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Sy K, Chevalier C, Maton M, Mokbel I, Mahieux S, Houcke I, Neut C, Grosgogeat B, Deveaux E, Gritsch K, Agossa K. Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study. Antibiotics (Basel) 2023; 12:1416. [PMID: 37760713 PMCID: PMC10525524 DOI: 10.3390/antibiotics12091416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested on pathogens found in both the root canal and the periodontal pocket. Exposure to 0.5% and 1% CHX-loaded ICMs decreased the growth of Porphyromonas gingivalis and was effective in eradicating or inhibiting an Enterococcus faecalis biofilm. CH was injected into the root canal of extracted human teeth immersed in deionized water. CHX-loaded ICMs resulted in the transradicular diffusion of active components outside the tooth through the apex and the lateral dentinal tubules, as shown by the release of CHX (from 3.99 µg/mL to 51.28 µg/mL) and changes in pH (from 6.63 to 8.18) and calcium concentrations (from 2.42 ppm to 14.67 ppm) after 7 days. The 0.5% CHX-loaded ICM was non-toxic and reduced the release of IL-6 by periodontal cells stimulated by P. gingivalis lipopolysaccharides. Results indicate that the root canal may serve as a reservoir for periodontal drug delivery and that CHX-based ICMs can be an adjuvant for the control of infections and inflammation in endo-periodontal lesions.
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Affiliation(s)
- Kadiatou Sy
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Charlène Chevalier
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Mickaël Maton
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Ilham Mokbel
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Séverine Mahieux
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Isabelle Houcke
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Christel Neut
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Etienne Deveaux
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Kerstin Gritsch
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Kevimy Agossa
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
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Gambin DJ, Vitali FC, De Carli JP, Mazzon RR, Gomes BPFA, Duque TM, Trentin MS. Prevalence of red and orange microbial complexes in endodontic-periodontal lesions: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6533-6546. [PMID: 34495401 DOI: 10.1007/s00784-021-04164-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/24/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This systematic review assesses the prevalence of microbial complexes in endodontic-periodontal lesion. MATERIALS AND METHODS Nine databases were searched through August 2020. Experts were consulted to indicate additional studies. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies that evaluated the prevalence of microbial orange and red complexes among patients with endodontic-periodontal lesion were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS From 572 articles found on all databases, 11 clinical studies were finally included. The following microorganisms were investigated: P. gingivalis, T. forsythia, T. denticola, F. nucleatum, F. periodonticum, P. micra, P. intermedia, P. nigrescens, S. constellatus, C. gracilis, C. rectus, C. showae and E. nodatum. Considering the orange complex, P. micra, E. nodatum and S. constellatus were prevalent in both root canal and periodontal pockets. P. gingivalis and T. forsythia belonging to the red complex were prevalent only in periodontal pockets. The red complex microorganisms were not found very frequently in root canal. CONCLUSIONS There is a similarity between the microbiome of root canal and periodontal pockets, with prevalence of the three microorganisms of the orange complex. Two microorganisms from the red complex were prevalent only in periodontal pockets. CLINICAL RELEVANCE The prevalence of specific microorganisms in endodontic-periodontal lesion is important to understand the microbiological profile of the patients involved and to correlate it with possible clinical and repair conditions of this pathology.
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Affiliation(s)
- Diego José Gambin
- Post-Graduate Program in Dentistry, Faculty of Dentistry, University of Passo Fundo, Av. Brasil Leste, São José, Passo Fundo, RS, 28599052-900, Brazil
| | - Filipe Colombo Vitali
- Department of Dentistry, Post-Graduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n-Trindade, Florianópolis, SC, 88040-900, Brazil
| | - João Paulo De Carli
- Department of Oral Medicine and Prosthodontics, University of Passo Fundo, Av. Brasil Leste, São José, Passo Fundo, RS, 28599052-900, Brazil
| | - Ricardo Ruiz Mazzon
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n-Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. LimeiraPiracicaba, AreiãoSP, 90113414-903, Brazil
| | - Thais Mageste Duque
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n-Trindade, Florianópolis, SC, 88040-900, Brazil.
