Bioadhesion in the oral cavity and approaches for biofilm management by surface modifications

Background: All soft and solid surface structures in the oral cavity are covered by the acquired pellicle followed by bacterial colonization. This applies for natural structures as well as for restorative or prosthetic materials; the adherent bacterial biofilm is associated among others with the development of caries, periodontal diseases, peri-implantitis, or denture-associated stomatitis. Accordingly, there is a considerable demand for novel materials and coatings that limit and modulate bacterial attachment and/or propagation of microorganisms. Objectives and findings: The present paper depicts the current knowledge on the impact of different physicochemical surface characteristics on bioadsorption in the oral cavity. Furthermore, it was carved out which strategies were developed in dental research and general surface science to inhibit bacterial colonization and to delay biofilm formation by low-fouling or “easy-to-clean” surfaces. These include the modulation of physicochemical properties such as periodic topographies, roughness, surface free energy, or hardness. In recent years, a large emphasis was laid on micro- and nanostructured surfaces and on liquid repellent superhydrophic as well as superhydrophilic interfaces. Materials incorporating mobile or bound nanoparticles promoting bacteriostatic or bacteriotoxic properties were also used. Recently, chemically textured interfaces gained increasing interest and could represent promising solutions for innovative antibioadhesion interfaces. Due to the unique conditions in the oral cavity, mainly in vivo or in situ studies were considered in the review. Conclusion: Despite many promising approaches for modulation of biofilm formation in the oral cavity, the ubiquitous phenomenon of bioadsorption and adhesion pellicle formation in the challenging oral milieu masks surface properties and therewith hampers low-fouling strategies. Clinical relevance: Improved dental materials and surface coatings with easy-to-clean properties have the potential to improve oral health, but extensive and systematic research is required in this field to develop biocompatible and effective substances. © 2020, The Author(s)

Bioadhesion on Textured Interfaces in the Human Oral Cavity—An In Situ Study

Extensive biofilm formation on materials used in restorative dentistry is a common reason for their failure and the development of oral diseases like peri-implantitis or secondary caries. Therefore, novel materials and strategies that result in reduced biofouling capacities are urgently sought. Previous research suggests that surface structures in the range of bacterial cell sizes seem to be a promising approach to modulate bacterial adhesion and biofilm formation. Here we investigated bioadhesion within the oral cavity on a low surface energy material (perfluorpolyether) with different texture types (line-, hole-, pillar-like), feature sizes in a range from 0.7–4.5 µm and graded distances (0.7–130.5 µm). As a model system, the materials were fixed on splints and exposed to the oral cavity. We analyzed the enzymatic activity of amylase and lysozyme, pellicle formation, and bacterial colonization after 8 h intraoral exposure. In opposite to in vitro experiments, these in situ experiments revealed no clear signs of altered bacterial surface colonization regarding structure dimensions and texture types compared to unstructured substrates or natural enamel. In part, there seemed to be a decreasing trend of adherent cells with increasing periodicities and structure sizes, but this pattern was weak and irregular. Pellicle formation took place on all substrates in an unaltered manner. However, pellicle formation was most pronounced within recessed areas thereby partially masking the three-dimensional character of the surfaces. As the natural pellicle layer is obviously the most dominant prerequisite for bacterial adhesion, colonization in the oral environment cannot be easily controlled by structural means

