Streptococcus mutans: a new Gram-positive paradigm?

Ribosomal-processing cysteine protease homolog modulates Streptococcus mutans glucan production and interkingdom interactions

Glucan-dependent biofilm formation is a crucial process in the establishment of Streptococcus mutans as a cariogenic oral microbe. The process of glucan formation has been investigated in great detail, with glycosyltransferases GtfB, GtfC, and GtfD shown to be indispensable for the synthesis of glucans from sucrose. Glucan production can be visualized during biofilm formation through fluorescent labeling, and its abundance, as well as the effect of glucans on general biofilm architecture, is a common phenotype to study S. mutans virulence regulation. Here, we describe an entirely new phenotype associated with glucan production, caused by a mutation in the open reading frame SMU_848, which is located in an operon encoding ribosome-associated proteins. This mutation led to the excess production and accumulation of glucan-containing droplets on the surface of biofilms formed on agar plates after prolonged incubation. While not characterized in S. mutans, SMU_848 shows homology to the phage-related ribosomal protease Prp, essential in cleaving off the N-terminal extension of ribosomal protein L27 for functional ribosome assembly in Staphylococcus aureus. We present a further characterization of SMU_848/Prp, demonstrating that the deletion of this gene leads to significant changes in S. mutans gtfBC expression. Surprisingly, it also profoundly impacts the interkingdom interaction between S. mutans and Candida albicans, a relevant dual-species interaction implicated in severe early childhood caries. The presented data support a potential broader role for SMU_848/Prp, possibly extending its functionality beyond the ribosomal network to influence important ecological processes.

IMPORTANCE

Streptococcus mutans is an important member of the oral biofilm and is implicated in the initiation of caries. One of the main virulence mechanisms is the glucan-dependent formation of biofilms. We identified a new player in the regulation of glucan production, SMU_848, which is part of an operon that also encodes for ribosomal proteins L27 and L21. A mutation in SMU_848, which encodes a phage-related ribosomal protease Prp, leads to a significant accumulation of glucan-containing droplets on S. mutans biofilms, a previously unknown phenotype. Further investigations expanded our knowledge about the role of SMU_848 beyond its role in glucan production, including significant involvement in interkingdom interactions, thus potentially playing a global role in the virulence regulation of S. mutans.

Potential interaction of sugar intake and tobacco exposure on dental caries in adults-A cross-sectional study from the National Health and Nutrition Examination Survey

Background/purpose

We suspected that there might be an interaction between sugar intake and tobacco exposure on the risk of dental caries. The study aimed to investigate the associations of sugar intake or tobacco exposure with the risk of dental caries.

Materials and methods

This cross-sectional study obtained data of 18804 participants from National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Weighted univariable and multivariable logistic regression models were applied to explore the associations of total sugar intake or tobacco exposure with the risk of dental caries. The relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI) evaluated the interaction between total sugar intake and tobacco exposure on the risk of dental caries. The effect size of odds ratio (OR), and 95% confidence interval (CI) was inputted.

Results

The OR of dental caries in adults with cotinine >10 ng/mL was 1.59 (95%CI: 1.38-1.82). The increased risk of dental caries was found in people with total sugar >19.5%E compared to those with total sugar ≤19.5%E (OR = 1.55, 95%CI: 1.34-1.78). Compared to people with cotinine ≤10 ng/mL and total sugar ≤19.5%E, adults with cotinine >10 ng/mL and total sugar >19.5%E were correlated with elevated risk of dental caries (OR = 2.76, 95%CI: 2.29-3.33). The interaction indicators RERI was 0.980 (95%CI: 0.413-1.547), API was 0.355 (95%CI: 0.192-0.517), and SI was 2.250 (95%CI: 1.344-3.767).

Conclusion

There might be interaction between sugar intake and tobacco exposure on the occurrence of dental caries in adults.

A Color Indicator Based on 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium Bromide (MTT) and a Biodegradable Poly(ester amide) for Detecting Bacterial Contamination

Bacterial contamination is a hazard in many industries, including food, pharmaceuticals, and healthcare. The availability of a rapid and simple method for detecting this type of contamination in sterile areas enables immediate intervention to avoid or reduce detrimental effects. Among these methods, colorimetric indicators are becoming increasingly popular due to their affordability, ease of use, and quick visual interpretation of the signal. In this article, a bacterial contamination indicator system was designed by incorporating MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) into an electrospun PADAS matrix, which is a biodegradable poly(ester amide) synthesized from L-alanine, 1,12-dodecanediol, and sebacic acid. Uniaxial stress testing, thermogravimetric analysis and scanning electron microscopy were used to examine the mechanical properties, thermal stability, and morphology of the mats, respectively. The capacity for bacterial detection was not only analyzed with agar and broth assays but also by replicating important environmental conditions. Among the MTT concentrations tested in this study (0.2%, 2%, and 5%), it was found that only with a 2% MTT content the designed system produced a color response visible to the naked eye with optimal intensity, a sensitivity limit of 104 CFU/mL, and 86% cell viability, which showed the great potential for its use to detect bacterial contamination. In summary, by means of the process described in this work, it was possible to obtain a simple, low-cost and fast-response bacterial contamination indicator that can be used in mask filters, air filters, or protective clothing.

Morphological changes and viability of Streptococcus mutans biofilm treated with erythrosine: A confocal laser scanning microscopy analysis

Antimicrobial photodynamic therapy (a-PDT) is a modality that aims to induce microorganisms through visible light, a photosensitizer, and molecular oxygen. This therapy has shown promising results in controlling cariogenic biofilm in vitro and in vivo counterparts. This study investigated bacterial viability and morphological characterization of Streptococcus mutans mature biofilms after combination of erythrosine and a high potency dental curing light. Biofilms were formed on saliva-coated hydroxyapatite disks in batch culture. The samples were performed in triplicates. Fresh medium was replaced daily for five days and treated using 40 μM of E activated by HL 288 J/cm2 and total dose of 226 J at 1200 mW/cm2. Phosphate buffer saline and 0.12% of chlorhexidine were used as negative and positive control, respectively. After treatment, biofilms were assessed for microbial viability and morphological characterization by means of bio-volume and thickness. COMSTAT software was used for image analysis. Data were analyzed using two-way ANOVA followed by Tukey test with significance level 5%. The application of a-PDT and CHX treatments decreased S. mutans bacterial viability. The image analysis showed more red cells on biofilms when compared to other groups, demonstrating photobacterial killing. Erythrosine irradiated with a high potency curing light can potentially act as an antimicrobial tool in the treatment of cariogenic biofilms. The morphology and viability of microorganisms were impacted after treatment. Treatment with photodynamic therapy may be able to reduce the bio-volume and viability of bacteria present in biofilms. CLINICAL RELEVANCE AND RESEARCH HIGHLIGHTS: The use of the a-PDT technique has been applied in dentistry with satisfactory results. Some applications of this technique are in stomatology and endodontics. In the present study, we sought to understand the use of photodynamic therapy in the control of biofilm and the results found are compatible with the objective of microbiological control proposed by this technique, thus raising the alert for future studies in vivo using the combination of a-PDT with erythrosine, since they are easily accessible materials for the dental surgeon and can be applied in clinical practice.

Effects of glucose and lactate on Streptococcus mutans abundance in a novel multispecies oral biofilm model

The oral microbiome plays an important role in protecting oral health. Here, we established a controlled mixed-species in vitro biofilm model and used it to assess the impact of glucose and lactate on the ability of Streptococcus mutans, an acidogenic and aciduric species, to compete with commensal oral bacteria. A chemically defined medium was developed that supported the growth of S. mutans and four common early colonizers of dental plaque: Streptococcus gordonii, Actinomyces oris, Neisseria subflava, and Veillonella parvula. Biofilms containing the early colonizers were developed in a continuous flow bioreactor, exposed to S. mutans, and incubated for up to 7 days. The abundance of bacteria was estimated by quantitative polymerase chain reaction (qPCR). At high glucose and high lactate, the pH in bulk fluid rapidly decreased to approximately 5.2, and S. mutans outgrew other species in biofilms. In low glucose and high lactate, the pH remained above 5.5, and V. parvula was the most abundant species in biofilms. By contrast, in low glucose and low lactate, the pH remained above 6.0 throughout the experiment, and the microbial community in biofilms was relatively balanced. Fluorescence in situ hybridization confirmed that all species were present in the biofilm and the majority of cells were viable using live/dead staining. These data demonstrate that carbon source concentration is critical for microbial homeostasis in model oral biofilms. Furthermore, we established an experimental system that can support the development of computational models to predict transitions to microbial dysbiosis based on metabolic interactions.IMPORTANCEWe developed a controlled (by removing host factor) dynamic system metabolically representative of early colonization of Streptococcus mutans not measurable in vivo. Hypotheses on factors influencing S. mutans colonization, such as community composition and inoculation sequence and the effect of metabolite concentrations, can be tested and used to predict the effect of interventions such as dietary modifications or the use of toothpaste or mouthwash on S. mutans colonization. The defined in vitro model (species and medium) can be simulated in an in silico model to explore more of the parameter space.

