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Abdullahi AD, Unban K, Saenjum C, Kodchasee P, Kangwan N, Thananchai H, Shetty K, Khanongnuch C. Antibacterial activities of Miang extracts against selected pathogens and the potential of the tannin-free extracts in the growth inhibition of Streptococcus mutans. PLoS One 2024; 19:e0302717. [PMID: 38718045 PMCID: PMC11078415 DOI: 10.1371/journal.pone.0302717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Bacterial pathogens have remained a major public health concern for several decades. This study investigated the antibacterial activities of Miang extracts (at non-neutral and neutral pH) against Bacillus cereus TISTR 747, Escherichia coli ATCC 22595, Salmonella enterica serovar Typhimurium TISTR 292 and Streptococcus mutans DMST 18777. The potential of Polyvinylpolypyrrolidone (PVPP)-precipitated tannin-free Miang extracts in growth-inhibition of the cariogenic Streptococcus mutans DMST 18777 and its biofilms was also evaluated. The tannin-rich fermented extracts had the best bacterial growth inhibition against S. mutans DMST 18777 with an MIC of 0.29 and 0.72 mg/mL for nonfilamentous fungi (NFP) Miang and filamentous-fungi-processed (FFP) Miang respectively. This observed anti-streptococcal activity still remained after PVPP-mediated precipitation of bioactive tannins especially, in NFP and FFP Miang. Characterization of the PVPP-treated extracts using High performance liquid chromatography quadrupole-time of flight-mass spectrometry (HPLC-QToF-MS) analysis, also offered an insight into probable compound classes responsible for the activities. In addition, Crystal violet-staining also showed better IC50 values for NFP Miang (4.30 ± 0.66 mg/mL) and FFP Miang (12.73 ± 0.11 mg/mL) against S. mutans DMST 18777 biofilms in vitro. Homology modeling and molecular docking analysis using HPLC-MS identified ligands in tannin-free Miang supernatants, was performed against modelled S. mutans DMST 18777 sortase A enzyme. The in silico analysis suggested that the inhibition by NFP and FFP Miang might be attributed to the presence of ellagic acid, flavonoid aglycones, and glycosides. Thus, these Miang extracts could be optimized and explored as natural active pharmaceutical ingredients (NAPIs) for applications in oral hygienic products.
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Affiliation(s)
- Aliyu Dantani Abdullahi
- Interdisciplinary Program in Biotechnology, The Graduate School, Chiang Mai University, Muang, Chiang Mai, Thailand
| | - Kridsada Unban
- Faculty of Agro-Industry, Division of Food Science and Technology, School of Agro-Industry, Chiang Mai University, Muang, Chiang Mai, Thailand
| | - Chalermpong Saenjum
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Chiang Mai University, Muang, Chiang Mai, Thailand
| | - Pratthana Kodchasee
- Research Center for Multidisciplinary Approaches to Miang, Multidisciplinary Research Institute (MDRI), Chiang Mai University, Muang, Chiang Mai, Thailand
| | - Napapan Kangwan
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao, Thailand
| | - Hathairat Thananchai
- Faculty of Medicine, Department of Microbiology, Chiang Mai University, Muang, Chiang Mai, Thailand
| | - Kalidas Shetty
- Faculty of Agriculture, Department of Plant Sciences, North Dakota State University, Fargo, North Dakota, United States of America
| | - Chartchai Khanongnuch
- Research Center for Multidisciplinary Approaches to Miang, Multidisciplinary Research Institute (MDRI), Chiang Mai University, Muang, Chiang Mai, Thailand
- Faculty of Science, Department of Biology, Chiang Mai University, Chiang Mai, Thailand
- Research Center of Microbial Diversity and Sustainable Utilization, Chiang Mai University, Chiang Mai, Thailand
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Torabi J, Luis H, Hurlbutt M. Anticaries and Antigingivitis Properties of Cannabinoid-Containing Oral Health Products: A Review. Cannabis Cannabinoid Res 2024. [PMID: 38593455 DOI: 10.1089/can.2023.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