| | - Micheline Sandini Trentin
- Department of Periodontics, Faculty of Dentistry, University of Passo Fundo, Av. Brasil Leste, São José, Passo Fundo, RS, 28599052-900, Brazil
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The Microbiota Profile Analysis of Combined Periodontal-Endodontic Lesions Using 16S rRNA Next-Generation Sequencing. J Immunol Res 2021; 2021:2490064. [PMID: 34825007 PMCID: PMC8610669 DOI: 10.1155/2021/2490064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/10/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022] Open
Abstract
Objective The primary aim of this investigation was to analyze the microbiome in patients with combined periodontal-endodontic lesions. Method Patients with loose and/or painful teeth referred for treatment from March 2020 to December 2020 in the First People's Hospital of Jinzhong were recruited. Samples were collected from teeth diagnosed as chronic periodontics (PE), ulcerative pulpitis (PU), and retrograde pulpitis (RE). Genomic DNA was extracted. The quantitative polymerase chain reaction, targeting the 16S ribosomal RNA (rRNA), was adopted for the quantification of bacteria. Then, the V3-V4 hypervariable regions of the 16S rRNA gene were amplified and subjected to next-generation sequencing. The statistical analysis was performed by R software (V3.5.1). Results A total of 57 qualified samples were collected from 48 patients and analyzed (7 PE, 21 PU, and 19 RE). By linear discriminant analysis effect size, Kingella and Barnesiella were significantly increased in the periodontal pocket of retrograde pulpitis (RE-PE), compared with PE. The relative abundance of Clostridiales Incertae Sedis XI, Fusobacteriaceae, Fusobacterium, Parvimonas, Micrococcaceae, and Rothia was significantly increased in the pulp of retrograde pulpitis (RE-PU) than PU and RE-PE. Prevotella, Leptotrichia, Porphyromonas, Streptococcus, and Fusobacterium are consistently at a high abundance, across PU, RE-PE, and RE-PU. Conclusion The current study highlighted the evidence that a specific microbial community is associated with the occurrence of retrograde pulpitis. The microenvironment of the root canal and pulp chamber will select microbiota. This study offered insights into the pathogenesis of retrograde pulpitis.
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Lopes EM, Passini MRZ, Kishi LT, Chen T, Paster BJ, Gomes BPFA. Interrelationship between the Microbial Communities of the Root Canals and Periodontal Pockets in Combined Endodontic-Periodontal Diseases. Microorganisms 2021; 9:microorganisms9091925. [PMID: 34576820 PMCID: PMC8465609 DOI: 10.3390/microorganisms9091925] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
Periodontal and Endodontic diseases are biofilm-related diseases. The presence of microorganisms in root canals (RCs) and the complex microbiota of periodontal pockets (PPs) contribute to the development of endodontic-periodontal diseases. This study performed a systemic analysis using state-of-the-art sequence data to assess the microbial composition of infected RCs and PPs to further assess the microbiota and verify the possibility of cross-infection between these sites. The microbiomes of these combined diseases were examined with a focus on the V3-V4 hypervariable region of the 16S rRNA gene. The number of species in PP was higher than in RC, and there was a predominance of obligate anaerobes and gram-negative bacteria. In the RCs, the genera Enterococcus, Parvimonas, Stomatobaculum predominated, in contrast, the PPs revealed a predominance of Enterococcus, Parvimonas, Stomatobaculum, Peptostreptococcus and Mogibacterium. The RC and PP microbiome was not similar with regards to the sharing of OTUs for phyla and genera (8 and 67, respectively). The evaluation of molecular markers revealed a large number of markers for resistance to antibiotics of the carbapenem and beta-lactam type (broad spectrum). Another relevant finding of this study was the markers related to systemic diseases related to cardiac muscle and rheumatology, among others. In conclusion, the RC microbiota was less complex and diverse than PP. Interactions between microbial communities were present. The shared genus can signal communication between the endodontic and periodontal microbiomes.
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Affiliation(s)
- Erica M. Lopes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas -UNICAMP, Piracicaba 13400-001, SP, Brazil;
- Correspondence: (E.M.L.); (B.P.F.A.G.)
| | - Maicon R. Z. Passini
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas -UNICAMP, Piracicaba 13400-001, SP, Brazil;
| | - Luciano T. Kishi
- National Laboratory of Scientific Computing, Petrópolis 25715-183, RJ, Brazil;
| | - Tsute Chen
- Department of Molecular Genetics, The Forsyth Institute, Cambridge, MA 02142, USA;
| | - Bruce J. Paster
- Microbiology Department, The Forsyth Institute, Cambridge, MA 02142, USA;
| | - Brenda P. F. A. Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas -UNICAMP, Piracicaba 13400-001, SP, Brazil;
- Correspondence: (E.M.L.); (B.P.F.A.G.)
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Proteome Analysis of Molecular Events in Oral Pathogenesis and Virus: A Review with a Particular Focus on Periodontitis. Int J Mol Sci 2020; 21:ijms21155184. [PMID: 32707841 PMCID: PMC7432693 DOI: 10.3390/ijms21155184] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/11/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023] Open
Abstract
Some systemic diseases are unquestionably related to periodontal health, as periodontal disease can be an extension or manifestation of the primary disease process. One example is spontaneous gingival bleeding, resulting from anticoagulant treatment for cardiac diseases. One important aspect of periodontal therapy is the care of patients with poorly controlled disease who require surgery, such as patients with uncontrolled diabetes. We reviewed research on biomarkers and molecular events for various diseases, as well as candidate markers of periodontal disease. Content of this review: (1) Introduction, (2) Periodontal disease, (3) Bacterial and viral pathogens associated with periodontal disease, (4) Stem cells in periodontal tissue, (5) Clinical applications of mass spectrometry using MALDI-TOF-MS and LC-MS/MS-based proteomic analyses, (6) Proteome analysis of molecular events in oral pathogenesis of virus in GCF, saliva, and other oral Components in periodontal disease, (7) Outlook for the future and (8) Conclusions. This review discusses proteome analysis of molecular events in the pathogenesis of oral diseases and viruses, and has a particular focus on periodontitis.