Polymerase chain reaction-based identification of various serotypes of Streptococcus mutans in adults with and without dental caries

Background

Dental caries is a multistep process which initiates the development of plaque' defined as a structured biofilm containing microbial communities. Teeth provide unique surfaces for bacterial colonization. Serotypes of Streptococcus mutans implicate the development of dental caries.

Aim

The aim of the study was to determine the prevalence and association of serotypes of S. mutans in groups with and without dental caries.

Materials and Methods

One hundred and fifty adults aged between 18 and 35 years were included in the study. Supragingival plaque samples were collected, followed by deoxyribonucleic acid extraction. Polymerase chain reaction was performed to identify S. mutans and its serotypes. Proportions of S. mutans and its serotypes were correlated with caries-active (CA) and caries-free (CF) groups.

Results

CA group showed 66.7% positivity for S. mutans and CF group showed only 42.7% of positivity. Serotype C showed a higher proportion followed by E' F, and K in the CA group, whereas in the CF group, higher proportion was observed with K followed by C' E, and F. 70.8% cases showed single serotype in the CA group and 83.3% in CF group. Multiple serotypes were seen in 29.2% in the CA group and 16.7% in the CF group.

Conclusions

The study clearly established variation in proportions of S. mutans and its serotypes between CA and CF groups. Positive correlation was observed in the CA group for S. mutans and its serotypes.

In Silico Molecular Docking of Phytochemicals of Murraya koenigii Against Streptococcus mutans

Background The curry leaf tree, Murraya koenigii, is a tropical to subtropical tree in the family Rutaceae that is native to Asia. The plant parts are shown to have potential antimicrobial, antioxidant, antifungal, antidiarrheal, antidiabetic, anticancer, and anti-inflammatory properties. Streptococcus mutans is a facultative anaerobic, Gram-positive cocci, a common inhabitant of the human oral cavity that forms biofilms, contributing to dental caries. Aim The study aimed to analyze the inhibitory potential of phytocompounds in M. koenigii against the oral pathogen S. mutans. Materials and methods The protein and ligand were prepared, and molecular docking was carried out using the Hex protein docking server. The PyMOL program was used to view, analyze, and annotate the docked complex. The interaction of the drug, including the mechanism of action, and predicted adverse effects were predicted using the Way2Drug PASS Online server. The absorption, distribution, metabolism, excretion, and toxicity properties of the drug candidates were analyzed using the SwissADME online server. Results The study identified O-methyl murrayamine, koenigine, koenigicine, and murrayone as having inhibitory potential against the glycosyltransferase protein of S. mutans. Among the four compounds analyzed for docking, koenigicine had the lowest E-score, indicating a strong interaction with the receptor. Among the four compounds analyzed, murrayone had a high topological polar surface area score, while all four compounds had similar bioavailability scores. Conclusion This study concluded that O-methyl murrayamine, koenigine, koenigicine, and murrayone exhibit potent inhibitory potential against S. mutans. M. koenigiileaf extract can be used in toothpaste as an antibacterial agent to protect teeth against dental caries. These findings are important for the potential use of the above compound to act as an anticariogenic agent in oral health applications.

Competitiveness of reutericyclin producing and nonproducing Limosilactobacillus reuteri in food and intestinal ecosystems: a game of rock, paper, and scissors?

The ecological relationships among antimicrobial producing, resistant, and sensitive strains have been proposed to follow rock-paper-scissors dynamics, but evidence is mainly based on Gram-negative bacteriocins in vitro. The ecological relevance of antimicrobials in vivo or in situ has not been systematically studied. This study therefore aimed to analyze binary and ternary competitions among reutericyclin-producing strain Limosilactobacillus reuteri TMW1.656, its reutericyclin-resistant, nonproducing isogenic derivative L. reuteri TMW1.656∆rtcN, and the reutericyclin-sensitive, nonproducing L. reuteri TMW1.656∆rtcN∆rtcT in vitro (liquid culture and static plate), in situ (sourdough fermentation), and in vivo (gut of germ-free mice). In liquid culture, L. reuteri TMW1.656 had a higher fitness than TMW1.656∆rtcN and TMW1.656∆rtcN∆rtcT. Limosilactobacillus reuteri TMW1.656∆rtcN∆rtcT had a higher fitness than TMW1.656∆rtcN. On agar plates, L. reuteri TMW1.656 had a higher fitness than TMW1.656∆rtcN∆rtcT. In situ, reutericyclin production and resistance had no influence on the fitness of the strains. In vivo, TMW1.656 had an advantage over TMW1.656∆rtcN and TMW1.656∆rtcN∆rtcT. Ternary competitions showed reutericyclin production was ecologically beneficial in all ecosystems. The findings support the ecological importance of reutericyclin in a variety of environments/niches, providing an explanation for the acquisition of the reutericyclin gene cluster in L. reuteri and its contribution to the ecological fitness of Streptococcus mutans.

An in vitro coculture approach to study the interplay between dental pulp cells and Streptococcus mutans

AIM

To develop a new coculture system that allows exposure of dental pulp cells (DPCs) to Streptococcus mutans and dentine matrix proteins (eDMP) to study cellular interactions in dentine caries.

METHODOLOGY

Dental pulp cells and S. mutans were cocultured with or without eDMP for 72 h. Cell proliferation and viability were assessed by cell counting and MTT assays, while bacterial growth and viability were determined by CFU and LIVE/DEAD staining. Glucose catabolism and lactate excretion were measured photometrically as metabolic indicators. To evaluate the inflammatory response, the release of cytokines and growth factors (IL-6, IL-8, TGF-β1, VEGF) was determined by ELISA. Non-parametric statistical analyses were performed to compare all groups and time points (Mann-Whitney U test or Kruskal-Wallis test; α = .05).

RESULTS

While eDMP and especially S. mutans reduced the number and viability of DPCs (p ≤ .0462), neither DPCs nor eDMP affected the growth and viability of S. mutans during coculture (p > .0546). The growth of S. mutans followed a common curve, but the death phase was not reached within 72 h. S. mutans consumed medium glucose in only 30 h, whereas in the absence of S. mutans, cells were able to catabolize glucose throughout 72 h, resulting in the corresponding amount of l-lactate. No change in medium pH was observed. S. mutans induced IL-6 production in DPCs (p ≤ .0011), whereas eDMP had no discernible effect (p > .7509). No significant changes in IL-8 were observed (p > .198). TGF-β1, available from eDMP supplementation, was reduced by DPCs over time. VEGF, on the other hand, was increased in all groups during coculture.

CONCLUSIONS

The results show that the coculture of DPCs and S. mutans is possible without functional impairment. The bacterially induced stimulation of proinflammatory and regenerative cytokines provides a basis for future investigations and the elucidation of molecular biological relationships in pulp defence against caries.

Diverse nature of ClpX degradation motifs in Streptococcus mutans

IMPORTANCE

Cytoplasmic Clp-related proteases play a major role in maintaining cellular proteome in bacteria. ClpX/P is one such proteolytic complex that is important for conserving protein homeostasis. In this study, we investigated the role of ClpX/P in Streptococcus mutans, an important oral pathogen. We identified several putative substrates whose cellular levels are regulated by ClpX/P in S. mutans and subsequently discovered several recognition motifs that are critical for degradation. Our study is the first comprehensive analysis of determining ClpX/P motifs in streptococci. We believe that identifying the substrates that are regulated by ClpX/P will enhance our understanding about virulence regulation in this important group of pathogens.

Dynamic interactions between Candida albicans and different streptococcal species in a multispecies oral biofilm

The oral cavity is colonized by a plethora of bacteria, fungi, and archaea, including streptococci of the mitis group (MSG) and the yeast Candida albicans. This study aims to investigate the role of streptococcal species in the development of oral biofilm and the cross-kingdom interactions between some of the members of the commensal MSG and the pathogen yeast C. albicans using a multispecies supragingival biofilm model. A total of nine different in vitro biofilms were grown, quantified with culture analyses, and visually examined with confocal laser scanning microscopy (CLSM). A four-species biofilm without any streptococcal species was used as a basic biofilm. In each subsequent inoculum, one species of MSG was added and afterward combined with Streptococcus mutans. The eight-species biofilm contained all eight strains used in this study. Culture analyses showed that the presence of S. mutans in a four-species biofilm with Streptococcus oralis or S. oralis subsp. tigurinus did not differ significantly in C. albicans colony-forming unit (CFU) counts compared to biofilms without S. mutans. However, compared to other mitis species, Streptococcus gordonii combined with S. mutans resulted in the lowest CFUs of C. albicans. Visual observation by CLSM showed that biofilms containing both S. mutans and one species of MSG seemed to induce the formation of filamentous form of C. albicans. However, when several species of MSG were combined with S. mutans, C. albicans was again found in its yeast form.