Pathogenicity of Helicobacter hepaticus : genomic and functional aspects

Helicobacter hepaticus stellt den Prototyp der enterohepatischen Helicobacter dar und führt zu einer persistenten Infektion von Mäusen. In immundefizienten Tieren kann er eine chronische Entzündung des Darmtraktes auslösen, welche den chronisch entzündlichen Darmerkrankungen des Menschen, Morbus Crohn und Colitis Ulcerosa, ähnelt. Deshalb wird H. hepaticus bevorzugt als Modellorganismus zur Untersuchung der immunologischen Ursachen von chronisch entzündlichen Darmerkrankungen im Tiermodell eingesetzt. Ebenfalls kann eine Infektion mit H. hepaticus in suszeptiblen Mäusestämmen (z.B. Balb/c, C3H/An) zu Entzündungen der Leber und Gallengänge führen, welche sich bis zu einer Hepatitis und Leberkarzinomen ausweiten können. In den meisten Studien wurde H. hepaticus bisher aber hauptsächlich als Auslöser dieser Erkrankungen eingesetzt, während die bakterielle Seite kaum betrachtet wurde. Im Rahmen dieser Arbeit wurde in einer Kooperation mit MWG Biotech, GeneData und dem Massachusetts Institute of Technology (MIT) die Gesamtgenomsequenz des H. hepaticus Referenzstammes ATCC 51449 bestimmt und annotiert. Das Genom hat eine Größe von 1.799.146 bp und kodiert für 1.875 Proteine. Die globale Ähnlichkeit des Genoms von H. hepaticus ist etwa gleich groß zu den sequenzierten Genomen von H. pylori und C. jejuni. Es fehlen H. hepaticus aber die meisten Virulenzfaktoren von H. pylori wie Adhäsine (SabA, BabA, AlpA), VacA und die meisten Proteine der cag-Pathogenitätsinsel, während Homologe zu Pathogenitätsfaktoren von C. jejuni wie CDT und Peb1 vorhanden sind. Das Genom von H. hepaticus enthält neben vielen kleineren genomischen Inseln eine Genominsel mit einer Größe von 71 kb, welche als HHGI1 benannt wurde. Sie kodiert mutmaßlich für ein TypIV-Sekretionssystem und enthält weitere Virulenzfaktoren. In Microarray- basierten Gesamtgenomvergleichen konnte gezeigt werden, dass die Insel in sieben von 13 untersuchten Stämmen großteils oder komplett fehlt. Während Mäuse, aus denen HHGI1-positive Stämme isoliert wurden, pathologische Veränderungen der Leber aufwiesen, wies keine von den Mäusen, aus denen HHGI1-negative Stämme isoliert wurden, Auffälligkeiten in der Leber oder dem Gallentrakt auf. In einem Tiermodell wurde in Kooperation mit dem MIT gezeigt, dass zwei Insel-negative Stämme zu einer geringeren Besiedlung und einer schwächeren Entzündung der Leber als der Insel-positive Referenzstamm ATCC 51449 führen. Durch die Genomvergleiche konnte auch gezeigt werden, dass verschiedene H. hepaticus-Stämme trotz einer niedrigen Sequenzvariabilität eine hohe Variation des Genomgehalts aufweisen und dass neben der HHGI1-Insel weitere kleinere Inseln in einzelnen Stämmen fehlen. Es wurden in der vorliegenden Arbeit erstmals verschiedene isogene Mutanten von H. hepaticus in der HHGI-1-Insel hergestellt, die in vitro eine verringerte Immunstimulation in Makrophagen zeigten. Der Mechanismus dieser Immunsuppression konnte noch nicht vollständig aufgeklärt werden, sie werden jedoch derzeit in Mausmodellen weiter auf ihre krankheitsauslösenden Eigenschaften untersucht. Da bisher keine gut charakterisierten Zellkulturmodelle für die in vitro-Untersuchung von H. hepaticus vorlagen, wurden solche im Rahmen dieser Arbeit etabliert. Dazu wurden die intestinale murine epitheliale Zelllinie m-ICcl2, welche das primäre Habitat von H. hepaticus (Krypten im Dünndarm) imitiert, die murine Hepatozytenzelllinie NCTC Klon 1469, welche ein mögliches sekundäres Habitat (Lebercanaliculi) imitiert und die murine Makrophagenzelllinie J774 benutzt. Während J774 und NCTC Klon 1469 durch die meisten Liganden für Mustererkennungsrezeptoren stimuliert werden konnten, reagierten m-ICcl2- Zellen substantiell nur auf den TLR4-Liganden E. coli-LPS. Dementsprechend induzierte H. hepaticus in J774 und NCTC Klon 1469 eine starke proinflammatorische Antwort, während m-ICcl2 trotz guter Adhärenz nur schwach von H. hepaticus stimuliert wurde. Es wurde gezeigt, dass LPS und Flagelline von H. hepaticus