To evaluate the anticaries and antigingivitis properties of cannabinoid-containing oral health products. A systematic research strategy was employed. Specific search terms were used, including "Cannabinoids AND dental caries," "Cannabinoids AND oral health," "Cannabinoids AND dental plaque," "Cannabinoids AND gingivitis AND periodontitis," "Cannabinoids AND S. mutans," "Cannabidiol AND oral health," and "Cannabidiol AND oral biofilm." The search was conducted in PubMed, Cochrane, and EBSCO Host databases. The search yielded a total of 73 articles, out of which 15 articles (20.5%) were relevant to the scope of this systematic review. Among the relevant articles, only eight (10.9%) directly addressed the research question. The findings from these articles suggest that cannabinoids have the potential to reduce the metabolism of cariogenic bacteria, specifically Streptococcus mutans, and decrease the number of bacterial colonies in dental plaque. In vitro studies also demonstrated a significant inhibitory effect of cannabinoids on oral biofilms and create a considerable inhibitory zone of growth when investigated on oral biofilms in vitro. Furthermore, CBD exhibited antibacterial properties against Porphyromonas gingivalis, a primary pathogen associated with periodontal disease. The current review shows insufficient data to conclude on the anticaries and antigingivitis effects of cannabinoids. Despite extensive research on their systemic therapeutic benefits, their oral health impact remains underexplored, lacking clinical trials and primary research.
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Affiliation(s)
- Jila Torabi
- West Coast University, Dental Hygiene Program, Anaheim, CA, USA
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), RHODes-Dental Hygienists for Science, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Henrique Luis
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), RHODes-Dental Hygienists for Science, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, Leiria, Portugal
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He X, Zhang S, Zhong Y, Huang X, Liu F, He J, Mai S. A low-shrinkage-stress and anti-bacterial adherent dental resin composite: physicochemical properties and biocompatibility. J Mater Chem B 2024; 12:814-827. [PMID: 38189164 DOI: 10.1039/d3tb01556d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Polymerisation shrinkage and biofilm accumulation are the two main problems associated with dental resin composites (DRCs) that induce secondary caries, which can cause restoration failure. Polymerisation shrinkage can lead to microleakage gaps between the tooth and the DRCs, causing the aggregation of bacteria and development of secondary caries. Reducing the shrinkage stress (SS) and improving the resistance to bacterial adhesion have always been the focus of this field in modifying DRCs. A thiol-ene resin system can effectively reduce the polymerisation SS via its step-growth mechanism for delaying the gel point. Fluorinated compounds can reduce the surface free energies, thereby reducing bacterial adhesion. Thus, in this study, a range of mass fractions (0, 10, 20, 30, and 40 wt%) of a fluorinated thiol-ene resin system were added to a fluorinated dimethacrylate resin system/tricyclo decanedimethanol diacrylate to create a fluorinated methacrylate-thiol-ene ternary resin matrix. DRCs were prepared using the obtained ternary resin matrix, and their physical and chemical properties, effect on bacterial adhesion, and biocompatibility were investigated. The results demonstrated that the volumetric shrinkage and SS of the DRCs were reduced with no reduction in conversion degree even after the thiol-ene resin system was added. All DRC-based fluorinated resin systems exhibited an excellent anti-bacterial adhesion effect, as evidenced by the colony-forming unit counts, live/dead bacterial staining, and crystal violet staining tests against Streptococcus mutans (S. mutans). The genetic expressions associated with the bacterial adhesion of S. mutans were substantially affected after being cultured with fluorinated DRCs. All fluorinated DRCs demonstrated good biocompatibility through the in vitro cytotoxicity test and live/dead staining images of the L-929 cells. The above results illustrate that the DRCs based on the fluorinated methacrylate-thiol-ene resin matrix can be potentially applied in clinical practice due to their low SS and anti-bacterial adhesion effect.
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Affiliation(s)
- Xinlin He
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China.