Transcriptome Analysis of Streptococcus mutans Quorum Sensing-Mediated Persisters Reveals an Enrichment in Genes Related to Stress Defense Mechanisms

Persisters are a small fraction of growth-arrested phenotypic variants that can survive lethal concentrations of antibiotics but are able to resume growth once antibiotics are stopped. Their formation can be a stochastic process or one triggered by environmental cues. In the human pathogen Streptococcus mutans, the canonical peptide-based quorum-sensing system is an inducible DNA repair system that is pivotal for bacterial survival. Previous work has shown that the CSP-signaling peptide is a stress-signaling alarmone that promotes the formation of stress-induced persisters. In this study, we exposed S. mutans to the CSP pheromone to mimic DNA damage conditions and isolated the antibiotic persisters by treating the cultures with ofloxacin. A transcriptome analysis was then performed to evaluate the differential gene expression between the normal stationary-phase cells and the persisters. RNA sequencing revealed that triggered persistence was associated with the upregulation of genes related to several stress defense mechanisms, notably, multidrug efflux pumps, the arginine deaminase pathway, and the Opu/Opc system. In addition, we showed that inactivation of the VicK kinase of the YycFG essential two-component regulatory system abolished the formation of triggered persisters via the CSP pheromone. These data contribute to the understanding of the triggered persistence phenotype and may suggest new therapeutic strategies for treating persistent streptococcal infections.

Antimicrobial efficacy of chlorine agents against selected oral pathogens

OBJECTIVES

Method-dependent comparison of antimicrobial agents' efficacy against oral pathogens.

MATERIALS AND METHODS

Several sodium hypochlorite solutions (NaOCl)-Perisolv®, Carisolv® and Dakin's solution-were equated with chlorhexidine (CHX) and hydrogen peroxide (H2O2) against ten oral micro-organisms related to caries and periodontitis using different minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) techniques. Agents were adjusted to the final 70 mmol/L concentration of active chlorine molecule.

RESULTS

Apart from H2O2 and the amino acids of Perisolv®, all the agents revealed an antimicrobial effect. Agar diffusion test ranked CHX (p < 0.05) as the most effective against all ten specimens, followed by the NaOCl of Perisolv® and Dakin's solution. Correspondingly, in broth microdilution on agar, CHX was the most effective in eradicating micro-organisms at 0.03 mmol/L compared with 2.2 mmol/L of Dakin's solution. In contrast, the bactericidal concentration of Dakin's solution was the most effective at 0.2 mmol/L, (p < 0.001), followed by Perisolv® (2.14 mmol/L), CHX (2.38 mmol/L) and Carisolv® (3.33 mmol/L) after 5 and 10 min in broth dilution test. In live/dead analysis, 60-min exposure to a 2-fold concentration of agents resulted in two-log Aggregatibacter actinomycetemcomitans inhibition by CHX (35 mmol/L) whilst Streptococcus mutans was more susceptible, in 0.8 and 8.8 mmol/L, after 10 min to CHX and Dakin's respectively.

CONCLUSION

Replacement of CHX with tested hypochlorite agents showed evident potential and promoted rapid antimicrobial effect.

CLINICAL RELEVANCE

Effective antimicrobial agents are crucial in controlling pathogen-induced oral infections increasing clinical possibilities to combat oral biofilms. Additionally, CHX substitution with hypochlorite agents could eliminate CHX's adverse effects.

In Vitro Evaluation of Candida albicans Adhesion on Heat-Cured Resin-Based Dental Composites

Microbial adhesion on dental restorative materials may jeopardize the restorative treatment long-term outcome. The goal of this in vitro study was to assess Candida albicans capability to adhere and form a biofilm on the surface of heat-cured dental composites having different formulations but subjected to identical surface treatments and polymerization protocols. Three commercially available composites were evaluated: GrandioSO (GR), Venus Diamond (VD) and Enamel Plus HRi Biofunction (BF). Cylindrical specimens were prepared for quantitative determination of C. albicans S5 planktonic CFU count, sessile cells CFU count and biomass optical density (OD570 nm). Qualitative Concanavalin-A assays (for extracellular polymeric substances of a biofilm matrix) and Scanning Electron Microscope (SEM) analyses (for the morphology of sessile colonies) were also performed. Focusing on planktonic CFU count, a slight but not significant reduction was observed with VD as compared to GR. Regarding sessile cells CFU count and biomass OD570 nm, a significant increase was observed for VD compared to GR and BF. Concanavalin-A assays and SEM analyses confirmed the quantitative results. Different formulations of commercially available resin composites may differently interact with C. albicans. The present results showed a relatively more pronounced antiadhesive effect for BF and GR, with a reduction in sessile cells CFU count and biomass quantification.

Pharmacoinformatics-Based Approach for Uncovering the Quorum-Quenching Activity of Phytocompounds against the Oral Pathogen, Streptococcus mutans

Streptococcus mutans, a gram-positive oral pathogen, is the primary causative agent of dental caries. Biofilm formation, a critical characteristic of S. mutans, is regulated by quorum sensing (QS). This study aimed to utilize pharmacoinformatics techniques to screen and identify effective phytochemicals that can target specific proteins involved in the quorum sensing pathway of S. mutans. A computational approach involving homology modeling, model validation, molecular docking, and molecular dynamics (MD) simulation was employed. The 3D structures of the quorum sensing target proteins, namely SecA, SMU1784c, OppC, YidC2, CiaR, SpaR, and LepC, were modeled using SWISS-MODEL and validated using a Ramachandran plot. Metabolites from Azadirachta indica (Neem), Morinda citrifolia (Noni), and Salvadora persica (Miswak) were docked against these proteins using AutoDockTools. MD simulations were conducted to assess stable interactions between the highest-scoring ligands and the target proteins. Additionally, the ADMET properties of the ligands were evaluated using SwissADME and pkCSM tools. The results demonstrated that campesterol, meliantrol, stigmasterol, isofucosterol, and ursolic acid exhibited the strongest binding affinity for CiaR, LepC, OppC, SpaR, and Yidc2, respectively. Furthermore, citrostadienol showed the highest binding affinity for both SMU1784c and SecA. Notably, specific amino acid residues, including ASP86, ARG182, ILE179, GLU143, ASP237, PRO101, and VAL84 from CiaR, LepC, OppC, SecA, SMU1784c, SpaR, and YidC2, respectively, exhibited significant interactions with their respective ligands. While the docking study indicated favorable binding energies, the MD simulations and ADMET studies underscored the substantial binding affinity and stability of the ligands with the target proteins. However, further in vitro studies are necessary to validate the efficacy of these top hits against S. mutans.

Adaptation of Prokaryotic Toxins for Negative Selection and Cloning-Independent Markerless Mutagenesis in Streptococcus Species

The Streptococcus mutans genetic system offers a variety of strategies to rapidly engineer targeted chromosomal mutations. Previously, we reported the first S. mutans negative selection system that functions in a wild-type background. This system utilizes induced sensitivity to the toxic amino acid analog p-chlorophenylalanine (4-CP) as a negative selection mechanism and was developed for counterselection-based cloning-independent markerless mutagenesis (CIMM). While we have employed this system extensively for our ongoing genetic studies, we have encountered a couple limitations with the system, mainly its narrow host range and the requirement for selection on a toxic substrate. Here, we report the development of a new negative selection system that addresses both limitations, while still retaining the utility of the previous 4-CP-based markerless mutagenesis system. We placed a variety of toxin-encoding genes under the control of the xylose-inducible gene expression cassette (Xyl-S) and found the Fst-sm and ParE toxins to be suitable candidates for inducible negative selection. We combined the inducible toxins with an antibiotic resistance gene to create several different counterselection cassettes. The most broadly useful of these contained a wild-type fst-sm open reading frame transcriptionally fused to a point mutant form of the Xyl-S expression system, which we subsequently named IFDC4. IFDC4 was shown to exhibit exceptionally low background resistance, with 3- to 4-log reductions in cell number observed when plating on xylose-supplemented medium. IFDC4 also functioned similarly in multiple strains of S. mutans as well as with Streptococcus gordonii and Streptococcus sanguinis. We performed CIMM with IFDC4 and successfully engineered a variety of different types of markerless mutations in all three species. The counterselection strategy described here provides a template approach that should be adaptable for the creation of similar counterselection systems in many other bacteria. IMPORTANCE Multiple medically significant Streptococcus species, such as S. mutans, have highly sophisticated genetic systems available, largely as a consequence of their amenability to genetic manipulation via natural competence. Despite this, few options are available for the creation of markerless mutations in streptococci, especially within wild-type strains. Markerless mutagenesis is a critical tool for genetic studies, as it allows the user to explore many fundamental questions that are not easily addressable using marked mutagenesis. Here, we describe a new approach for streptococcal markerless mutagenesis that offers a variety of advantages over the current approach, which employs induced sensitivity to the toxic substrate 4-CP. The approach employed here should be readily adaptable for the creation of similar markerless mutagenesis systems in other organisms.

