Identification of Anticryptococcal Bornyl Compounds from Verbesina turbacensis and Their Structure-Activity Relationships

Cryptococcus neoformans is an opportunistic fungal pathogen that has limited treatment options. Natural product plant extracts offer a cost-effective option for the discovery of new anticryptococcal lead compounds. The acetone bark extract of Verbesina turbacensis was found to potently inhibit C. neoformans and was subjected to bioautography. Two compounds that inhibited the growth of C. neoformans were isolated and displayed minimum inhibitory concentration values of 10 and 310 µg/mL. The compounds were identified as the bornyl hydroxycinnamic esters bornyl caffeate and bornyl ferulate, respectively. To better understand initial structure-activity relationships, anticryptococcal activity was characterized for similar compounds. All compounds were further evaluated for mammalian cell toxicity using the MTT assay with MCF-7 and HEK-293 cell lines. Overall, bornyl caffeate demonstrated promising anticryptococcal potential given its potent inhibition of C. neoformans and low mammalian cell toxicity.

Associations between interpregnancy interval and preterm birth by previous preterm birth status in four high-income countries: a cohort study

OBJECTIVE

To investigate the effect of interpregnancy interval (IPI) on preterm birth (PTB) according to whether the previous birth was preterm or term.

DESIGN

Cohort study.

SETTING

USA (California), Australia, Finland, Norway (1980-2017).

POPULATION

Women who gave birth to first and second (n = 3 213 855) singleton livebirths.

METHODS

Odds ratios (ORs) for PTB according to IPIs were modelled using logistic regression with prognostic score stratification for potential confounders. Within-site ORs were pooled by random effects meta-analysis.

OUTCOME MEASURE

PTB (gestational age <37 weeks).

RESULTS

Absolute risk of PTB for each IPI was 3-6% after a previous term birth and 17-22% after previous PTB. ORs for PTB differed between previous term and preterm births in all countries (P-for-interaction ≤ 0.001). For women with a previous term birth, pooled ORs were increased for IPI <6 months (OR 1.50, 95% CI 1.43-1.58); 6-11 months (OR 1.10, 95% CI 1.04-1.16); 24-59 months (OR 1.16, 95% CI 1.13-1.18); and ≥ 60 months (OR 1.72, 95%CI 1.60-1.86), compared with 18-23 months. For previous PTB, ORs were increased for <6 months (OR 1.30, 95% CI 1.18-1.42) and ≥60 months (OR 1.29, 95% CI 1.17-1.42), but were less than ORs among women with a previous term birth (P < 0.05).

CONCLUSIONS

Associations between IPI and PTB are modified by whether or not the previous pregnancy was preterm. ORs for short and long IPIs were higher among women with a previous term birth than a previous PTB, which for short IPI is consistent with the maternal depletion hypothesis. Given the high risk of recurrence and assuming a causal association between IPI and PTB, IPI remains a potentially modifiable risk factor for women with previous PTB.

TWEETABLE ABSTRACT

Short versus long interpregnancy intervals associated with higher ORs for preterm birth (PTB) after a previous PTB.

Preterm birth phenotypes in women with autoimmune rheumatic diseases: a population-based cohort study

OBJECTIVE

To investigate preterm birth (PTB) phenotypes in women with different autoimmune rheumatic diseases in a large population-based cohort.

DESIGN

Retrospective cohort study.

SETTING

California, USA.

POPULATION

All live singleton births in California between 2007 and 2011 were analysed. Patients with autoimmune disease at delivery were identified by International Classification of Diseases, Ninth Revision , Clinical Modification (ICD-9-CM), codes for systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), polymyositis/dermatomyositis (DM/PM), and juvenile idiopathic arthritis (JIA).

METHODS

Maternally linked hospital and birth certificate records of 2 481 516 deliveries were assessed (SLE n = 2272, RA n = 1501, SSc n = 88, JIA n = 187, DM/PM n = 38). Multivariable Poisson regression models estimated the risk ratios (RRs) for different PTB phenotypes (relative to term deliveries) for each autoimmune disease compared with the general obstetric population, adjusting for maternal age, race/ethnicity, body mass index, smoking, education, payer, parity, and prenatal care.

MAIN OUTCOME MEASURES

Preterm birth (PTB) was assessed overall (20-36 weeks of gestation) and by subphenotype: preterm prelabour rupture of membranes (PPROM), spontaneous birth, or medically indicated PTB. The risk of PTB overall and for each phenotype was partitioned by gestational age: early (20-31 weeks of gestation) and late (32-36 weeks of gestation).

RESULTS

Risks for PTB were elevated for each autoimmune disease evaluated: SLE (RR 3.27, 95% CI 3.01-3.56), RA (RR 2.04, 95% CI 1.79-2.33), SSc (RR 3.74, 95% CI 2.51-5.58), JIA (RR 2.23, 95% CI 1.54-3.23), and DM/PM (RR 5.26, 95% CI 3.12-8.89). These elevated risks were observed for the majority of PTB phenotypes as well.

CONCLUSIONS

Women with systemic autoimmune diseases appear to have an elevated risk of various PTB phenotypes. Therefore, preconception counselling and close monitoring during pregnancy is crucial.

TWEETABLE ABSTRACT

This study found that women with systemic autoimmune diseases have an elevated risk of preterm birth phenotypes.

'The obesity paradox': a reconsideration of obesity and the risk of preterm birth

OBJECTIVE

The association between obesity and spontaneous preterm births (sPTBs) has been shown to be influenced by obesity-attendant comorbidities. Our objective was to better understand the complex relationship of obesity and its attendant comorbidities with sPTBs.