- Guanghua School of Stomatology, Sun Yat-sen University, Guangdong, 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China
| | - Shengcan Zhang
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong, 510641, People's Republic of China.
| | - Yewen Zhong
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China.
- Guanghua School of Stomatology, Sun Yat-sen University, Guangdong, 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China
| | - Xiangya Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China.
- Guanghua School of Stomatology, Sun Yat-sen University, Guangdong, 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China
| | - Fang Liu
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong, 510641, People's Republic of China.
| | - Jingwei He
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong, 510641, People's Republic of China.
| | - Sui Mai
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China.
- Guanghua School of Stomatology, Sun Yat-sen University, Guangdong, 510055, People's Republic of China
- Institute of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, 510055, People's Republic of China
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Gabarin A, Yarmolinsky L, Budovsky A, Khalfin B, Ben-Shabat S. Cannabis as a Source of Approved Drugs: A New Look at an Old Problem. Molecules 2023; 28:7686. [PMID: 38067416 PMCID: PMC10707504 DOI: 10.3390/molecules28237686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
Cannabis plants have been used in medicine since ancient times. They are well known for their anti-diabetic, anti-inflammatory, neuroprotective, anti-cancer, anti-oxidative, anti-microbial, anti-viral, and anti-fungal activities. A growing body of evidence indicates that targeting the endocannabinoid system and various other receptors with cannabinoid compounds holds great promise for addressing multiple medical conditions. There are two distinct avenues in the development of cannabinoid-based drugs. The first involves creating treatments directly based on the components of the cannabis plant. The second involves a singular molecule strategy, in which specific phytocannabinoids or newly discovered cannabinoids with therapeutic promise are pinpointed and synthesized for future pharmaceutical development and validation. Although the therapeutic potential of cannabis is enormous, few cannabis-related approved drugs exist, and this avenue warrants further investigation. With this in mind, we review here the medicinal properties of cannabis, its phytochemicals, approved drugs of natural and synthetic origin, pitfalls on the way to the widespread clinical use of cannabis, and additional applications of cannabis-related products.
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Affiliation(s)
- Adi Gabarin
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Ludmila Yarmolinsky
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Arie Budovsky
- Research and Development Authority, Barzilai University Medical Center, Ashkelon 7830604, Israel;
| | - Boris Khalfin
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
| | - Shimon Ben-Shabat
- The Department of Clinical Biochemistry & Pharmacology, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel; (A.G.); (L.Y.); (B.K.)
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Nunn AVW, Guy GW, Bell JD. Informing the Cannabis Conjecture: From Life's Beginnings to Mitochondria, Membranes and the Electrome-A Review. Int J Mol Sci 2023; 24:13070. [PMID: 37685877 PMCID: PMC10488084 DOI: 10.3390/ijms241713070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Before the late 1980s, ideas around how the lipophilic phytocannabinoids might be working involved membranes and bioenergetics as these disciplines were "in vogue". However, as interest in genetics and pharmacology grew, interest in mitochondria (and membranes) waned. The discovery of the cognate receptor for tetrahydrocannabinol (THC) led to the classification of the endocannabinoid system (ECS) and the conjecture that phytocannabinoids might be "working" through this system. However, the how and the "why" they might be beneficial, especially for compounds like CBD, remains unclear. Given the centrality of membranes and mitochondria in complex organisms, and their evolutionary heritage from the beginnings of life, revisiting phytocannabinoid action in this light could be enlightening. For example, life can be described as a self-organising and replicating far from equilibrium dissipating system, which is defined by the movement of charge across a membrane. Hence the building evidence, at least in animals, that THC and CBD modulate mitochondrial function could be highly informative. In this paper, we offer a unique perspective to the question, why and how do compounds like CBD potentially work as medicines in so many different conditions? The answer, we suggest, is that they can modulate membrane fluidity in a number of ways and thus dissipation and engender homeostasis, particularly under stress. To understand this, we need to embrace origins of life theories, the role of mitochondria in plants and explanations of disease and ageing from an adaptive thermodynamic perspective, as well as quantum mechanics.