Druggable sites identification in Streptococcus mutans VicRK system evaluated by catechols

Dental caries is a global public health problem, being the most common non-communicable disease. Streptococcus mutans, the causative agent of human cariogenic dental biofilms, produce glycosyltransferases (Gtfs) whose gene expression is modulated by the VicRK system, which makes them a promising target for dental biofilm inhibitor developments. Bioinformatics have playing a significant role in drug discovery programs mainly in novel hit identification. In this study, potential inhibitors against the S. mutans VicK system have been identified through Structure-based Virtual Screening performed between the VicK druggable sites followed byMolecular Dynamic simulations (MD) with binding affinity analysis by MM-PBSA approach. First, VicK protein was downloaded from PDB, and druggability analyses were performed by PockDrug and FTMap servers describing three interaction sites (S1, S2, and S3) that covered the most important domains for stability and activity. Next, a catechol virtual screening (n = 383) was performed on AutoDock4.2, and better-docked catechols showed strong binding affinity interaction through hydrogen bonding, hydrophobic interactions, and π-stacking with VicK auto kinase and phosphatase activity sites. Ligand efficiency indexes were also calculated (LE, LELP, LLE, and BEI) and showed optimal values. Furthermore, a 200 ns MD simulation run showed stability (RMSD and RMSF) and a high number of hydrogen bonds into peltatoside and maritimein, the two best VicK complexes. These results supported that catechols could potentially inhibit exopolysaccharides synthesis and be used in the biofilm management of new anti-cariogenic and antimicrobial agents.

Current Infections of the Orofacial Region: Treatment, Diagnosis, and Epidemiology

Undoubtedly, diagnosing and managing infections is one of the most challenging issues for orofacial clinicians. As a result of the diversity of symptoms, complicated behavior, and sometimes confusing nature of these conditions, it has become increasingly difficult to diagnose and treat them. It also highlights the need to gain a deeper insight into the orofacial microbiome as we try to improve our understanding of it. In addition to changes in patients' lifestyles, such as changes in diet, smoking habits, sexual practices, immunosuppressive conditions, and occupational exposures, there have been changes in patients' lifestyles that complicate the issue. Recent years have seen the development of new infection treatments due to the increased knowledge about the biology and physiology of infections. This review aimed to provide a comprehensive overview of the types of infections in the mouth, including the types that viruses, fungi, or bacteria may cause. It is important to note that we searched the published literature in the Scopus, Medline, Google Scholar, and Cochran databases from 2010 to 2021 using the following keywords: "Orofacial/Oral Infections," "Viral/Fungal/Bacterial Infections", "Oral Microbiota" And "Oral Microflora" without limiting our search to languages and study designs. According to the evidence, the most common infections in the clinic include herpes simplex virus, human papillomavirus, Candida albicans, Aspergillus, Actinomycosis, and Streptococcus mutans. The purpose of this study is to review the new findings on characteristics, epidemiology, risk factors, clinical manifestations, diagnosis, and new treatment for these types of infectious diseases.

Medical and Dental Applications of Titania Nanoparticles: An Overview

Currently, titanium oxide (TiO₂) nanoparticles are successfully employed in human food, drugs, cosmetics, advanced medicine, and dentistry because of their non-cytotoxic, non-allergic, and bio-compatible nature when used in direct close contact with the human body. These NPs are the most versatile oxides as a result of their acceptable chemical stability, lower cost, strong oxidation properties, high refractive index, and enhanced aesthetics. These NPs are fabricated by conventional (physical and chemical) methods and the latest biological methods (biological, green, and biological derivatives), with their advantages and disadvantages in this epoch. The significance of TiO₂ NPs as a medical material includes drug delivery release, cancer therapy, orthopedic implants, biosensors, instruments, and devices, whereas their significance as a dental biomaterial involves dentifrices, oral antibacterial disinfectants, whitening agents, and adhesives. In addition, TiO₂ NPs play an important role in orthodontics (wires and brackets), endodontics (sealers and obturating materials), maxillofacial surgeries (implants and bone plates), prosthodontics (veneers, crowns, bridges, and acrylic resin dentures), and restorative dentistry (GIC and composites).

Candida species and selected behavioral factors co-associated with severe early childhood caries: Case-control study

Severe Early Childhood Caries (sECC) is a multifactorial disease associated with the occurrence of specific oral microorganisms and other environmental, behavioral, and genetic factors. This study aimed to construct a multivariable model including the occurrence of Candida spp. and selected behavioral factors (length of breastfeeding, serving sweet beverages and beginning of brushing child’s teeth) to determine their relationships to the occurrence of sECC.

In this case-control study 164 children with sECC and 147 children without dental caries were included. MALDI-TOF MS and multiplex qPCR were used to identify Candida spp. and selected bacteria in dental plaque samples, respectively. A questionnaire on oral hygiene, diet, and children’s health was filled in by the parents.

The constructed multivariable logistic regression model showed an independent influence of the microbial and behavioral factors in sECC etiopathogenesis. The occurrence of C. albicans and C. dubliniensis was associated with higher odds of sECC development (odds ratio, OR: 9.62 and 16.93, respectively), together with breastfeeding of 6 months or less (OR: 2.71), exposure to sweet beverages (OR: 3.77), and starting to brush child’s teeth after the 12^th month of age (OR: 4.10), all statistically significant (p < 0.01).

Considering the high occurrence of C. albicans and C. dubliniensis in dental plaque in children with sECC, we propose them as “keystone pathogens” and risk factors for sECC. The models showed that presence of specific species of Candida in dental plaque may be a better descriptor of sECC than the mentioned behavioral factors.

Inhibition of Streptococcus mutans adhesion and biofilm formation with small-molecule inhibitors of sortase A from Juniperus chinensis

Background

Streptococcus mutans, an important Gram-positive pathogen in dental caries, uses sortase A (SrtA) to anchor surface proteins to the bacterial cell wall, thereby promoting biofilm formation and attachment to the tooth surface.

Design

Based on activity-guided separation, inhibitors of S. mutans SrtA were isolated from Juniperus chinensis and identified through combined spectroscopic analysis. Further effects of isolated SrtA inhibitor on S. mutans were evaluated on bacterial aggregation, adherence and biofilm formation.

Results

Six compounds (1–6) were isolated from the dried heartwood of J. chinensis. A novel compound designated 3’,3”-dihydroxy-(−)-matairesinol (1) was identified, which exhibited potent inhibitory activity toward S. mutans SrtA (IC₅₀ = 16.1 μM) without affecting microbial viability (minimum inhibitory concentration > 300 μM). The results of subsequent bioassays using compound 1 indicated that this compound inhibits S. mutans aggregation, adhesion and biofilm formation on solid surfaces by inhibiting SrtA activity. The onset and magnitude of inhibition of adherence and biofilm formation in S. mutans treated with compound 1 at 4× the SrtA IC₅₀ are comparable to the behaviors of the untreated srtA-deletion mutant.

Conclusion

Our findings suggest that small-molecule inhibitors of S. mutans SrtA may be useful for the prevention of dental plaque and treatment of dental microbial diseases.

Anti-enteric efficacy and mode of action of tridecanoic acid methyl ester isolated from Monochoria hastata (L.) Solms leaf

Monochoria hastata (L.) Solms (family Pontederiaceae), an ethnomedicinal aquatic herb, is used to remedy several gastrointestinal diseases by various ethnic groups in India. The present study aimed to purify and characterize the antibacterial active ingredient against gastrointestinal (GI) diseases and its mode of action using in vitro experimental models. The active lead molecule in the ethyl acetate extract (EA-Mh) fraction has been purified and characterized through high-performance liquid chromatography (HPLC), proton nuclear magnetic resonance (1H NMR), and electrospray ionization mass spectrometry (ESI-MS) methods. The anti-enteric efficacy has been evaluated against enteropathogenic Gram-positive and Gram-negative bacteria by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), lactate dehydrogenase (LDH), and scanning electron microscopy (SEM) studies. The synergistic and antagonistic studies were done on E. coli MTCC 723 using standard antibiotics (ampicillin and kanamycin, final conc. 50 µg/ml) in a sterilized 96-well micro-plate, incubated at 37 ℃ for 24 h. The chromatographic and spectroscopic analyses revealed the presence of tridecanoic acid methyl ester (TAME) in the bioactive fraction. The compound causes significant extracellular leakage activity by disrupting cellular morphology in the Enterococcus faecalis MCC 2041 T and Salmonella enterica serovar Typhimurium MTCC 98, at a dose of 375 μg/ml and 750 μg/ml, respectively. The SEM study shows a significant rupturing of E. coli and E. faecalis cells due to TAME induced autolysis. It has synergistic activity with ampicillin. The in silico molecular docking through the AutoDock Vina 4.2 and GROMACS (ver. 5.1) Charmm27 force field results showed that the TAME had a strong binding affinity Escherichia coli DNA Gyrase B (PDB ID: 5l3j.pdb) protein and caused conformational changes. Thus, the manuscript reports the first time on the characterization of TAME from this plant with a detailed antibacterial mode of action studies.

