (MPO I, II, and III), all of which can kill this organism in the presence of H2O2 and chloride. In this study, we characterized the binding of native human neutrophil MPO to A. actinomycetemcomitans by an elution procedure dependent on the cationic detergent cetyltrimethylammonium bromide. Binding of native MPO was rapid and reached apparent equilibrium within 1 min. A proportion of binding under equilibrium conditions was saturable and highly avid, with a capacity of 4,500 sites per cell and a dissociation constant of 7.9 X 10(-10) M. At equal protein concentrations, more MPO III bound than MPO II, and more MPO II bound than MPO I. The high-avidity interaction was inhibitable with yeast mannan and with the serotype-defining mannan of A. actinomycetemcomitans. Binding was also partially reversible with yeast mannan. MPO bound to the high-avidity sites did not oxidize guaiacol but oxidized chloride, as detected by the chlorination of taurine. MPO bound to the high-avidity sites was incapable of killing A. actinomycetemcomitans alone in the presence of H2O2 and Cl-, but potentiated killing when sufficient additional MPO was provided. The killing of A. actinomycetemcomitans by the MPO-H2O2-Cl- system was inhibited by yeast mannan and a serotype-defining mannan of A. actinomycetemcomitans. We conclude that high-avidity binding of MPO to the surface of A. actinomycetemcomitans is a mannan-specific interaction and that MPO bound to the high-avidity sites is essential but not alone sufficient to kill A. actinomycetemcomitans.

Antimicrobial properties of hydrogen peroxide and sodium bicarbonate individually and in combination against selected oral, gram-negative, facultative bacteria

The topical application of hydrogen peroxide (H2O2) and sodium bicarbonate (NaHCO3), individually and in combination, has been used empirically in the treatment of periodontal diseases. In this study, we examined both minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of these disinfectants individually and in combination against selected facultative, Gram-negative oral bacteria in a microtiter dilution assay. The bacteria studied included Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, Eikenella corrodens, and Capnocytophaga gingivalis. These bacteria exhibited MBC (one hr) values ranging from 75 mumol/L to greater than 10 mmol/L and MIC from less than 5 to 500 mumol/L for H2O2. The tested bacteria exhibited MIC values for NaHCO3 of from 23 to 182 mmol/L, and the MBC (one hr) exceeded 728 mmol/L for most of the strains examined. At sublethal (sub-MIC) concentrations, sodium bicarbonate antagonized the ability of H2O2 to inhibit bacterial growth in MIC assays, but sublethal concentrations of H2O2 had no effect on the MIC values of NaHCO3. Lethal concentrations of H2O2 and NaHCO3 exhibited synergistic antimicrobial activity in combination in one-hour bactericidal assays. Since the bactericidal properties of these antimicrobial agents are synergistic, we conclude that it may be rational to use them in combination to treat certain forms of periodontal disease. Also, lower and perhaps safer concentrations of H2O2 can be used in combination with NaHCO3 when oxidative antimicrobial chemotherapy is indicated.

Killing of Actinobacillus actinomycetemcomitans by the human neutrophil myeloperoxidase-hydrogen peroxide-chloride system

Actinobacillus actinomycetemcomitans is a facultative gram-negative coccobacillus associated with periodontal disease and nonoral infections. This organism is resistant to serum bactericidal mechanisms but is nevertheless killed by human neutrophils under aerobic and anaerobic conditions. Most of the killing attributable to oxidative mechanisms is inhibited by sodium cyanide, which suggests that the myeloperoxidase-hydrogen peroxide-chloride (MPO-H2O2-Cl-) system may be a key factor in the oxidative killing process. In this report, we examine whether the isolated MPO-H2O2-Cl- system is bactericidal against A. actinomycetemcomitans. We found that three major chromatographic forms of MPO were capable of killing A. actinomycetemcomitans at sublethal concentrations of H2O2 and that both catalase-positive and catalase-negative strains of this organism were sensitive to killing by the MPO-H2O2-Cl- system. We conclude that the isolated MPO-H2O2-Cl- system is bactericidal for A. actinomycetemcomitans independent of other neutrophil granule constituents and may be an important component of the oxygen-dependent bactericidal activity of the neutrophil with respect to this periodontopathic organism.

Oxidative and nonoxidative killing of Actinobacillus actinomycetemcomitans by human neutrophils

Actinobacillus actinomycetemcomitans is a facultative gram-negative microorganism which has been implicated as an etiologic agent in localized juvenile periodontitis and in subacute bacterial endocarditis and abscesses. Although resistant to serum bactericidal action and to oxidant injury mediated by superoxide anion (O2-) and hydrogen peroxide (H2O2), this organism is sensitive to killing by the myeloperoxidase-hydrogen peroxide-chloride system (K.T. Miyasaki, M.E. Wilson, and R.J. Genco, Infect. Immun. 53:161-165, 1986). In this study, we examined the sensitivity of A. actinomycetemcomitans to killing by intact neutrophils under aerobic conditions, under anaerobic conditions, and under aerobic conditions in the presence of the heme-protein inhibitor sodium cyanide. Intact neutrophils killed opsonized A. actinomycetemcomitans under aerobic and anaerobic conditions, and the kinetics of these reactions indicated that both oxidative and nonoxidative mechanisms were operative. Oxidative mechanisms contributed significantly, and most of the killing attributable to oxidative mechanisms was inhibited by sodium cyanide, which suggested that the myeloperoxidase-hydrogen peroxide-chloride system participated in the oxidative process. We conclude that human neutrophils are capable of killing A. actinomycetemcomitans by both oxygen-dependent and oxygen-independent pathways, and that most oxygen-dependent killing requires myeloperoxidase activity.