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Affiliation(s)
- Alistair V. W. Nunn
- Research Centre for Optimal Health, Department of Life Sciences, University of Westminster, London W1W 6UW, UK; (G.W.G.); (J.D.B.)
- The Guy Foundation, Beaminster DT8 3HY, UK
| | - Geoffrey W. Guy
- Research Centre for Optimal Health, Department of Life Sciences, University of Westminster, London W1W 6UW, UK; (G.W.G.); (J.D.B.)
- The Guy Foundation, Beaminster DT8 3HY, UK
| | - Jimmy D. Bell
- Research Centre for Optimal Health, Department of Life Sciences, University of Westminster, London W1W 6UW, UK; (G.W.G.); (J.D.B.)
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Wolfson G, Sionov RV, Smoum R, Korem M, Polacheck I, Steinberg D. Anti-Bacterial and Anti-Biofilm Activities of Anandamide against the Cariogenic Streptococcus mutans. Int J Mol Sci 2023; 24:ijms24076177. [PMID: 37047147 PMCID: PMC10094667 DOI: 10.3390/ijms24076177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023] Open
Abstract
Streptococcus mutans is a cariogenic bacterium in the oral cavity involved in plaque formation and dental caries. The endocannabinoid anandamide (AEA), a naturally occurring bioactive lipid, has been shown to have anti-bacterial and anti-biofilm activities against Staphylococcus aureus. We aimed here to study its effects on S. mutans viability, biofilm formation and extracellular polysaccharide substance (EPS) production. S. mutans were cultivated in the absence or presence of various concentrations of AEA, and the planktonic growth was followed by changes in optical density (OD) and colony-forming units (CFU). The resulting biofilms were examined by MTT metabolic assay, Crystal Violet (CV) staining, spinning disk confocal microscopy (SDCM) and high-resolution scanning electron microscopy (HR-SEM). The EPS production was determined by Congo Red and fluorescent dextran staining. Membrane potential and membrane permeability were determined by diethyloxacarbocyanine iodide (DiOC2(3)) and SYTO 9/propidium iodide (PI) staining, respectively, using flow cytometry. We observed that AEA was bactericidal to S. mutans at 12.5 µg/mL and prevented biofilm formation at the same concentration. AEA reduced the biofilm thickness and biomass with concomitant reduction in total EPS production, although there was a net increase in EPS per bacterium. Preformed biofilms were significantly affected at 50 µg/mL AEA. We further show that AEA increased the membrane permeability and induced membrane hyperpolarization of these bacteria. AEA caused S. mutans to become elongated at the minimum inhibitory concentration (MIC). Gene expression studies showed a significant increase in the cell division gene ftsZ. The concentrations of AEA needed for the anti-bacterial effects were below the cytotoxic concentration for normal Vero epithelial cells. Altogether, our data show that AEA has anti-bacterial and anti-biofilm activities against S. mutans and may have a potential role in preventing biofilms as a therapeutic measure.
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Govindarajan RK, Mishra AK, Cho KH, Kim KH, Yoon KM, Baek KH. Biosynthesis of Phytocannabinoids and Structural Insights: A Review. Metabolites 2023; 13:metabo13030442. [PMID: 36984882 PMCID: PMC10051821 DOI: 10.3390/metabo13030442] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Cannabis belongs to the family Cannabaceae, and phytocannabinoids are produced by the Cannabis sativa L. plant. A long-standing debate regarding the plant is whether it contains one or more species. Phytocannabinoids are bioactive natural products found in flowers, seeds, and fruits. They can be beneficial for treating human diseases (such as multiple sclerosis, neurodegenerative diseases, epilepsy, and pain), the cellular metabolic process, and regulating biological function systems. In addition, several phytocannabinoids are used in various therapeutic and pharmaceutical applications. This study provides an overview of the different sources of phytocannabinoids; further, the biosynthesis of bioactive compounds involving various pathways is elucidated. The structural classification of phytocannabinoids is based on their decorated resorcinol core and the bioactivities of naturally occurring cannabinoids. Furthermore, phytocannabinoids have been studied in terms of their role in animal models and antimicrobial activity against bacteria and fungi; further, they show potential for therapeutic applications and are used in treating various human diseases. Overall, this review can help deepen the current understanding of the role of biotechnological approaches and the importance of phytocannabinoids in different industrial applications.