STUDY DESIGN

A retrospective analysis utilizing maternally linked hospital and birth certificate records of 2 049 196 singleton California deliveries from 2007 to 2011. Adjusted relative risks (aRRs) for sPTBs were estimated using multivariate Poisson regression modeling.

RESULTS

Obese women had higher aRRs for sPTBs than their normal body mass index (BMI) controls. aRRs (95% confidence interval) increased with increasing BMI category: Obese I=1.10 (1.08 to 1.12); Obese II=1.15 (1.12 to 1.18); and Obese III=1.26 (1.22 to 1.30). When comparing only obese women without comorbidities to their normal BMI controls, aRRs reversed, that is, obese women had lower aRRs of sPTBs: Obese I=0.96 (0.94 to 0.98), Obese II=0.95 (0.91 to 0.98); and Obese III=0.98 (0.94 to 1.03). This same reversal of aRR direction was also observed among women with comorbidities: 0.92 (0.89 to 0.96); 0.89 (0.85 to 0.93); and 0.89 (0.85 to 0.93), respectively. Increasing BMI increased the aRRs for sPTBs among patients with gestational diabetes (P<0.05), while decreasing the risk among patients with chronic hypertension and pregnancy-related hypertensive disease (P<0.05).

CONCLUSIONS

The obesity and preterm birth paradox is an example of what has been described as 'Simpson's Paradox'. Unmeasured confounding factors mediated by comorbidities may explain the observed protective effect of obesity upon conditioning on the presence or absence of comorbidities and thus resolve the paradox.

Body Mass Index Change between Pregnancies and Risk of Spontaneous Preterm Birth

Objective Studies have reported an increased risk of spontaneous preterm birth associated with elevated prepregnancy body mass index (BMI) among nulliparous but not multiparous women. We examined whether changes in BMI and weight between pregnancies contributed to risk of preterm birth among obese (BMI > 29 kg/m(2)) women. Study Design This study utilized maternally linked California birth records of sequential singleton births between 2007 and 2010. Preterm birth was defined as 20 to 31 or 32 to 36 weeks of gestation. BMI was examined as category change and by tertile of weight change. Primary analyses included women without diabetes or hypertensive disorders; these women were compared with those without prior preterm birth, women with preterm deliveries preceded by spontaneous preterm labor, and women without any exclusions (i.e., diabetes or hypertensive disorders). Results Analyses showed that obesity was not associated with increased risk of spontaneous preterm birth among multiparous women. Women whose BMI increased had a decreased risk of spontaneous preterm birth at 32 to 36 weeks. Change in BMI or weight between pregnancies did not substantively alter results. Conclusion Among multiparous women, obesity was associated with reduced risk of spontaneous preterm delivery. This observed association is complex and may be influenced by maternal age, gestational age, placental insufficiency, and altered immune response.

Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: a retrospective cohort study

OBJECTIVES

We assessed whether interpregnancy interval (IPI) length after live birth and after pregnancy termination was associated with preterm birth (PTB).

DESIGN

Multiyear birth cohort.

SETTINGS

Fetal death, birth and infant death certificates in California merged with Office of Statewide Health Planning and Development.

POPULATION

One million California live births (2007-10) after live birth and after pregnancy termination.

METHODS

Logistic regression was used to estimate odds ratios (ORs) of PTB of 20-36 weeks of gestation and its subcategories for IPIs after a live birth and after a pregnancy termination. We used conditional logistic regression (two IPIs/mother) to investigate associations within mothers.

MAIN OUTCOME MEASURE

PTB relative to gestations of ≥ 37 weeks.

RESULTS

Analyses included 971 211 women with IPI after live birth, and 138 405 women with IPI after pregnancy termination with 30.6% and 74.6% having intervals of <18 months, respectively. IPIs of <6 months or 6-11 months after live birth showed increased odds of PTB adjusted ORs for PTB of 1.71 (95% CI 1.65-1.78) and 1.20 (95% CI 1.16-1.24), respectively compared with intervals of 18-23 months. An IPI >36 months (versus 18-23 months) was associated with increased odds for PTB. Short IPI after pregnancy termination showed a decreased OR of 0.87 (95% CI 0.81-0.94). The within-mother analysis showed the association of increased odds of PTB for short IPI, but not for long IPI.

CONCLUSIONS

Women with IPI <1 or >3 years after a live birth were at increased odds of PTB-an important group for intervention to reduce PTB. Short IPI after pregnancy termination was associated with reduced odds for PTB and needs to be further explored.

TWEETABLE ABSTRACT

Short and long IPI after live birth, but not after pregnancy termination, showed increased odds for PTB.

Women's prepregnancy underweight as a risk factor for preterm birth: a retrospective study

OBJECTIVE

To investigate the distribution of known factors for preterm birth (PTB) by severity of maternal underweight; to investigate the risk-adjusted relation between severity of underweight and PTB, and to assess whether the relation differed by gestational age.

DESIGN

Retrospective cohort study.

SETTING

State of California, USA.

METHODS

Maternally linked hospital and birth certificate records of 950 356 California deliveries in 2007-2010 were analysed. Singleton live births of women whose prepregnancy body mass index (BMI) was underweight (<18.5 kg/m² ) or normal (18.50-24.99 kg/m² ) were analysed. Underweight BMI was further categorised as: severe (<16.00), moderate (16.00-16.99) or mild (17.00-18.49). PTB was grouped as 22-27, 28-31, 32-36 or <37 weeks (compared with 37-41 weeks). Adjusted multivariable Poisson regression modeling was used to estimate relative risk for PTB.

MAIN OUTCOME MEASURES

Risk of PTB.

