Evaluation of serum-containing substrates for cultivation of oral spirochetes

Identification of a Treponema denticola OppA homologue that binds host proteins present in the subgingival environment

Proteins secreted or exported by Treponema denticola have been implicated as mediators of specific interactions between the spirochete and subgingival tissues in periodontal diseases. However, limited information is available on the ability of this peptidolytic organism to bind or transport soluble peptides present in the subgingival environment. A prominent 70-kDa protein was isolated from surface extracts of T. denticola ATCC 35405. A clone expressing a portion of the protein was identified in an Escherichia coli expression library of T. denticola DNA. DNA sequence analysis showed that the cloned gene encoded a peptide homologous to OppA, the solute binding protein of an ATP-binding cassette-type peptide transporter involved in peptide uptake and environmental signaling in a wide range of bacteria. Genes encoding OppB, -C, -D, and -F were identified directly downstream of oppA in T. denticola. OppA was present in representative strains of T. denticola and in Treponema vincentii but was not detected in Treponema pectinovorum or Treponema socranskii. Immunogold electron microscopy suggested that OppA was accessible to proteins at the surface of the spirochete. Native OppA bound soluble plasminogen and fibronectin but did not bind to immobilized substrates or epithelial cells. A T. denticola oppA mutant bound reduced amounts of soluble plasminogen, and plasminogen binding to the parent strain was inhibited by the lysine analog epsilon-aminocaproic acid. Binding of soluble host proteins by OppA may be important both for spirochete-host interactions in the subgingival environment and for uptake of peptide nutrients.

Antimicrobial susceptibility tests on anaerobic oral mixed cultures in periodontal diseases

The ecosystem of the dental plaque in periodontal diseases is very complex: the study of such micro-organisms, which are mostly strict anaerobes, requires the use of specific techniques under conditions of strict anaerobiosis. The aim of the present study was to design a rapid method to evaluate the activity of antimicrobials on mixed bacterial plaque of subjects with periodontal diseases. The study was carried out using a computerised instrument generally used for simultaneous diagnostic tests with aerobic bacteria. Operative and methodological modifications were made to obtain conditions of strict anaerobiosis and the balanced growth of all the microbial forms present in the mixed cultures of the plaque. Penicillins and cephalosporins were active on all the samples, whereas colistin, gentamicin, kanamycin and nalidixic acid showed no activity. Clindamycin, tetracycline, erythromycin and penicillin G were effective only against some samples. The activity of the antimicrobials towards isolated strains was analogous to that towards the corresponding mixed culture.

Serum IgG and IgM levels to bacterial antigens in necrotizing ulcerative gingivitis

Previous studies of the systemic antibody response in necrotizing ulcerative gingivitis (NUG) have elicited varying results. The purpose of this study was to determine the humoral response to site-specific isolates of microbiota associated with NUG. Sera from 21 active NUG subjects and 21 age-sex-race matched controls were assessed for IgG and IgM antibodies to 4 clinical isolates of Prevotella intermedia and 3 clinical isolates of Treponema species. P. intermedia and Treponema strains were isolated from active and inactive sites of NUG patients and gingivitis sites of controls. P. intermedia was also isolated from noninflamed sites of the controls. IgG and IgM serum levels to these 7 bacteria were measured by ELISA. Compared to control subjects, the NUG sera exhibited significantly lower IgG and IgM levels to all 4 isolates of P. intermedia (P < or = 0.001). It was also noted that sera from NUG subjects had elevated IgM levels to all 3 spirochete isolates but significantly higher only to the spirochete isolated from a gingivitis site of a control subject (P < or = 0.005). The data suggest that failure to mount a substantial antibody response to P. intermedia may be associated with onset of disease activity in NUG. However, the assumed lack of "biological significance" between differences in antibody responses measured indicates the relationship is weak or nonexistent. It also appears that antibody response to spirochetes is not associated with onset of NUG.

Improved detection of oral spirochetes with an anaerobic culture method

A method for routine culturing of oral spirochetes was studied in periodontitis patients and subjects with healthy gingivae. Subgingival plaque bacteria, including oral spirochetes were cultured anaerobically using the steel wool jar method, the glove-box procedure and the plate-in-bottle method. They were also observed directly with a phase-contrast microscope. The number of colonies of recovered spirochetes was significantly higher with the plate-in-bottle method when Medium 10 (M10) or M10 supplemented with 10% rumen fluid was used. In almost all cases, spirochetes were detected with this culture method. The ratios of spirochetes from patient samples, cultured by the plate-in-bottle method, and of other microorganisms, cultured in Eggerth-Gagnon (EG) medium by the steel wool jar method, were almost identical of those observed by phase-contrast microscopy. These results indicate that it can be just as possible to culture certain oral spirochetes as other anaerobic bacteria.

Susceptibility of small-sized oral spirochetes to eight antibiotics and chlorhexidine

The purpose of the study was to examine the susceptibility of two different small-sized spirochete morphotypes from subgingival plaque to eight antibiotics and chlorhexidine. MIC-values were determined by a broth dilution method and related to achievable antibiotic tissue- and blood concentrations. The spirochetes were characterized as susceptible, moderate susceptible, and resistant to the different antibiotics. The MICs of tetracycline hydrochloride, doxycycline, penicillin G, and chlorhexidine were all considerably lower for spirochete strains with a 2:4:2 endoflagella system (two endoflagella from each cell-end) than for strains with a 1:2:1 endoflagella system (one endoflagellum from each cell-end). No differences were observed for the remaining antibiotics. Spirochetes containing one endoflagellum from each cell-end were found to be susceptible to metronidazole and doxycycline, susceptible to moderate susceptible to tetracycline hydrochloride, moderate susceptible to penicillin G, and resistant to the remaining antibiotics. Spirochetes containing two endoflagella from each cell-end were susceptible to doxycycline, tetracycline hydrochloride, and metronidazole. Susceptible to moderate susceptible to penicillin G. These spirochetes were resistant to the remaining agents. The significance of these observations is discussed in relation to obtainable gingival crevicular fluid concentrations and treatment of marginal periodontitis.

Cultivation on solid media of spirochetes in subgingival plaque from advanced marginal periodontitis in humans

Six solid substrates were compared for suitability to support growth of spirochetes from 18 subgingival plaque samples in patients with advanced marginal periodontitis. The following substrates with rabbit serum were tested: BHIA-SC + blood, RGCA-SC + blood, GM-1 +/- blood and MGM-1 +/- blood. All media contained rifampicin and polymyxin B. After incubation in a glovebox (70% N2, 20% H2, 10% CO2) for 14 days spirochete colonies were semiquantitated and the colony morphologies described. The spirochetes in six of the primary samples and in the related colonies after cultivation were identified ultrastructurally by number of endoflagella. The results showed that the colony morphologies were more related to the substrate used than to the various types of spirochetes, and that individual colonies contained different types of spirochetes. The substrates MGM-1, RGCA-SC, and BHIA-SC, all with blood, showed the highest recoveries of about 5%. Spirochetes with less than four endoflagella grew on all substrates, but the MGM-1 + blood and RGCA-SC + blood media seemed the most versatile as they showed growth of all types of spirochetes observed in the primary samples.