nur eine geringe immunstimulatorische Wirkung besitzen, während Lipoproteine und vermutlich auch Peptidoglykan die wichtigsten PAMPs von H. hepaticus darstellen. Durch die Analyse der durch H. hepaticus ausgelösten globalen Genregulation in J774 und NCTC Klon 1469 wurde nachgewiesen, dass H. hepaticus nicht primär über NF-κB, sondern über MAP-Kinasen eine proinflammatorische Antwort auslöst. Außerdem wurde gezeigt, dass H. hepaticus untypisch für extrazelluläre Bakterien eher eine Wirtsantwort auslöst, welche der durch intrazelluläre Bakterien ähnelt. In diesen Modellen führten HHGI1-negative Stämme oder Mutanten der HHGI1-Insel zu einer leicht verringerten proinflammatorischen Antwort. Dies spiegelte sich auch in der transkriptionellen Regulation von Schlüsselfaktoren der angeborenen Immunantwort wie TLR2, IL-12, NOD2 oder Tollip wieder. In m-ICcl2-Zellen führte eine Koinkubation mit lebenden H. hepaticus oder Lysaten zu einer verringerten durch E. coli-LPS ausgelösten Induktion von MIP-2. Darauf basierend wurde gezeigt, dass LPS von H. hepaticus einen wesentlichen Faktor für diese Inhibierung der proinflammatorischen Antwort darstellt, nicht jedoch die HHGI-1-Insel oder andere vermutete Virulenzfaktoren. Zumindest auf mRNA-Ebene wurde durch H. hepaticus auch die Induktion anderer Cytokine wie TNF-α oder MIP-1α gehemmt. Eine primäre Koinkubation von m-ICcl2 mit E. coli-LPS führte zu einer Toleranzinduktion gegenüber einer zweiten Stimulation. Diese Toleranzinduktion wurde durch eine Inkubation mit H. hepaticus ebenfalls gehemmt. Die Hemmung der proinflammatorischen Antwort durch H. hepaticus-LPS konnte auch in NCTC Klon 1469 und unter serumfreien Bedingungen für die durch S. typhimurium- Flagellin induzierte IL-8 Sekretion in der humanen Kolonkarzinomzelllinie Caco2 nachgewiesen werden. Damit war diese Hemmung weder zellspezifisch noch spezifisch für die TLR4-abhängige Stimulation. Basierend auf dieser Arbeit wurde ein Modell für die Entstehung einer chronischen Entzündung im Intestinaltrakt entwickelt, welches Erklärungsansätze für die Entwicklung einer chronisch entzündlichen Darmerkrankung im Menschen liefern könnte.H. hepaticus is the prototype species of the enterohepatic group of Helicobacter species and leads to a persistent infection in mice. It is able to cause a chronic inflammation of the intestinal tract in immuno-deficient mice that resembles the common human inflammatory bowel diseases Crohn’s disease und ulcerative colitis. Therefore H. hepaticus is widely used as a model organism to study the possible immunological causes underlying the development of inflammatory bowel disease in the animal model. H. hepaticus can also lead to diseases in the liver and biliary tract of susceptible mouse strains (e.g. Balb/c, C3H/An) such as hepatitis and even liver cancer. But in most studies H. hepaticus was mainly used to trigger these diseases, while only little attention was paid to the bacterial determinants of pathogenesis. In this work the complete genome sequence of the H. hepaticus reference strain ATCC 51449 was determined and annotated in cooperation with GeneData, MWG Biotech and the Massachusetts Institute of Technology (MIT). The genome has a size of 1,799,146 bp and codes for 1,875 proteins. Generally the average similarity of the genome is about equal to the sequenced genomes of H. pylori and C. jejuni. But H. hepaticus misses most of the virulence factors of H. pylori such as adhesins (e.g. SabA, BabA, or AlpA), the vacuolating cytotoxin VacA and most genes of the cag pathogenicity island. On the other hand it possesses many orthologs of C. jejuni virulence factors like the cytolethal distending toxin CDT or the adhesion factor Peb1. In addition to several smaller genomic islands, the genome of H. hepaticus contains a large 71 kb genomic island, which we called HHGI1. It presumably codes for a type IV secretion system and several additional virulence factors. By a microarray-based genome comparison study, we could show that this island was missing in seven out of 13 isolates. While