RESULTS

About 72 686 (7.6%) women were underweight. Increasing severity of underweight was associated with increasing percent PTB: 7.8% (n = 4421) in mild, 9.0% (n = 1001) in moderate and 10.2% (475) in severe underweight. The adjusted relative risk of PTB also significantly increased: adjusted relative risk (aRR) = 1.22 (95% CI 1.19-1.26) in mild, aRR = 1.41 (95% CI 1.32-1.50) in moderate and aRR = 1.61 (95% CI 1.47-1.76) in severe underweight. These findings were similar in spontaneous PTB, medically indicated PTB, and the gestational age groupings.

CONCLUSION

Increasing severity of maternal prepregnancy underweight BMI was associated with increasing risk-adjusted PTB at <37 weeks. This increasing risk was of similar magnitude in spontaneous and medically indicated births and in preterm delivery at 28-31 and at 32-36 weeks of gestation.

TWEETABLE ABSTRACT

Increasing severity of maternal underweight BMI was associated with increasing risk of preterm birth.

Acidogenic Potential of “Sugar-Free” Cough Drops

A patient presented with extensive marginal ditching around restorations recently placed during whole-mouth rehabilitation. The patient was not xerostomic and was otherwise normal except for the self-reported excessive use of “sugar-free” cough drops sweetened with sorbitol and Isomalt® (an equimolar mix of glucosyl-mannitol and glucosylsorbitol). This prompted anin vitroinvestigation to determine whetherStreptococcus sobrinus6715, a cariogenic streptococcus, could grow and produce acid in growth medium containing an aqueous extract of such “sugar-free” cough drops. The results indicate thatS. sobrinus6715 uses Isomalt® and sorbitol extensively, producing terminal culture pH as low as 4.2 when grown on medium with cough drop extract containing these sugars. This pH is sufficient to demineralize dental enamel. Patients should be cautioned against the chronic overuse of “sugar-free” cough drops and other “sugar-free” confections sweetened with a mixture of Isomalt® and sorbitol.

Extracellular proteolytic activities expressed by Bacillus pumilus isolated from endodontic and periodontal lesions

The purpose of the present study was to identify 12 Bacillus isolates that had been obtained from root canals of teeth requiring endodontic therapy and from periodontal pockets in severe marginal periodontitis, and to determine whether these isolates exhibited extracellular proteolytic activity and, using in vitro assays, whether any such activity could degrade substrates that would be pathophysiologically relevant with regard to the production of endodontic and periodontal lesions. Biochemical and carbohydrate fermentation patterns were used in the identification of all strains, which was confirmed by determination of the16S rRNA gene sequence for strain BJ0055. Screening for production of extracellular proteolytic activity by all strains was done with a general proteinase substrate. All isolates were identified as representing Bacillus pumilus and all exhibited extracellular proteolytic activity. The putative pathophysiological relevance of extracellular proteinase production in strain BJ0055 was assessed using fluorophore-labelled elastin and collagen and several chromogenic peptides. Probable classes of proteinases acting on each substrate were investigated using class-specific inhibitors. Activity-pH profiles were determined in buffers at different pH values. Extracellular activities that were caseinolytic, elastinolytic, collagenolytic, glutamyl endopeptidase-like, and alanyl tripeptidyl peptidase-like were observed. No trypsin-like activities were detected. Serine- and chymotrypsin-like serine proteinase activities were detected, with activity observed at neutral and alkaline, but not acidic, pH. B. pumilus strains isolated from endodontic and periodontal lesions exhibited extracellular activities that degrade elastin, collagen and other substrates. These activities may be virulence factors that contribute to tissue damage in apical periodontitis and severe marginal periodontitis.

Isolation and properties of extracellular proteinases of Penicillium marneffei

Penicillium marneffei is a dimorphic fungus native to Southeast Asia. Disease caused by this organism, until recently a very rare condition, has increased dramatically in parallel with the increase in the number of individuals in the region immunocompromised by AIDS and other conditions. While much research has been performed on the control of dimorphic switching in P. marneffei, there is a relative dearth of information regarding the proteinases secreted by this pathogen. Our laboratory has purified and characterized two proteinases produced by this organism in liquid culture and cloned the gene of a third. Both the recombinant enzyme expressed from the cloned gene and one of those purified from culture supernatants have been identified as members of the eqolisin family, a group of pepstatin-insensitive acid proteinases. The other enzyme purified from a culture supernatant is a serine proteinase with activity in the neutral pH range. These enzymes appear to be differentially expressed, depending on culture conditions.

Inhibition of Porphyromonas gingivalis proteinases (gingipains) by chlorhexidine: synergistic effect of Zn(II)

BACKGROUND/AIMS

Gingipains, proteolytic enzymes produced by the periodontal pathogen Porphyromonas gingivalis, are regarded as virulence factors in the pathogenesis of periodontitis. Inhibition of gingipain activity therefore may have therapeutic potential, and it has been suggested that chlorhexidine may inhibit the activities of these enzymes. The purposes of the present study were to examine systematically the inhibitory effects of chlorhexidine on three purified gingipains and to determine the effect of Zn(II) on chlorhexidine inhibition.

METHODS

The activities of lys-gingipain (Kgp) and two forms of arg-gingipain (RgpB and HRgpA) were measured in the presence of varying concentrations of chlorhexidine and with chlorhexidine supplemented with Zn(II). Inhibition constants (K(i)'s) were determined for chlorhexidine alone and in the presence of Zn(II). Fractional inhibitory constant indices were calculated to assess the synergy of the chlorhexidine-Zn(II) inhibition.