Pharmaceutical Nanotechnology Applied to Phthalocyanines for the Promotion of the Antimicrobial Photodynamic Therapy: A Literature Review

Phthalocyanines are photosensitizers activated by light at a specific wavelength in the presence of oxygen and act topically through the production of Reactive Oxygen Species, which simultaneously attack several biomolecular targets in the pathogen agent and, therefore, have multiple and variable action sites. This nonspecific action site delineates the conventional resistance mechanisms. Antimicrobial Photodynamic Therapy (aPDT) is safe, easy to implement and, unlike conventional agents, the activity spectrum of photoantimicrobials. This work is a systematic review of the literature based on nanocarriers containing phthalocyanines in aPDT against bacteria, fungi, viruses, and protozoa. The search was performed in two different databases (MEDLINE/PubMed and Web of Science) between 2011 and May 2021. Nanocarriers often improve the action or are equivalent to free drugs, but their use allows substituting the organic solvent in the case of hydrophobic phthalocyanines, allowing for a safer application of aPDT with the possibility of prolonged release. In the case of hydrophilic phthalocyanines, they would allow for nonspecific site delivery with a possibility of cellular internalization. A single infectious lesion can have multiple microorganisms, and PDT with phthalocyanines is an interesting treatment given its ample spectrum of action. It is possible to highlight the upconversion nanosystems, which allow for the activation of phthalocyanine in deeper tissues by using longer wavelengths, as a system that has not yet been studied, but which could provide treatment solutions. The use of nanocarriers containing phthalocyanines requires more studies in animal models and clinical studies to establish the use of aPDT in humans.

Antibacterial Activity of Essential Oils against Oral Pathogens

This updated review article covers the literature between 2011 and 2021 on the antibacterial activity of EOs against the main bacteria that cause caries and periodontal diseases. The criteria to classify the in vitro antibacterial activity of EOs is updated and the most promising results are addressed.

Microbial approaches for the assessment of toothpaste efficacy against oral species: A method comparison

Antibacterial properties of toothpastes enable chemical plaque control in limited‐access tooth regions that are mechanically not sufficiently reached by toothbrushes. Therefore, this study aimed to compare different microbial methods to assess antimicrobial toothpaste properties and evaluate different toothpastes in terms of their antibacterial efficacy against different oral microorganisms in an in vitro setting. Six toothpaste suspensions with varying antibacterial supplements were applied to a multispecies biofilm model (Actinomyces oris, Candida albicans, Fusobacterium nucleatum, Streptococcus oralis, and Streptococcus mutans) as well as to each microorganism. A culture method was used to assess the anti‐biofilm effects and two different agar diffusion assays were performed for testing the antimicrobial effect on each microorganism. The measurements of the culture and diffusion analyses were statistically normalized and compared and toothpastes were ranked according to their antimicrobial efficacy. The results of both agar diffusion assays showed a high correlation across all tested species (Spearman correlation coefficients ρ_s > 0.95). The results of the multispecies biofilm model, however, substantially differed in its assessment of antibacterial properties (ρ_s ranging from 0.22 to 0.87) compared to the results of both diffusion assays. Toothpastes with amine fluoride (with and without stannous fluoride), and toothpastes with triclosan resulted in the highest antimicrobial efficacy. Activated carbon supplements in toothpastes were comparable in their antimicrobial action to the negative control NaCl. The appropriate selection of a broad range of oral microorganisms seems crucial when testing the chemical impact of toothpaste and toothpaste supplements.

Surface Characteristics and Microbiological Analysis of a Vat-Photopolymerization Additive-Manufacturing Dental Resin

The wide application of additive manufacturing in dentistry implies the further investigation into oral micro-organism adhesion and biofilm formation on vat-photopolymerization (VP) dental resins. The surface characteristics and microbiological analysis of a VP dental resin, printed at resolutions of 50 μm (EG-50) and 100 μm (EG-100), were evaluated against an auto-polymerizing acrylic resin (CG). Samples were evaluated using a scanning electron microscope, a scanning white-light interferometer, and analyzed for Candida albicans (CA) and Streptococcus mutans (SM) biofilm, as well as antifungal and antimicrobial activity. EG-50 and EG-100 exhibited more irregular surfaces and statistically higher mean (Ra) and root-mean-square (rms) roughness (EG-50-Ra: 2.96 ± 0.32 µm; rms: 4.05 ± 0.43 µm/EG-100-Ra: 3.76 ± 0.58 µm; rms: 4.79 ± 0.74 µm) compared to the CG (Ra: 0.52 ± 0.36 µm; rms: 0.84 ± 0.54 µm) (p < 0.05). The biomass and extracellular matrix production by CA and SM and the metabolic activity of SM were significantly decreased in EG-50 and EG-100 compared to CG (p < 0.05). CA and SM growth was inhibited by the pure unpolymerized VP resin (48 h). EG-50 and EG-100 recorded a greater irregularity, higher surface roughness, and decreased CA and SM biofilm formation over the CG.

Proteomic Characterization and Target Identification Against Streptococcus mutans Under Bacitracin Stress Conditions Using LC-MS and Subtractive Proteomics

The aim of the present study, is to identify potential targets against the highly pathogenic bacteria Streptococcus mutans that causes dental caries as well as the deadly infection of endocarditis. The powerful and highly sensitive technique of liquid chromatography-mass spectrometry (LC–MS/MS) identified 321 proteins of S. mutans when grown under stressful conditions induced by the antibiotic bacitracin. These 321 proteins were subjected to the insilico method of subtractive proteomics to screen out potential targets by utilizing different analyses like CD-HIT, non-homologous sequence screening, KEGG pathway, essentiality screening, gut-flora non-homology, and codon usage analysis. A database of essential proteins was employed to find sequence homology of non-paralogous proteins to determine proteins which are essential for bacterial survival. Cellular localization analysis of the selected proteins was done to localize them inside the cell along with physico-chemical characterization and druggability analysis. Using computational tools, 22 proteins out of 321, that are functionally distinguishable from their human counterparts and passed the criterion of a potential therapeutic candidate were identified. The selected proteins comprise central energy metabolic proteins, virulence factors, proteins of the sortase family, and essentiality factors. The presented analyses identified proteins of the sortase family, which appear as key therapeutic targets against caries infection. These proteins regulate a number of virulence factors, thus can be simultaneously inhibited to obstruct multiple virulence pathways.

Effects of cigarette smoking on the growth of Streptococcus mutans biofilms: An in vitro study

The increased incidence of dental caries by cigarette smoking (CS) has been widely reported in epidemiological studies, but the relationship between CS and cariogenic biofilm growth has been rarely studied. This study aims to investigate the effects of CS exposure on the growth and virulence of Streptococcus mutans biofilms (S. mutans). Briefly, S. mutans biofilms were formed on saliva-coated hydroxyapatite disks, which were exposed to CS 1, 3, and 6 times per day, respectively. In addition, S. mutans biofilms without CS exposure were considered as the control group. Acidogenicity, dry weight, colony-forming units (CFUs), water-soluble/insoluble extracellular polysaccharides (EPSs), and intracellular polysaccharides (IPSs) were analyzed and confocal laser scanning microscopy (CLSM) images of 74-h-old S. mutans biofilms were obtained. The lowest accumulation of biofilms and EPSs were detected in the 6 times/day CS exposure group compared with those of the control group and other CS exposure groups in 74-h-old S. mutans biofilms. CLSM also revealed the lowest bacterial count (live and dead cells) and EPSs biovolume in the six times/day CS exposure group in 74-h-old S. mutans biofilms. CS exposure inhibited the growth of S. mutans biofilm in vitro study, the anti-cariogenic biofilm formation was enhanced with a dose (frequency)-dependent at which frequency has more influence in the present findings.

Amyloid Aggregation of Streptococcus mutans Cnm Influences Its Collagen-Binding Activity

The cnm gene, coding for the glycosylated collagen- and laminin-binding surface adhesin Cnm, is found in the genomes of approximately 20% of Streptococcus mutans clinical isolates and is associated with systemic infections and increased caries risk. Other surface-associated collagen-binding proteins of S. mutans, such as P1 and WapA, have been demonstrated to form an amyloid quaternary structure with functional implications within biofilms. In silico analysis predicted that the β-sheet-rich N-terminal collagen-binding domain (CBD) of Cnm has a propensity for amyloid aggregation, whereas the threonine-rich C-terminal domain was predicted to be disorganized. In this study, thioflavin-T fluorescence and electron microscopy were used to show that Cnm forms amyloids in either its native glycosylated or recombinant nonglycosylated form and that the CBD of Cnm is the main amyloidogenic unit of Cnm. We then performed a series of in vitro, ex vivo, and in vivo assays to characterize the amylogenic properties of Cnm. In addition, Congo red birefringence indicated that Cnm is a major amyloidogenic protein of S. mutans biofilms. Competitive binding assays using collagen-coated microtiter plates and dental roots, a substrate rich in collagen, revealed that Cnm monomers inhibit S. mutans binding to collagenous substrates, whereas Cnm amyloid aggregates lose this property. Thus, while Cnm contributes to recognition and initial binding of S. mutans to collagen-rich surfaces, amyloid formation by Cnm might act as a negative regulatory mechanism to modulate collagen-binding activity within S. mutans biofilms and warrants further investigation. IMPORTANCE Streptococcus mutans is a keystone pathogen that promotes caries by acidifying the dental biofilm milieu. The collagen- and laminin-binding glycoprotein Cnm is a virulence factor of S. mutans. Expression of Cnm by S. mutans is hypothesized to contribute to niche expansion, allowing colonization of multiple sites in the body, including collagen-rich surfaces such as dentin and heart valves. Here, we suggest that Cnm function might be modulated by its aggregation status. As a monomer, its primary function is to promote attachment to collagenous substrates via its collagen-binding domain (CBD). However, in later stages of biofilm maturation, the same CBD of Cnm could self-assemble into amyloid fibrils, losing the ability to bind to collagen and likely becoming a component of the biofilm matrix. Our findings shed light on the role of functional amyloids in S. mutans pathobiology and ecology.