only mice that harbored an island positive strain showed signs of liver disease, not a single mouse with an island negative strain showed any pathological changes of the liver or the biliary tract. In cooperation with the MIT, it was shown in an animal model that two island negative strains led to a reduced colonization and weaker inflammation of the liver compared to the island positive reference strain ATCC 51449. By the genome comparisons, it was also shown that despite low sequence variability the genome contents of different H. hepaticus isolates can differ widely and that smaller islands are either present or absent in different strains. In the framework of these investigations, several isogenic H. hepaticus mutants in the HHGI1 island were constructed. These mutants showed in comparison to the wild type a deficiency to activate macrophages, but the exact mechanism could not be identified so far. The isogenic mutants are currently further tested in animal models for their disease-eliciting potential. Because no well-characterized cell culture model was yet available for the in vitro examination of H. hepaticus-associated pathogenesis, such models were established in this dissertation. Therefore the murine intestinal epithelial cell line m-ICcl2 which resembles the primary habitat of H. hepaticus in the mouse caecum, the murine hepatocyte cell line NCTC clone 1469 which imitates one possible secondary habitat (mouse liver canaliculi) and the murine macrophage cell line J774 were used. While a wide range of ligands for pattern recognition receptors were able to stimulate NCTC clone 1469 and J774, m-ICcl2 cells only reacted substantially to the TLR4 ligand E. coli LPS. Accordingly, infection with H. hepaticus led to a strong proinflammatory response in J774 und NCTC clone 1469, while m-ICcl2 cells were only weakly stimulated by H. hepaticus despite good adherence. It was shown that H. hepaticus LPS and flagellins are only weak stimulators of the innate immune system while, as the results suggested, the proinflammatory response was mainly induced by lipoproteins and probably also by peptidoglycans of H. hepaticus. By analyzing the global gene regulation in J774 and NCTC clone 1469 after coincubation with H. hepaticus, it was established that the proinflammatory response is not mainly dependent on NF-κB but on MAP kinases. Also, the global response of the cells resembled more those induced by intracellular than extracellular pathogens. In these model systems, HHGI1-negative strains or mutants in the HHGI1 island led to a weaker proinflammatory response than HHGI1-containing strains. This was also in concordance with a different regulation pattern of different factors like TLR2, IL- 12, NOD2 or Tollip. In m-ICcl2 cells, after coincubation with live H. hepaticus or lysates, a reduced secretion of MIP-2 after stimulation with E. coli LPS was observed. It was shown that H. hepaticus LPS is one important factor for this inhibition of LPS-induced MIP-2 secretion, but not the HHGI-1 island nor other presumed H. hepaticus virulence factors. On the mRNA level, the induction of other cytokines like TNF-α or MIP-1α was also reduced by H. hepaticus. We could show, that, as described in other cells before, a primary coincubation with E. coli LPS leads to a tolerance against a second stimulation round. This tolerance development was inhibited by H. hepaticus. Inhibition of the proinflammatory response by H. hepaticus LPS was also obtained with NCTC clone 1469 cells. When using the human intestinal epithelial carcinoma cell line Caco2, S. typhimurium flagellin triggered IL-8 secretion was almost completely reduced under serum-free conditions, while no inhibition was found under serum-containing conditions. Therefore, this inhibitory effect was neither cell-specific nor specific for induction via TLR4. Based on this work, a model for the development of a chronic inflammation of the intestinal tract could be established, which may offer possible explanations for the development of inflammatory bowel diseases in humans