RESULTS

RgpB, HRgpA, and Kgp were all inhibited by chlorhexidine with K(i)'s in the micromolar range. For RgpB and HRgpA, the inhibitory effects of chlorhexidine were enhanced 3-30-fold by Zn(II). The chlorhexidine-Zn(II) interaction was synergistic for inhibition of HRgpA and RgpB. For Kgp, the effect of Zn(II) on chlorhexidine inhibition was antagonistic.

CONCLUSIONS

Chlorhexidine is an effective inhibitor of gingipains, and the inhibition of R-gingipains is enhanced by Zn(II). A mixture of chlorhexidine and Zn(II) may be useful as an adjunct in the treatment of periodontitis and in the post-treatment maintenance of periodontitis patients.

Characterization of an extracellular dipeptidase from Streptococcus gordonii FSS2

PepV, a dipeptidase found in culture fluids of Streptococcus gordonii FSS2, was purified and characterized, and its gene was cloned. PepV is a monomeric metalloenzyme of approximately 55 kDa that preferentially degrades hydrophobic dipeptides. The gene encodes a polypeptide of 467 amino acids, with a theoretical molecular mass of 51,114 Da and a calculated pI of 4.8. The S. gordonii PepV gene is homologous to the PepV gene family from Lactobacillus and Lactococcus spp.

Characterisation of a novel homodimeric N-acetyl-beta-D-glucosaminidase from Streptococcus gordonii

An N-acetyl-beta-D-glucosaminidase (GcnA) from Streptococcus gordonii FSS2 was cloned and sequenced. GcnA had a deduced molecular mass of 72,120 Da. The molecular weight after gel-filtration chromatography was 140,000 Da and by SDS-PAGE was 70,000 Da, indicating that the native protein was a homodimer. The deduced amino acid sequence had significant homology to a glycosyl hydrolase from Streptococcus pneumoniae and the conserved catalytic domain of the Family 20 glycosyl hydrolases. GcnA catalysed the hydrolysis of the synthetic substrates, 4-methylumbelliferyl (4MU)-N-acetyl-beta-D-glucosaminide, 4MU-N-acetyl-beta-D-galactosaminide, 4-MU-beta-D-N,N'-diacetylchitobioside, and 4-MU-beta-D-N,N',N''-chitotrioside as well as the respective chito-oligosaccharides. GcnA was optimally active at pH 6.6 and 42 degrees C. The Km for 4-MU-beta-D-N,N',N''-chitotrioside, 45 microM, was the lowest for all the substrates tested. Hg2+, Cu2+, Fe2+, and Zn2+ completely inhibited while Co2+, Mn2+, and Ni2+ partially inhibited activity. S. gordonii FSS2 and a GcnA negative mutant grew equally well on chito-oligosaccharides as substrates. The S. gordonii sequencing projects indicate two further N-acetyl-beta-D-glucosaminidase activities.

Hemolytic bacteria in water from the dental air-water syringe

PURPOSE

The purpose of this pilot study was to determine whether aquatic bacteria expressing hemolysis, a classical virulence factor of pathogenic bacteria, could be found in water flowing from the dental air-water syringe (AWS).

METHODS

Water samples were collected from the AWS in each of five dental operatories, and a control sample was collected from the cold-water tap in the sink adjacent to one of the dental operatories. Water samples were plated on NWRI agar to enumerate aquatic heterotrophic bacteria and on Tryptic Soy Blood (TSB) agar to enumerate hemolytic bacteria. After incubation, plates were counted to determine total colony-forming units per mL of AWS water. In addition, TSB plates were examined for hemolytic colonies, which were counted if present.

RESULTS

AWS water samples contained an average of 9.4 x 10(4) colony-forming units cfu/mL on NWRI agar, and 1.3 x 10(4) cfu/mL on TSB agar. The control sample from the cold-water tap contained 2.5 x 102 and 50 cfu/mL on NWRI and TSB agars, respectively. Four out of five AWS water samples contained hemolytic bacteria, with an average hemolytic count of 3.2 x 10(3) hemolytic cfu/mL on TSB agar. No hemolytic bacteria were detected from tap water. Most hemolytic organisms exhibited alpha-hemolysis although beta-hemolytic colonies were seen.

CONCLUSIONS

AWS water can contain hemolytic bacteria--such bacteria express a virulence factor and therefore may be regarded as potential pathogens. According to a Medline search conducted April 23, 2002, this is the first report of hemolytic bacteria from dental unit water.

Extracellular arginine aminopeptidase from Streptococcus gordonii FSS2

Streptococcus gordonii is a primary etiological agent in the development of subacute bacterial endocarditis (SBE), producing thrombus formation and tissue damage on the surfaces of heart valves. This is ironic, considering its normal role as a benign inhabitant of the oral microflora. However, strain FSS2 of S. gordonii has been found to produce several extracellular aminopeptidase- and fibrinogen-degrading activities during growth in a pH-controlled batch culture. In this report, we describe the purification, characterization, and partial cloning of a predicted serine class arginine aminopeptidase (RAP) with some cysteine class characteristics. Isolation of this enzyme by anion-exchange, gel filtration, and isoelectric focusing chromatography yielded a protein monomer of approximately 70 kDa, as shown by matrix-assisted laser desorption ionization, gel filtration, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis under denaturing conditions. Nested-PCR cloning enabled the isolation of a 324-bp-long DNA fragment encoding the 108-amino-acid N terminus of RAP. Culture activity profiles and N-terminal sequence analysis indicated the export of this protein from the cell surface. Homology was found with a putative dipeptidase from Streptococcus pyogenes and nonspecific dipeptidases from Lactobacillus helveticus and Lactococcus lactis. We believe that RAP may serve as a critical factor for arginine acquisition during nutrient stress in vivo and also in the proteolysis of host proteins and peptides during SBE pathology.