Effects of brief sodium fluoride treatments on the growth of early and mature cariogenic biofilms

Although fluoride has been widely used as a preventive agent for dental caries, the effects of fluoride on the activities of biofilms in different stages of cariogenic biofilm formation are less studied. This study was designed to investigate the antibiofilm activity of sodium fluoride during the early and mature stages of Streptococcus mutans (S. mutans) biofilm formation. S. mutans biofilms were formed on saliva-coated hydroxyapatite disks. In the early (0-46 h) and mature (46-94 h) biofilm stages, the biofilms were treated with different concentrations of fluoride (250, 500, 1000, 2000 ppm; 5 times in total, 1 min/treatment). Acidogenicity, dry weight, colony-forming units (CFUs), water-soluble/insoluble extracellular polysaccharides (EPSs), and intracellular polysaccharides were analysed, and confocal laser scanning microscopy images were obtained of the two stages of biofilms to determine antibiofilm activities of fluoride at varying concentrations during the formation of early and mature biofilms. In the early stages of cariogenic biofilm formation, test groups with all fluoride concentrations significantly inhibited the growth of S. mutans biofilms. The antibiofilm and anti-EPS formation activities of the brief fluoride treatments increased with a concentration-dependent pattern. At the mature biofilm stage, only the 2000 ppm fluoride treatment group significantly inhibited biofilm accumulation, activity, and intracellular/extracellular polysaccharide content compared with those of the control and other fluoride treatment groups. The antimicrobial effect of fluoride treatment on the growth of S. mutans biofilms was linked with the stage of cariogenic biofilm formation. The inhibition of S. mutans biofilm growth by fluoride treatment was easier in the early formation stage than in the mature stage. Fluoride treatment in the early stage of cariogenic biofilm formation may be an effective approach to controlling cariogenic biofilm development and preventing dental caries.

Inhibition of Streptococcus mutans biofilms with bacterial-derived outer membrane vesicles

BACKGROUND

Biofilms are microbial communities surrounded by a self-produced extracellular matrix which protects them from environmental stress. Bacteria within biofilms are 10- to 1000-fold more resistant to antibiotics, making it challenging but imperative to develop new therapeutics that can disperse biofilms and eradicate infection. Gram-negative bacteria produce outer membrane vesicles (OMV) that play critical roles in communication, genetic exchange, cargo delivery, and pathogenesis. We have previously shown that OMVs derived from Burkholderia thailandensis inhibit the growth of drug-sensitive and drug-resistant bacteria and fungi.

RESULTS

Here, we examine the antibiofilm activity of Burkholderia thailandensis OMVs against the oral biofilm-forming pathogen Streptococcus mutans. We demonstrate that OMV treatment reduces biofilm biomass, biofilm integrity, and bacterial cell viability. Both heat-labile and heat-stable components, including 4-hydroxy-3-methyl-2-(2-non-enyl)-quinoline and long-chain rhamnolipid, contribute to the antibiofilm activity of OMVs. When OMVs are co-administered with gentamicin, the efficacy of the antibiotic against S. mutans biofilms is enhanced.

CONCLUSION

These studies indicate that bacterial-derived OMVs are highly effective biological nanoparticles that can inhibit and potentially eradicate biofilms.

Efficiency of Bacillus subtilis metabolism of sugar alcohols governs its probiotic effect against cariogenic Streptococcus mutans

Bacillus subtilis is a Gram-positive probiotic bacterium that successfully colonises plant roots due to its ability to utilise various sugars. The vast probiotic potential of B. subtilis has been recently demonstrated in numerous host organisms under different environmental conditions. We examined the probiotic potential of B. subtilis against the pathogenic bacterium Streptococcus mutans, which is involved in various oral disorders due to its robust biofilm-forming capability. B. subtilis cells attenuated biofilm formation by S. mutans during their dual growth in the presence of sugar alcohols. Transcription of genes encoding key enzymes in the metabolism of sugar alcohols by B. subtilis were highly induced. Moreover, growth-curve analysis suggested that B. subtilis is more efficient at early utilising sugar alcohols than S. mutans, as supported by the bacterial metabolic activity rates. Similarly, a comparison of secondary metabolites of mono and mixed cultures of B. subtilis and S. mutans indicated that B. subtilis is more active metabolically in the dual culture. Finally, knock-out mutations of the genes encoding key enzymes in the central metabolic pathway significantly reduced B. subtilis' ability to mitigate biofilm formation by S. mutans. We conclude that effective metabolism of sugar alcohols by B. subtilis reinforces the probiotic potential of this bacterium against pathogenic species such as S. mutans.

Anticariogenic activities of Libidibia ferrea, gallic acid and ethyl gallate against Streptococcus mutans in biofilm model

ETHNOPHARMACOLOGICAL RELEVANCE

In Brazil, ethnopharmacological studies show that Libidibia ferrea (Mart. ex Tul.) L. P. Queiroz is commonly used in folk medicine as an antifungal, antimicrobial and anti-inflammatory. In the Amazon region, the dried fruit powder of L. ferrea are widely used empirically by the population in an alcoholic tincture as an antimicrobial mouthwash in oral infections and the infusion is also recommended for healing oral wounds. However, there are few articles that have evaluated the antimicrobial activity against oral pathogens in a biofilm model, identifying active compounds and mechanisms of action.

AIM OF THE STUDY

The aim of this study was to evaluate the antimicrobial and anti-adherence activities of the ethanolic extract, fractions and isolated compounds (gallic acid and ethyl gallate) of the fruit and seed of L. ferrea against Streptococcus mutans. The inhibition of acidicity/acidogenicity and the expression of the S. mutans GTF genes in biofilms were also evaluated.

MATERIALS AND METHODS

Minimal Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Inhibitory Concentration of Cell Adhesion (MICA) were evaluated with ethanolic extract (EELF), fractions, gallic acid (GA) and ethyl gallate (EG) against S. mutans. Inhibition of biofilm formation, pH drop and proton permeability tests were conducted with EELF, GA and EG, and also evaluated the expression of the GTF genes in biofilms. The compounds of dichloromethane fraction were identified by GC-MS.

RESULTS

This is the first report of shikimic, pyroglutamic, malic and protocatechuic acids identified in L. ferrea. EELF, GA and EG showed MIC at 250 μg/mL, and MBC at 1000 μg/mL by EELF. EELF biofilms showed reduced dry weight and acidogenicity of S. mutans in biofilms. GA and EG reduced viable cells, glucans soluble in alkali, acidogenicity, aciduricity and downregulated expression of gtfB, gtfC and gtfD genes in biofilms. SEM images of GA and EG biofilms showed a reduction of biomass, exopolysaccharide and microcolonies of S. mutans.

CONCLUSIONS

The ethanolic extract of fruit and seed of L. ferrea, gallic acid and ethyl gallate showed great antimicrobial activity and inhibition of adhesion, reduction of acidogenicity and aciduricity in S. mutans biofilms. The results obtained in vitro validate the use of this plant in ethnopharmacology, and open opportunities for the development of new oral anticariogenic agents, originated by plants that can inhibit pathogenic biofilm that leads to the development of caries.

Streptococcus mutans Lacking sufCDSUB Is Viable, but Displays Major Defects in Growth, Stress Tolerance Responses and Biofilm Formation

Streptococcus mutans appears to possess a sole iron-sulfur (Fe-S) cluster biosynthesis system encoded by the sufCDSUB cluster. This study was designed to examine the role of sufCDSUB in S. mutans physiology. Allelic exchange mutants deficient of the whole sufCDSUB cluster and in individual genes were constructed. Compared to the wild-type, UA159, the sufCDSUB-deficient mutant, Δsuf::kan^r, had a significantly reduced growth rate, especially in medium with the absence of isoleucine, leucine or glutamate/glutamine, amino acids that require Fe-S clusters for biosynthesis and when grown with medium adjusted to pH 6.0 and under oxidative and nitrosative stress conditions. Relative to UA159, Δsuf::kan^r had major defects in stress tolerance responses with reduced survival rate of > 2-logs following incubation at low pH environment or after hydrogen peroxide challenge. When compared to UA159, Δsuf::kan^r tended to form aggregates in broth medium and accumulated significantly less biofilm. As shown by luciferase reporter fusion assays, the expression of sufCDSUB was elevated by > 5.4-fold when the reporter strain was transferred from iron sufficient medium to iron-limiting medium. Oxidative stress induced by methyl viologen increased sufCDSUB expression by > 2-fold, and incubation in a low pH environment led to reduction of sufCDSUB expression by > 7-fold. These results suggest that lacking of SufCDSUB in S. mutans causes major defects in various cellular processes of the deficient mutant, including growth, stress tolerance responses and biofilm formation. In addition, the viability of the deficient mutant also suggests that SUF, the sole Fe-S cluster machinery identified is non-essential in S. mutans, which is not known in any other bacterium lacking the NIF and/or ISC system. However, how the bacterium compensates the Fe-S deficiency and if any novel Fe-S assembly systems exist in this bacterium await further investigation.