Functional expression of the entire adhesiome of Salmonella enterica serotype Typhimurium

Abstract Adhesins are crucial virulence factors of pathogenic bacteria involved in colonization, transmission and pathogenesis. Many bacterial genomes contain the information for a surprisingly large number of diverse adhesive structures. One prominent example is the invasive and facultative intracellular pathogen Salmonella enterica with an adhesiome of up to 20 adhesins. Such large repertoire of adhesins contributes to colonization of a broad range of host species and may allow adaptation to various environments within the host, as well as in non-host environments. For S. enterica, only few members of the adhesiome are functionally expressed under laboratory conditions, and accordingly the structural and functional understanding of the majority of adhesins is sparse. We have devised a simple and versatile approach to functionally express all adhesins of S. enterica serotype Typhimurium, either within Salmonella or within heterologous hosts such as Escherichia coli. We demonstrate the surface expression of various so far cryptic adhesins and show ultrastructural features using atomic force microscopy and transmission electron microscopy. In summary, we report for the first time the expression of the entire adhesiome of S. enterica serotype Typhimurium

Identification of disulfide reductases in campylobacterales: A bioinformatics investigation

Disulfide reductases of host-colonising bacteria are involved in the expression of virulence factors, resistance to drugs, and elimination of toxic compounds. Large-scale genome analyses of 281 prokaryotes identified CXXC and CXXC-derived motifs in each microorganism. The total number of these motifs showed correlations with genome size and oxygen tolerance of the prokaryotes. Specific bioinformatic analyses served to identify putative disulfide reductases in the Campylobacterales Campylobacter jejuni, Helicobacter pylori, Wolinella succinogenes and Arcobacter butzleri which colonise the gastrointestinal tract of higher animals. Three filters applied to the genomes of these species yielded 35, 25, 28 and 34 genes, respectively, encoding proteins with the characteristics of disulfide reductases. Ten proteins were common to the four species, including four belonging to the thioredoxin system. The presence of thioredoxin reductase activities was detected in the four bacterial species by observing dithiobis-2-nitrobenzoic acid reduction with β-nicotinamide adenine dinucleotide phosphate as cofactor. Phylogenetic analyses of the thioredoxin reductases TrxB1 and TrxB2 of the four Campylobacterales were performed. Their TrxB1 proteins were more closely related to those of Firmicutes than to the corresponding proteins of other Proteobacteria. The Campylobacterales TrxB2 proteins were closer to glutathione reductases of other organisms than to their respective TrxB1 proteins. The phylogenetic features of the Campylobacterales thioredoxin reductases suggested a special role for these enzymes in the physiology of these bacteria

Bioadhesion on Textured Interfaces in the Human Oral Cavity—An In Situ Study

Extensive biofilm formation on materials used in restorative dentistry is a common reason for their failure and the development of oral diseases like peri-implantitis or secondary caries. Therefore, novel materials and strategies that result in reduced biofouling capacities are urgently sought. Previous research suggests that surface structures in the range of bacterial cell sizes seem to be a promising approach to modulate bacterial adhesion and biofilm formation. Here we investigated bioadhesion within the oral cavity on a low surface energy material (perfluorpolyether) with different texture types (line-, hole-, pillar-like), feature sizes in a range from 0.7–4.5 µm and graded distances (0.7–130.5 µm). As a model system, the materials were fixed on splints and exposed to the oral cavity. We analyzed the enzymatic activity of amylase and lysozyme, pellicle formation, and bacterial colonization after 8 h intraoral exposure. In opposite to in vitro experiments, these in situ experiments revealed no clear signs of altered bacterial surface colonization regarding structure dimensions and texture types compared to unstructured substrates or natural enamel. In part, there seemed to be a decreasing trend of adherent cells with increasing periodicities and structure sizes, but this pattern was weak and irregular. Pellicle formation took place on all substrates in an unaltered manner. However, pellicle formation was most pronounced within recessed areas thereby partially masking the three-dimensional character of the surfaces. As the natural pellicle layer is obviously the most dominant prerequisite for bacterial adhesion, colonization in the oral environment cannot be easily controlled by structural means

Quantification of Bacterial DNA from Infected Human Root Canals Using qPCR and DAPI after Disinfection with Established and Novel Irrigation Protocols