Novel extracellular x-prolyl dipeptidyl-peptidase (DPP) from Streptococcus gordonii FSS2: an emerging subfamily of viridans Streptococcal x-prolyl DPPs

Streptococcus gordonii is generally considered a benign inhabitant of the oral microflora, and yet it is a primary etiological agent in the development of subacute bacterial endocarditis (SBE), an inflammatory state that propagates thrombus formation and tissue damage on the surface of heart valves. Strain FSS2 produced several extracellular aminopeptidase and fibrinogen-degrading activities during growth in culture. In this report we describe the purification, characterization, and cloning of a serine class dipeptidyl-aminopeptidase, an x-prolyl dipeptidyl-peptidase (Sg-xPDPP, for S. gordonii x-prolyl dipeptidyl-peptidase), produced in a pH-controlled batch culture. Purification of this enzyme by anion exchange, gel filtration, and hydrophobic interaction chromatography yielded a protein monomer of approximately 85 kDa, as shown by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (PAGE) under denaturing conditions. However, under native conditions, the protein appeared to be a homodimer on the basis of gel filtration and PAGE. Kinetic studies indicated that purified enzyme had a unique and stringent x-prolyl specificity that is comparable to both the dipeptidyl-peptidase IV/CD26 and lactococcal x-prolyl dipeptidyl-peptidase families. Nested PCR cloning from an S. gordonii library enabled the isolation and sequence analysis of the full-length gene. A 759-amino-acid polypeptide with a theoretical molecular mass of 87,115 Da and a calculated pI of 5.6 was encoded by this open reading frame. Significant homology was found with the PepX gene family from Lactobacillus and Lactococcus spp. and putative x-prolyl dipeptidyl-peptidases from other streptococcal species. Sg-xPDPP may serve as a critical factor for the sustained bacterial growth in vivo and furthermore may aid in the proteolysis of host tissue that is commonly observed during SBE pathology.

Isolation and characterization of a highly specific serine endopeptidase from an oral strain of Staphylococcus epidermidis

Infection by Staphylococcus epidermidis, an opportunistic pathogen, has become a major problem due to the increased use of implanted medical devices and the growing number of patients who are therapeutically or infectiously immunosuppressed. These infections appear to proceed via modulation of the coagulation and complement systems. In this communication we describe the purification and characterization of a novel extracellular proteinase from an oral strain of S. epidermidis that can degrade fibrinogen, complement protein C5, and several other proteins. This proteinase has a strong preference for cleavage after glutamic acid residues, but not after aspartic acid. The S. epidermidis enzyme may be a multifunctional protein which not only provides this organism with both the ability to evade the complement defense system and to dysregulate the coagulation cascade, but also supplies nutrients for its growth through the degradation of Glu-rich proteins.

pH-regulated secretion of a glyceraldehyde-3-phosphate dehydrogenase from Streptococcus gordonii FSS2: purification, characterization, and cloning of the gene encoding this enzyme

Streptococcus gordonii and other viridans streptococci (VS) are primary etiologic agents of infective endocarditis, despite being part of the normal oral microflora. Recently, a surface-bound glyceraldehyde-3-phosphate dehydrogenase (GAPDH) has been found on the cells of all tested streptococcal species, where it has been implicated as a virulence factor. In contrast, we observed that a soluble extracellular GAPDH was the major secreted protein from S. gordonii FSS2, an endocarditis strain. The biochemical properties and gene sequence of S. gordonii GAPDH are almost identical to those of other streptococcal GAPDHs. Growth at defined pHs showed that secretion of GAPDH is regulated by environmental pH. GAPDH was primarily surface-associated at growth pH 6.5 and shifted to > 90% secreted at growth pH 7.5. Others have identified S. gordonii promoters that are up-regulated by a pH shift similar to that experienced by organisms entering the blood stream (neutral) from the oral cavity (slightly acid). Analysis of our results suggests that secretion of GAPDH may be a similar adaptation by S. gordonii.

Environmental regulation of glycosidase and peptidase production by Streptococcus gordonii FSS2

The synthesis of cell-associated and secreted proteins by Streptococcus gordonii FSS2, an infective endocarditis (IE) isolate, was influenced by both environmental pH and carbon source. Controlling the pH at 7.5 in stirred batch cultures showed that cell-associated and secreted protein concentrations were increased during late exponential and stationary phase by 68% and 125%, respectively, compared with similar cultures without pH control. The expression of five glycosidase and eight peptidase activities were examined using fluorogen-labelled synthetic substrates. Enzyme activities were significantly down-regulated during exponential growth, increasing during stationary phase (P<0.01) whether the culture pH was controlled at pH 7.5 or allowed to fall naturally to pH 4.4. Culture-supernatant activities were significantly increased (P<0.05) when the pH was maintained at 6.0 or 7.5, indicating modulation of enzyme activity by pH. Growth under nitrogen-limitation/glucose-excess conditions resulted in a significant repression of cell-associated glycosidase activities (P<0.01), whilst in the supernatant, activities were generally reduced. The expression of peptidase activities in the culture supernatant did not significantly change. The results suggest a possible role for catabolite repression by glucose in regulating enzyme expression. When S. gordonii FSS2 was cultured with 50% (v/v) added heat-inactivated foetal bovine serum, several cell-associated enzyme activities increased initially but were then reduced as the culture time was extended to 116 h. Culture-supernatant enzyme activities (N-acetyl-beta-D-glucosaminidase, N-acetyl-beta-D-galactosaminidase, thrombin, Hageman factor, collagenase and chymotrypsin), however, were significantly increased (P<0.01) over the same time period. The findings indicated that most of the important glycosidases synthesized by S. gordonii FSS2 were down-regulated by acid growth conditions and may also be subject to catabolite repression by glucose but conversely may be up-regulated by growth in serum. These results may have implications for streptococcal growth in an IE vegetation and in the mouth between meals or during sleep.