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Affiliation(s)
| | - Awdhesh Kumar Mishra
- Department of Biotechnology, Yeungnam University, Gyeongsan 38541, Gyeongbuk, Republic of Korea
| | - Kiu-Hyung Cho
- Gyeongbuk Institute for Bioindustry, Andong 36618, Gyeongbuk, Republic of Korea
| | - Ki-Hyun Kim
- Gyeongbuk Institute for Bioindustry, Andong 36618, Gyeongbuk, Republic of Korea
| | - Kyoung Mi Yoon
- Gyeongbuk Institute for Bioindustry, Andong 36618, Gyeongbuk, Republic of Korea
| | - Kwang-Hyun Baek
- Department of Biotechnology, Yeungnam University, Gyeongsan 38541, Gyeongbuk, Republic of Korea
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Avraham M, Steinberg D, Barak T, Shalish M, Feldman M, Sionov RV. Improved Anti-Biofilm Effect against the Oral Cariogenic Streptococcus mutans by Combined Triclosan/CBD Treatment. Biomedicines 2023; 11:biomedicines11020521. [PMID: 36831057 PMCID: PMC9953046 DOI: 10.3390/biomedicines11020521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Streptococcus mutans is a Gram-positive bacterium highly associated with dental caries, and it has a strong biofilm-forming ability, especially in a sugar-rich environment. Many strategies have been undertaken to prevent dental caries by targeting these bacteria. Recently, we observed that a sustained-release varnish containing triclosan and cannabidiol (CBD) was more efficient than each compound alone in preventing biofilm formation by the fungus Candida albicans, which is frequently involved in oral infections together with S. mutans. It was therefore inquiring to study the effect of this drug combination on S. mutans. We observed that the combined treatment of triclosan and CBD had stronger anti-bacterial and anti-biofilm activity than each compound alone, thus enabling the use of lower concentrations of each drug to achieve the desired effect. The combined drug treatment led to an increase in the SYTO 9low, propidium iodide (PI)high bacterial population as analyzed by flow cytometry, indicative for bacteria with disrupted membrane. Both triclosan and CBD induced membrane hyperpolarization, although there was no additive effect on this parameter. HR-SEM images of CBD-treated bacteria show the appearance of elongated and swollen bacteria with several irregular septa structures, and upon combined treatment with triclosan, the bacteria took on a swollen ellipse and sometimes oval morphology. Increased biofilm formation was observed at sub-MIC concentrations of each compound alone, while combining the drugs at these sub-MIC concentrations, the biofilm formation was prevented. The inhibition of biofilm formation was confirmed by CV biomass staining, MTT metabolic activity, HR-SEM and live/dead together with exopolysaccharide (EPS) staining visualized by spinning disk confocal microscopy. Importantly, the concentrations required for the anti-bacterial and anti-biofilm activities toward S. mutans were non-toxic to the normal Vero epithelial cells. In conclusion, the data obtained in this study propose a beneficial role of combined triclosan/CBD treatment for potential protection against dental caries.
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Affiliation(s)
- Maayan Avraham
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Biotechnology, Strauss Campus, Hadassah Academic College, Jerusalem 9514223, Israel
| | - Doron Steinberg
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Tamar Barak
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Hadassah Medical Center, Department of Orthodontics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Miriam Shalish
- Hadassah Medical Center, Department of Orthodontics, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Mark Feldman
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Ronit Vogt Sionov
- Faculty of Dental Medicine, Ein Kerem Campus, Institute of Biomedical and Oral Research (IBOR), The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Correspondence:
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