Development of a herbal mouthwash containing a mixture of essential oils and plant extracts and in vitro testing of its antimicrobial efficiency against the planktonic and biofilm-enclosed cariogenic bacterium Streptococcus mutans

A herbal mouthwash containing essential oils of holy basil and mountain tea, extracts of St John's wort and European goldenrod (Bucovia™) and cetylpyridinium chloride, was developed and in vitro tested for its efficiency against biofilm formation by Streptococcus mutans, together with its eradicating activity against already preformed (48 h with saccharose) streptococcal biofilm. The minimum inhibitory (MIC) and bactericidal concentrations (MBC) of the final formulation, as well as of its individual components, were initially determined. The results revealed that the mouthwash needed to be applied at two-times its MIC (0.63% v.v^-1) to completely inhibit biofilm formation by S. mutans, which was otherwise capable of developing a robust biofilm on the tested surface. Once fully developed, the matrix of the biofilm was found to contain a significant amount of exopolysaccharides protecting the cells, being impossible to eradicate even when exposed to pure mouthwash for 15 min, highlighting the great recalcitrance of biofilm-embedded S. mutans.

The Antimicrobial Effect of Cold Atmospheric Plasma against Dental Pathogens-A Systematic Review of In-Vitro Studies

Interest in the application of cold atmospheric plasma (CAP) in the medical field has been increasing. Indications in dentistry are surface modifications and antimicrobial interventions. The antimicrobial effect of CAP is mainly attributed to the generation of reactive oxygen and reactive nitrogen species. The aim of this article is to systematically review the available evidence from in-vitro studies on the antimicrobial effect of CAP on dental pathogens. A database search was performed (PubMed, Embase, Scopus). Data concerning the device parameters, experimental set-ups and microbial cultivation were extracted. The quality of the studies was evaluated using a newly designed assessment tool. 55 studies were included (quality score 31-92%). The reduction factors varied strongly among the publications although clusters could be identified between groups of set pathogen, working gases, and treatment time intervals. A time-dependent increase of the antimicrobial effect was observed throughout the studies. CAP may be a promising alternative for antimicrobial treatment in a clinically feasible application time. The introduced standardized protocol is able to compare the outcome and quality of in-vitro studies. Further studies, including multi-species biofilm models, are needed to specify the application parameters of CAP before CAP should be tested in randomized clinical trials.

Does Curcumin Have an Anticaries Effect? A Systematic Review of In Vitro Studies

BACKGROUND

Dental caries is one of the most important oral health problems and a common infectious microbial disease. Streptococcus mutans (S. mutans) has been regarded as the primary etiologic factor in the formation of dental caries. Curcumin (CUR) has an antibacterial action and could be used in the eradication of S. mutans to control dental caries. This systematic review was undertaken with the aim of evaluating the anticaries effect of CUR.

METHODS

A comprehensive search was conducted in the PubMed/Medline, Cochrane - CENTRAL, and Scopus databases. Based on the PICO model, studies which evaluated the anticaries effects of CUR up until 24 February 2020 with language restrictions were selected for this systematic review.

RESULTS

From 753 papers found, 13 met the eligibility criteria and were included. In 12 out of 13 included studies, CUR had significant antibacterial and anticaries effects. CUR had inhibitory effects on S. mutans growth, acid production, ATPase and sortase A activity, biomass, viability and metabolism reduction of biofilm, reduced exopolysaccharide production of biofilms, changes in biofilm structure, and had anti-adhesion effects against S. mutans.

CONCLUSION

This systematic review suggests promising antibacterial and anticaries effects of CUR including inhibition of S. mutans growth, acid production, ATPase and sortase A activity. This review provides unique information regarding the potential role of CUR in the prevention and treatment of dental carries as a natural, accessible, safe, and inexpensive agent to increase oral and dental health. However, clinical randomized controlled trials are needed to confirm these results.

Indonesian Strain of Lactobacillus reuteri Probiotic Reduces the Initial Biofilm Colonization

Background:

The benefits of probiotics for human health have long been proven. Probiotic Lactobacillus reuteri, can produce a beneficial broad-spectrum antibacterial compound called reuterin by metabolizing glycerol.

Objective:

The aim of the study was to investigate the effect of the Indonesian strain of L. reuteri LC382415 on mono- and dual-species Streptococcus mutans and Streptococcus sanguinis biofilms in vitro.

Methods:

Streptococcus mutans and S. sanguinis were cultured in BHI broth. Lactobacillus reuteri LC382415 was inoculated on MRS agar. The different concentrations effect of L. reuteri (1×104, 1×106, and 1×108 CFU/mL) with and without glycerol supplementation on microbial biofilms were examined using a biofilm assay after incubation for 1,3,6, and 24-h. The biofilm mass optical density was measured with a microplate spectrophotometer at 490 nm. Chlorhexidine gluconate (0.2%) was used as a positive control, and wells without treatment were used as negative controls.

Results:

A significant reduction in mono- and dual-species S. mutans and S. sanguinis biofilm formation was observed after treatment with all concentrations of L.reuteri and after all incubation periods (p<0.05) with or without glycerol supplementation. The concentration of 1×104 CFU/mL after 3-h incubation was the most effective in inhibiting biofilm formation, with 87.8% S. mutans, 95.9% S. sanguinis, and 80.4% dual-species biofilm reduction compared to the negative control (p<0.05).

Conclusion:

The Indonesian strain of L. reuteri effectively reduces mono- and dual-species S.mutans and S. sanguinis biofilms. This suggests that it may be useful in preventing biofilm formation in oral cavities. Future studies on the mechanism of action of this active component are warranted.

Dual antibacterial drug-loaded nanoparticles synergistically improve treatment of Streptococcus mutans biofilms

Dental caries (i.e., tooth decay), which is caused by biofilm formation on tooth surfaces, is the most prevalent oral disease worldwide. Unfortunately, many anti-biofilm drugs lack efficacy within the oral cavity due to poor solubility, retention, and penetration into biofilms. While drug delivery systems (DDS) have been developed to overcome these hurdles and improve traditional antimicrobial treatments, including farnesol, efficacy is still modest due to myriad resistance mechanisms employed by biofilms, suggesting that synergistic drug treatments may be more efficacious. Streptococcus mutans (S. mutans), a cariogenic pathogen and biofilm forming model organism, has several key virulence factors including acidogenicity and exopolysaccharide (EPS) matrix synthesis. Flavonoids, such as myricetin, can reduce both biofilm acidogenicity and EPS synthesis. Therefore, a nanoparticle carrier (NPC) DDS with flexibility to co-load farnesol in the hydrophobic core and myricetin within the cationic corona, was tested in vitro using established and developing S. mutans biofilms. Co-loaded NPC treatments effectively disrupted biofilm biomass (i.e., dry weight) and reduced biofilm viability by ~3 log CFU/mL versus single drug-only controls in developing biofilms, suggesting dual-drug delivery exhibits synergistic anti-biofilm effects. Mechanistic studies revealed that co-loaded NPCs synergistically inhibited planktonic bacterial growth compared to controls and reduced S. mutans acidogenicity due to decreased atpD expression, a gene associated with acid tolerance. Moreover, the myricetin-loaded NPC corona enhanced NPC binding to tooth-mimetic surfaces, which can increase drug efficacy through improved retention at the biofilm-apatite interface. Altogether, these findings suggest promise for co-delivery of myricetin and farnesol DDS as an alternative anti-biofilm treatment to prevent dental caries.

Collaboration in Natural Product Total Synthesis: Carolacton – A Decade of Discovery

Carolacton, a macrocyclic natural product with impressive anti-biofilm biological activity, has been a focus in multiple research groups for the past decade. Chemists and biologists, alike, have been interested in uncovering the mechanism of action and have made great strides towards this goal. Carolacton causes cellular defects in Streptococcus mutans biofilm, which leads to decreases in cellular viability. As biological targets have been uncovered, synthetic chemists have devised synthetic routes that have helped uncover the important chemical functionalities that lead to biological activity. Herein, we discuss our synthetic collaboration that galvanized an entire research program around the natural product carolacton.

Antimicrobial properties, compressive strength and fluoride release capacity of essential oil-modified glass ionomer cements-an in vitro study

OBJECTIVES

This study was designed to investigate the antimicrobial properties, compressive strength and fluoride release capacities of high-viscous glass ionomer cements (GICs) after incorporation of cinnamon and thyme essential oils.