Effect of in-line bacteriological filters on numbers of heterotrophic bacteria in water emitted from non-autoclavable dental air-water syringes

PURPOSE

To determine the effect of in-line bacteriological filters on the heterotrophic bacterial count of water from non-autoclavable dental air-water syringes.

MATERIALS AND METHODS

In-line bacteriological filters were placed in the waterlines of non-autoclavable dental air-water syringes. Filters were placed either as close as possible to the air-water syringe or at a distance of approximately 6 feet (1.8 meters) from the air-water syringe. After routine flushing of water lines and air-water syringes, water samples were collected aseptically. Samples were diluted, plated on NWRI agar, and incubated, and numbers of heterotrophic bacteria per ml were determined.

RESULTS

Filtration substantially reduced heterotrophic contamination of air-water syringe water when the filter was placed immediately adjacent to the air-water syringe. However, there was no beneficial effect when the filter was at a distance from the air-water syringe. Furthermore, filtered water containing no detectable heterotrophic bacteria was re-contaminated upon passage through the non-autoclavable air-water syringe.

beta-Hemolytic streptococci and other beta-hemolytic organisms in apical periodontitis and severe marginal periodontitis

Thirteen teeth with necrotic pulps and apical periodontitis and nine severe periodontal pockets were cultured for presence of beta-hemolytic streptococci and other beta-hemolytic organisms. Samples were dispersed and plated on two non-selective and one selective growth media and incubated anaerobically and in 10% CO2 in air. A total of 59 beta-hemolytic colonies were purified and identified. Eight beta-hemolytic streptococcal isolates were obtained from three of the severe marginal periodontitis sites. All were identified as belonging to the Streptococcus sanguis group. No beta-hemolytic streptococci were detected in apical periodontitis samples. Twenty obligately anaerobic isolates were detected, all of which were known periodontal and endodontic pathogens. Isolates from apical periodontitis sites were identified as Propionibacterium acnes, Actinomyces naeslundii, Actionomyces odontolyticus and Peptostreptococcus micros, while severe marginal periodontal sites contained the same species with the addition of Actinomyces viscosus and Actinomyces meyeri. Of 19 staphylococci and micrococci, Staphylococcus epidermidis was the predominant isolate in both apical periodontitis and severe marginal periodontitis sites. However, less commonly known organisms such as Staphylococcus cohnii and Micrococcus sp. were identified in severe marginal periodontitis sites. The isolation of Bacillus sp. (12 isolates) in one severe marginal periodontitis and two apical periodontitis subjects was especially interesting, warranting consideration of this organism as a legitimate isolate and potential pathogen in oral disease.

Neonatal equine herpesvirus type 1 infection on a thoroughbred breeding farm

Of 17 foals born on a Thoroughbred breeding farm between March and April 1995, infection with equine herpesvirus type 1 (EHV-1) was associated with neonatal morbidity in 5 foals, 3 of which died or were euthanized. Morbidity and mortality were associated with pulmonary inflammation, and EHV-1 was identified in the lungs of the 3 foals that died. All neonatal EHV-1 infections occurred in foals of mares housed in the same pasture and barn. No other clinical manifestations of EHV-1 infection (e.g., abortion, neurologic disease, or respiratory disease) occurred during this outbreak. Three foals were treated with acyclovir (1 died, 2 survived), which may have influenced the clinical outcome in the surviving foals.

Modulation of glycosidase and protease activities by chemostat growth conditions in an endocarditis strain of Streptococcus sanguis

The effects of growth conditions on the properties of the endocarditis-producing oral bacterium Streptococcus sanguis FSS2 were studied. This strain produces a variety of proteases and glycosidases, including a thrombin-like activity that is a potential virulence factor for endocarditis. Cultures were grown with limiting glucose or galactose in chemostats over a range of dilution rates and pH levels, and the following activities were measured at pH 7.5: thrombin-like, Hageman factor-like, N-acetyl-beta-D-galactosaminidase, beta-D-glucosidase, and beta-D-galactosidase. At growth pH 6.5, specific activities generally decreased as the dilution rate increased from 0.05 to 0.40 h(-1). At a dilution rate of 0.1 h(-1), specific activities generally were highest at growth pH 6.5 and lower and approximately equal at growth pH 5.5 and 7.5. The major exception was the thrombin-like activity, for which the specific activity at growth pH 7.5 was approximately 5-fold higher than at growth pH 5.5. Hageman factor-like activity was apparently glucose catabolite repressible, as its activity was 3-fold higher in galactose cultures. The measured activities changed as functions of growth conditions and thus were modulated by environment. Environmental regulation of thrombin-like activity by pH is consistent with an activity that is less important on tooth surfaces than in tissues.