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Yu X, Jiang H, Cheng G, Shang W, Zhang S. High levels of HIF-1ɑ in hypoxic dental pulps associated with teeth with severe periodontitis. J Mol Histol 2020; 51:265-275. [PMID: 32394128 DOI: 10.1007/s10735-020-09878-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/04/2020] [Indexed: 12/29/2022]
Abstract
In this study we investigated the expression of HIF-1ɑ in dental pulps of the teeth with severe periodontitis. The expression of HIF-1ɑ in dental pulps of the teeth with severe periodontitis was detected by immunohistochemistry, immunofluorescence and real-time PCR. Bone marrow macrophages (BMMs) were cultured under hypoxia in vitro. HIF-1ɑ, osteoclast-specific factors (NFATc1, CTSK and c-fos) and RANKL-induced osteoclastogenesis were evaluated by immunofluorescence, TRAP staining and western blotting. High levels of HIF-1ɑ protein were detected in dental pulps of teeth with severe periodontitis, whereas few positive HIF-1ɑ expressions were detected in healthy dental pulps. Hypoxia occurred in the dental pulps in response to heavy periodontitis. Many HIF-1ɑ-positive infiltratory inflammatory cells were observed around blood vessels. Tooth internal resorption was found in some teeth with severe periodontitis. The HIF-1ɑ levels were upregulated in BMMs under hypoxia, which also promoted osteoclast formation and resorption by NFATc1, CTSK and c-fos. Teeth with severe periodontitis show hypoxic dental pulps and increased potential of osteoclastic differentiation.
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Affiliation(s)
- Xijiao Yu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.,Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China
| | - Huan Jiang
- Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China
| | - Guannan Cheng
- Department of Orthodontics, Weihai Stomatological Hospital, Weihai, Shandong, People's Republic of China
| | - Wenzhi Shang
- Department of Endodontics, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China.
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, People's Republic of China.
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol 2018; 89 Suppl 1:S85-S102. [DOI: 10.1002/jper.16-0642] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 12/16/2022]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018; 45 Suppl 20:S78-S94. [DOI: 10.1111/jcpe.12941] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 01/29/2023]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Gomes BPFA, Berber VB, Kokaras AS, Chen T, Paster BJ. Microbiomes of Endodontic-Periodontal Lesions before and after Chemomechanical Preparation. J Endod 2015; 41:1975-84. [PMID: 26521147 DOI: 10.1016/j.joen.2015.08.022] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/22/2015] [Accepted: 08/27/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This study was conducted to evaluate the microbiomes of endodontic-periodontal lesions before and after chemomechanical preparation (CMP). METHODS Clinical samples were taken from 15 root canals (RCs) with necrotic pulp tissues and from their associated periodontal pockets (PPs) (n = 15) of teeth with endodontic-periodontal lesions before and after CMP. The Human Oral Microbe Identification using Next Generation Sequencing (NGS) protocol and viable culture were used to analyze samples from RCs and PPs. The Mann-Whitney U test and Benjamini-Hochberg corrections were performed to correlate the clinical and radiographic findings with microbial findings (P < .05). RESULTS Bacteria were detected in 100% of the samples in both sites (15/15) using NGS. Firmicutes was the most predominant phylum in both sites using both methods. The most frequently detected species in the RCs before and after CMP using NGS were Enterococcus faecalis, Parvimonas micra, Mogibacterium timidum, Filifactor alocis, and Fretibacterium fastidiosum. The species most frequently detected in the PPs before and after CMP using NGS were P. micra, E. faecalis, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia, and F. alocis. Associations were found between periapical lesions ≤ 2 mm and Desulfobulbus sp oral taxon 041 and with periodontal pockets ≥ 6 mm and Dialister invisius and Peptostreptococcus stomatis (all P < .05, found in the RCs before CMP). CONCLUSIONS It is concluded that the microbial community present in combined endodontic-periodontal lesions is complex and more diverse than previously reported. It is important to note that bacteria do survive in some root canals after CMP. Finally, the similarity between the microbiota of both sites, before and after CMP, suggests there may be a pathway of infection between the pulp and periodontium.
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Affiliation(s)
- Brenda P F A Gomes
- Endodontic Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts.
| | - Vanessa B Berber
- Endodontic Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alexis S Kokaras
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts
| | - Tsute Chen
- Department of Molecular Genetics, The Forsyth Institute, Cambridge, Massachusetts
| | - Bruce J Paster
- Department of Microbiology, The Forsyth Institute, Cambridge, Massachusetts
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