MATERIALS AND METHODS

Experimental-modified GICs were prepared by incorporation of thyme and cinnamon essential oils into the liquid phase of the cement at 5 and 10% v/v. Antimicrobial activity against selected microorganisms (Streptococcus mutans and Candida albicans) was done using direct contact test. Compressive strength of the four new formulations and control group was tested using a universal testing machine while fluoride ion release was measured by ion-selective electrode at 1, 7, 14 and 28 days. Data analysis and comparisons between groups were performed using factorial and one-way ANOVA and Tukey's tests.

RESULTS

All newly formulated GICs exhibited significantly higher inhibitory effects against both Streptococcus mutans and Candida albicans growth when compared to conventional GIC (p < 0.05). Compressive strength of 5% cinnamon-modified GIC (MPa = 160.32 ± 6.66) showed no significant difference when compared with conventional GIC (MPa = 165.7 ± 5.769) (p value > 0.05). Cumulative fluoride-releasing pattern at days 7, 14, and 28 were 10% cinnamon-GIC > 5% thyme-GIC > 5% cinnamon-GIC > 10% thyme GIC > conventional GIC.

CONCLUSIONS

Incorporation of 5% cinnamon oil into glass ionomer resulted in better antimicrobial effects against S. mutans and C. albicans and increased fluoride-release capacity without jeopardizing its compressive strength.

CLINICAL RELEVANCE

The 5% cinnamon-modified GIC appears to be a promising alternative restorative material in ART technique.

Curcuma longa L. (turmeric), Rosmarinus officinalis L. (rosemary), and Thymus vulgaris L. (thyme) extracts aid murine macrophages (RAW 264.7) to fight Streptococcus mutans during in vitro infection

Finding an effective alternative way to aid defense cells to fight Streptococcus mutans was the main goal of this study. The effect of plant extracts from Curcuma longa L. (turmeric), Rosmarinus officinalis L. (rosemary), and Thymus vulgaris L. (thyme) was evaluated on murine macrophages (RAW 264.7) infected by S. mutans. Minimum inhibitory concentration (MIC) of the extracts was determined. Macrophages were infected by S. mutans and treated with each extract. From the supernatants, it was measured nitric oxide (NO) level. Posteriorly, RAW 264.7 were lysed to expose living and phagocytosed bacteria. Cytotoxicity was checked by lysosomal activity analysis, using neutral red assay. Each extract helped RAW 264.7 to eliminate S. mutans during infection, as observed by a significant bacterial reduction. Significant cell viability was also found. Besides, an increased production of NO was verified using R. officinalis L. and T. vulgaris L. extracts. The evaluated extracts demonstrated an effective action to assist RAW 264.7 to fight S. mutans during infection.

Pyruvate secretion by oral streptococci modulates hydrogen peroxide dependent antagonism

Many commensal oral streptococci generate H₂O₂ via pyruvate oxidase (SpxB) to inhibit the growth of competing bacteria like Streptococcus mutans, a major cariogenic species. In Streptococcus sanguinis SK36 (SK36) and Streptococcus gordonii DL1 (DL1), spxB expression and H₂O₂ release are subject to carbon catabolite repression by the catabolite control protein A (CcpA). Surprisingly, ccpA deletion mutants of SK36 and DL1 fail to inhibit S. mutans despite their production of otherwise inhibitory levels of H₂O₂. Using H₂O₂-deficient spxB deletion mutants of SK36 and DL1, it was subsequently discovered that both strains confer protection in trans to other bacteria when H₂O₂ is added exogenously. This protective effect depends on the direct detoxification of H₂O₂ by the release of pyruvate. The pyruvate dependent protective effect is also present in other spxB-encoding streptococci, such as the pneumococcus, but is missing from spxB-negative species like S. mutans. Targeted and transposon-based mutagenesis revealed Nox (putative H₂O-forming NADH dehydrogenase) as an essential component required for pyruvate release and oxidative protection, while other genes such as sodA and dps play minor roles. Furthermore, pyruvate secretion is only detectable in aerobic growth conditions at biofilm-like cell densities and is responsive to CcpA-dependent catabolite control. This ability of spxB-encoding streptococci reveals a new facet of the competitive interactions between oral commensals and pathobionts and provides a mechanistic basis for the variable levels of inhibitory potential observed among H₂O₂-producing strains of commensal oral streptococci.

A narrative review of the effects of sugar-sweetened beverages on human health: A key global health issue

The provision of healthy and safe food is vital for human health, and the addition of unnecessary sugars in foodstuffs is an important global issue, leading to multiple long- and short-term health issues and spiraling costs for individuals and governments alike. The negative effect of excess sugar consumption contributes to adverse health conditions, including obesity, type 2 diabetes, and poor oral health in both high and low resource settings. A key plank of governmental and health promotion bodies' nutritional guidance is to raise public awareness of "hidden" sugars, salt, and fats, such as found in processed foods and sugar-sweetened beverages (SSBs), and guide individuals to reduce their consumption. This rapid narrative review brings together some of the key issues identified in the literature around the consumption of SSBs, including patterns of consumption, the general impact on human health and nutrition, specific effects on oral health and the oral microbiome, and strategies to address over-consumption. The range of long-term adverse effects on health is often misunderstood or unknown by the public. However, some strategies have succeeded in reducing the consumption of SSBs, including public health strategies and interventions and the imposition of taxes or levies, and this article makes recommendations for action.

Repurposing the Streptococcus mutans CRISPR-Cas9 System to Understand Essential Gene Function

A recent genome-wide screen identified ~300 essential or growth-supporting genes in the dental caries pathogen Streptococcus mutans. To be able to study these genes, we built a CRISPR interference tool around the Cas9 nuclease (Cas9Smu) encoded in the S. mutans UA159 genome. Using a xylose-inducible dead Cas9Smu with a constitutively active single-guide RNA (sgRNA), we observed titratable repression of GFP fluorescence that compared favorably to that of Streptococcus pyogenes dCas9 (Cas9Spy). We then investigated sgRNA specificity and proto-spacer adjacent motif (PAM) requirements. Interference by sgRNAs did not occur with double or triple base-pair mutations, or if single base-pair mutations were in the 3' end of the sgRNA. Bioinformatic analysis of >450 S. mutans genomes allied with in vivo assays revealed a similar PAM recognition sequence as Cas9Spy. Next, we created a comprehensive library of sgRNA plasmids that were directed at essential and growth-supporting genes. We discovered growth defects for 77% of the CRISPRi strains expressing sgRNAs. Phenotypes of CRISPRi strains, across several biological pathways, were assessed using fluorescence microscopy. A variety of cell structure anomalies were observed, including segregational instability of the chromosome, enlarged cells, and ovococci-to-rod shape transitions. CRISPRi was also employed to observe how silencing of cell wall glycopolysaccharide biosynthesis (rhamnose-glucose polysaccharide, RGP) affected both cell division and pathogenesis in a wax worm model. The CRISPRi tool and sgRNA library are valuable resources for characterizing essential genes in S. mutans, some of which could prove to be promising therapeutic targets.

The Role of Candida albicans Secreted Polysaccharides in Augmenting Streptococcus mutans Adherence and Mixed Biofilm Formation: In vitro and in vivo Studies

The oral cavity is a complex environment harboring diverse microbial species that often co-exist within biofilms formed on oral surfaces. Within a biofilm, inter-species interactions can be synergistic in that the presence of one organism generates a niche for another enhancing colonization. Among these species are the opportunistic fungal pathogen Candida albicans and the bacterial species Streptococcus mutans, the etiologic agents of oral candidiasis and dental caries, respectively. Recent studies have reported enhanced prevalence of C. albicans in children with caries indicating potential clinical implications for this fungal-bacterial interaction. In this study, we aimed to specifically elucidate the role of C. albicans-derived polysaccharide biofilm matrix components in augmenting S. mutans colonization and mixed biofilm formation. Comparative evaluations of single and mixed species biofilms demonstrated significantly enhanced S. mutans retention in mixed biofilms with C. albicans. Further, S. mutans single species biofilms were enhanced upon exogenous supplementation with purified matrix material derived from C. albicans biofilms. Similarly, growth in C. albicans cell-free spent biofilm culture media enhanced S. mutans single species biofilm formation, however, the observed increase in S. mutans biofilms was significantly affected upon enzymatic digestion of polysaccharides in spent media, identifying C. albicans secreted polysaccharides as a key factor in mediating mixed biofilm formation. The enhanced S. mutans biofilms mediated by the various C. albicans effectors was also demonstrated using confocal laser scanning microscopy. Importantly, a clinically relevant mouse model of oral co-infection was adapted to demonstrate the C. albicans-mediated enhanced S. mutans colonization in a host. Analyses of harvested tissue and scanning electron microscopy demonstrated significantly higher S. mutans retention on teeth and tongues of co-infected mice compared to mice infected only with S. mutans. Collectively, the findings from this study strongly indicate that the secretion of polysacharides from C. albicans in the oral environment may impact the development of S. mutans biofilms, ultimately increasing dental caries and, therefore, Candida oral colonization should be considered as a factor in evaluating the risk of caries.