Reduction of caries and of demineralization around orthodontic brackets: effect of a fluoride-releasing resin in the rat model

The effectiveness of fluoride in reduction of caries is well known. This study examined the ability of a fluoride-releasing resin to reduce caries, as well as demineralization around orthodontic brackets, by using the Sprague-Dawley rat as a model. Eighteen-day-old rats were infected with cariogenic Streptococcus sobrinus 6715. After infection was confirmed, standard orthodontic techniques were used to bond miniature orthodontic brackets to the lingual surfaces of maxillary first molars, with either a fluoride-releasing resin (group I) or a conventional resin (group II). A control group was infected but not bonded (group III). Bonding was done at age 34 days. Rats were fed a cariogenic diet and were killed at age 72 days. Lingual surfaces of maxillary first molars were evaluated for area of demineralization, and mandibular molars were scored for caries. Mean percent area of demineralization for group I was 4.7%, for group II 35.7%, and for group III 0%. The difference between groups I and II was statistically significant (p < 0.01). Mean mandibular molar enamel carious lesion unit count for group I was 9.8, for group II 16.3, and for group III 13.7. Group I had significantly fewer lesions than groups II and III (p < 0.01), and group II had significantly more lesions than group III (p < 0.01). These results indicate that a fluoride-releasing resin reduces demineralization at the site of application and reduces caries at distant sites in the experimental rat model.

Prevention of root caries with dentin adhesives

This in vitro investigation determined the feasibility of using dentin adhesives to protect root surfaces against caries. The roots of 22 recently extracted human teeth were all painted with a protective lacquer leaving two unprotected small windows. On each specimen, one window (control) was left untreated and the other window (experimental) was treated using a dentin adhesive (Scotchbond Multi-Purpose). The roots were then immersed in an in vitro acetate/calcium/phosphate demineralization model at pH 4.3. After 70 days, the samples were removed and sectioned through the windows. The undecalcified ground sections were examined under transmitted and polarized light. Lesions characteristic of natural root caries were seen in the untreated control windows. No such lesions were apparent in the experimental windows. The results of this preliminary study suggest that dentin adhesives may provide protection against root caries.

PDQ-R personality disorders in bipolar patients

The prevalence of personality traits and disorders in bipolar patients as reported in the literature varies widely. The Personality Diagnostic Questionnaire-Revised (PDQ-R) is a self-report instrument for DSM-IIIR personality disorders found to have validity, but with high sensitivity and moderate specificity. This study was designed to assess personality disorders in bipolar patients using the PDQ-R. Fifty bipolar patients in a long-term lithium treatment program completed the PDQ-R. Over one half the patients (58%) scored for one or more personality disorders. A total of 71 diagnoses was made among the 50 patients, or a mean of 1.42 per patient. The majority of the axis II diagnoses were from cluster B, with borderline the most prevalent, followed by histrionic. The PDQ-R has high sensitivity but moderate specificity and may overdiagnose personality disorders in bipolar patients. The PDQ-R may register subclinical aspects of affective disorder as personality.

Outcome of bipolar disorder on long-term treatment with lithium

The long-term treatment outcome of 248 bipolar patients in an out-patient lithium programme was assessed. Over half of the patients (138 or 56%) had no affective episodes in the year observed. Patients were divided into outcome groups according to GAS scores: the outcome for 40% of patients was good, for 41% fair, and for 19% poor. More frequent psychiatric admissions before starting lithium treatment was the best predictor of poor outcome, followed by a negative affective style in the family and lower social class. Current alcohol and drug abuse was associated with poor outcome. Although familial and psychosocial factors were significantly associated with outcome, the findings suggest there may be inherent differences in the pathophysiology of bipolar disorder reflected in an increased frequency of episodes which account for a large variance in lithium treatment outcome.

Bacterial biofilm: a source of contamination in dental air-water syringes

This study examined the bacteriology of dental air-water syringes, and found that the water delivered by these syringes can be persistently contaminated with bacteria. Flushing of the water line reduced but did not eliminate this contamination. Even after six minutes' flushing, some water samples still contained more than 10(4) viable bacterial cells per milliliter, although coliform counts were less than two per 100 milliliters as measured by a Most Probable Number assay. Sterilization of the tip or the entire syringe did not eliminate this contamination. Scanning electron microscopy revealed bacterial biofilms on the inner wall of the plastic tubing supplying water to the air-water syringe, but not on the air line or on new, unused tubing. Such biofilms probably can be found in any tubing which supplies water to components of dental units. The inoculum for these biofilms comes from ubiquitous environmental aquatic bacteria, some of which can cause disease in compromised patients. Biofilms can be held in check by regular flushing of the water lines with a biocide, and the authors affirm the use of the ADA guidelines for treatment of contaminated dental-unit water lines to control possible cross-infection.

Comparison of properties of collected cells and cells from the culture vessel during continuous culture of Streptococcus mutans Ingbritt

In continuous-culture studies chemostat effluents are usually collected into a receiving flask in an ice bath to obtain enough cells for an experiment. It is assumed that the properties of these are not significantly different from those of the culture in the chemostat vessel. This assumption has been tested for the dental pathogen Streptococcus mutans Ingbritt. Collected supernatant fluid and cells were compared with supernatant fluid and cells taken directly from the culture vessel, for four major groups of culture properties: viability and biomass, concentrations of metabolites and nutrients, activities of selected enzymes, and glycolytic rates. The assumption held true except for glycolytic rate during endogenous metabolism. It is suggested that comparison of collected and culture vessel cells is an important control which should be done in all continuous culture studies of microbial physiology and biochemistry, but that the properties of Strep. mutans cells collected on ice up to 16 h do reflect those of cells actively growing in the chemostat.

The role of social factors in affective disorders: a review

A number of researchers, dissatisfied with traditional models of affective illness, have developed multidimensional systems models that more accurately reflect how genetic, biological, and social factors may interact to increase vulnerability or resilience to stressors and illness. The role of five social factors in this process--demographics, early childhood experiences, life events, social support, and families--is reviewed. Serious methodologic difficulties hamper the study of social factors in affective illness, prompting the authors to suggest that researchers develop a new research paradigm that attempts not only to quantify social factors but to understand their meaning to the individual.