The removal of bacterial infections within the root canal system is still a challenge. Therefore, the cleansing effect of established and new irrigation-protocols (IP) containing silver diamine fluoride (SDF) 3.8% on the whole root canal system was analyzed using quantitative PCR (qPCR) and 4′,6-diamidino-phenylindole-(DAPI)-staining. Extracted human premolars were instrumented up to F2 (ProTaper Gold) under NaCl 0.9% irrigation and incubated with Enterococcus faecalis for 42 days. Subsequently, different ultrasonically agitated IP were applied to the roots: control (no irrigation), 1. NaOCl 3%, EDTA 20%, CHX 2%, 2. NaOCl 3%, EDTA 20%, 3. NaOCl 3%, EDTA 20%, SDF 3.8%, 4. SDF 3.8%, and 5. NaCl 0.9%. One half of the root was investigated fluorescent-microscopically with DAPI. The other half was grinded in a cryogenic mill and the bacterial DNA was quantified with qPCR. The qPCR results showed a statistically significant reduction of bacteria after the application of IP 1, 2, and 3 compared to the control group. While IP 4 lead to a bacterial reduction which was not significant, IP 5 showed no reduction. These data corresponded with DAPI staining. With qPCR a new molecular-biological method for the investigation of the complete root canal system was implemented. The novel IP 3 had an equally good cleansing effect as the already established IP

Inhibitory Effect of Enterohepatic Helicobacter hepaticus on Innate Immune Responses of Mouse Intestinal Epithelial Cells▿

Enterohepatic Helicobacter species infect the intestinal tracts and biliary trees of various mammals, including mice and humans, and are associated with chronic inflammatory diseases of the intestine, gallstone formation, and malignant transformation. The recent analysis of the whole genome sequence of the mouse enterohepatic species Helicobacter hepaticus allowed us to perform a functional analysis of bacterial factors that may play a role in these diseases. We tested the hypothesis that H. hepaticus suppresses or evades innate immune responses of mouse intestinal epithelial cells, which allows this pathogen to induce or contribute to chronic inflammatory disease. We demonstrated in the present study that the innate immune responses of intestinal epithelial cells to lipopolysaccharide (LPS) via Toll-like receptor 4 (TLR4) and to flagellin-mediated activation via TLR5 are reduced by H. hepaticus infection through soluble bacterial factors. In particular, H. hepaticus lysate and the soluble component LPS antagonized TLR4- and TLR5-mediated immune responses of intestinal epithelial cells. H. hepaticus lysate and LPS inhibited development of endotoxin tolerance to Escherichia coli LPS. Suppression of innate immune responses by H. hepaticus LPS thus may affect intestinal responses to the resident microbial flora, epithelial homeostasis, and intestinal inflammatory conditions

Different Helicobacter hepaticus Strains with Variable Genomic Content Induce Various Degrees of Hepatitis

A 70-kb genomic island (HHGI1) in Helicobacter hepaticus strain ATCC 51449 is a putative pathogenicity island (PAI). To determine the in vivo relevance of this PAI, we inoculated A/JCr mice with one of three strains of H. hepaticus: type strain Hh3B1, which contains the complete PAI, and strains HhNET and HhG, which lack all or large parts of HHGI1, respectively. Mice infected with HhG and HhNET developed less-severe hepatitis than male A/JCr mice infected with Hh3B1

Myc Is Required for Activation of the ATM-Dependent Checkpoints in Response to DNA Damage

Background: The MYC protein controls cellular functions such as differentiation, proliferation, and apoptosis. In response to genotoxic agents, cells overexpressing MYC undergo apoptosis. However, the MYC-regulated effectors acting upstream of the mitochondrial apoptotic pathway are still unknown. Principal Findings: In this study, we demonstrate that expression of Myc is required to activate the Ataxia telangiectasia mutated (ATM)-dependent DNA damage checkpoint responses in rat cell lines exposed to ionizing radiation (IR) or the bacterial cytolethal distending toxin (CDT). Phosphorylation of the ATM kinase and its downstream effectors, such as histone H2AX, were impaired in the myc null cell line HO15.19, compared to the myc positive TGR-1 and HOmyc3 cells. Nuclear foci formation of the Nijmegen Breakage Syndrome (Nbs) 1 protein, essential for efficient ATM activation, was also reduced in absence of myc. Knock down of the endogenous levels of MYC by siRNA in the human cell line HCT116 resulted in decreased ATM and CHK2 phosphorylation in response to irradiation. Conversely, cell death induced by UV irradiation, known to activate the ATR-dependent checkpoint, was similar in all the cell lines, independently of the myc status. Conclusion: These data demonstrate that MYC contributes to the activation of the ATM-dependent checkpoint responses, leading to cell death in response to specific genotoxic stimuli.Swedish Cancer SocietySwedish Research Counci