Social support and long-term lithium outcome

The failure rate in long-term lithium treatment of bipolar affective disorder is in the range of 20 to 30%, even with rigorous diagnostic criteria an adequate serum lithium levels. This may be due to a variety of biologic and psychosocial factors. Psychosocial factors affecting treatment outcome were studied in 60 RDC diagnosed bipolar patients treated with lithium for one year. Outcome was measured using an affective episode score, a social adjustment scale and a global assessment scale. Social support was the factor most strongly correlated with a good outcome on all three measures.

Detection of streptococcal mutants presumed to be defective in sugar catabolism

The tetrazolium method for detection of bacterial mutants defective in sugar catabolism was modified for use with streptococci. The critical factors were (i) the concentration of tetrazolium, which must be titrated to determine the optimum concentration for each species or even strain, and (ii) anaerobic incubation of tetrazolium-containing agar plates. When used with standard mutagenesis protocols, this method yielded lactose-negative mutants of nine streptococcal strains representing six species. A collection of lactose-negative mutants of streptococcus, sanguis Challis was characterized and contained phospho-beta-galactosidase, lactose phosphotransferase, and general phosphotransferase mutants.

New species definitions in phages of gram-positive cocci

About 290 phages of the bacterial genera Leuconostoc, Micrococcus, Staphylococcus, and Streptococcus were surveyed. The phages belong to the Myoviridae, Siphoviridae, and Podoviridae families and comprise seven basic morphotypes. Fourteen new species are proposed, bringing the number of phage species for gram-positive cocci to 27. The distribution of particular phage types may indicate phylogenetic relationships between host bacteria.

Synthesis of DNA by Micrococcus luteus is resistant to 6-(p-hydroxyphenylazo)uracil

The DNA synthesis inhibitor 6-(p-hydroxyphenylazo)uracil (HPUra), at concentrations ranging from 0.2 to 2000 micro M, had essentially no effect on DNA synthesis in Micrococcus luteus strain ML-1. Seven other M. luteus strains were unaffected by 200 micro M HPUra. In vitro DNA synthesis in toluene-treated M. luteus strain ML-1 ws resistant to both HPUra and reduced HPUra.

Families of manic-depressive patients: effect of treatment

The authors studied the families of 12 patients with bipolar manic-depressive illness. They measured family stability using a life events scale for a 2-year period before lithium treatment and for 2 years during lithium treatment. The patients responded well to treatment; they were able to resume normal roles within the family. The life events scores decreased substantially during treatment in comparison with before treatment. The most severe impact of the illness was found in the children: 45% (N = 10) were moderately ill or symptomatic. The authors discuss the effect of manic-depressive illness on the family system as a whole and emphasize the need to combine psychosocial treatment with lithium treatment.

DNA base composition, nature of intracellular DNA, morphology, and classification of bacteriophages infecting Micrococcus luteus

Ten bacteriophages infecting Micrococcus luteus have been characterized. All phages contain double-stranded DNA, of 64.3--73.5 mol% guanine plus cytosine (GC). The DNA of phage N7 has the highest GC content reported for any bacterial virus. No unusual bases have been found. The intracellular replicating DNAs of six phages are covalently closed circular molecules. All 10 phages have isometric, probably icosahedral, heads and long, flexible, noncontractile tails and can be sorted into two morphological groups based on size and presence or absence of a collar. Host-range studies indicate six host-range groups.

Changes in macromolecular synthesis in Xanthomonas oryzae infected with bacteriophage XP-12

Phage XP-12, which has complete substitution of the cytosine residues in its DNA with 5-methylcytosine residues, was shown to inhibit incorporation of uracil into host DNA and RNA during the latent period. This apparent inhibition of host macromolecular synthesis was not accompanied by extensive degradation of the host chromosome. Phage DNA synthesis in infected cells occurred at a faster rate than host DNA synthesis in analogous uninfected cells. However, phage DNA synthesis could not be accurately monitored by incorporation of [methyl-3H]thymidine into DNA because, soon after infection, there was a marked inhibition of utilization of exogenous thymidine for DNA synthesis. Phage infection conferred upon a thymine auxotrophic host the ability to synthesize thymine nucleotides for phage DNA synthesis. It is suggested that a phage-induced thymidylate synthetase activity is partially responsible for the inhibition of thymidine incorporation.

Unusual properties of the DNA from Xanthomonas phage XP-12 in which 5-methylcytosine completely replaces cytosine

Xanthomonas phage XP-12 contains 5-methylcytosine completely replacing cytosine. This substitution confers several unusual properties upon XP-12 DNA. The buoyant density of XP-12 DNA in CsCl gradients is 1.710 g/cm-3, 0.16 g/cm-3 lower than that expected for a normal DNA with the same percentage of adenine plus thymine. The melting temperature for XP-12 DNA in 0.012 M Na+ is the highest reported for any naturally occurring DNA, 83.2 degrees C, 6.1 degrees C higher than that of normal DNAs with the same percentage of adenine plus thymine. Unlike the minor amounts of 5-methylcytosine found in most plant and animal DNAs, the 5-methylcytosine residues of XP-12 derive their methyl group from the 3-carbon of serine instead of from the thiomethyl carbon of methionine. .

Phosphoenolpyruvate-dependent glucose transport in oral streptococci

Streptococcus mutans, S sanguis, and S salivarius use a phosphoenolpyruvate (PEP)-dependent phosphotransferase system that results in phosphorylation of glucose at carbon 6. This enzyme system is not sensitive to fluoride. Glucose uptake into resting cell suspensions is sensitive to fluoride because of inhibition of intracellular PEP production. The glucose phosphotransferase system is constitutive in oral streptococci.