Specificity of antibodies induced by Streptococcus mutans during immunization against dental caries.

Protection against smooth surface dental caries was investigated in fifteen young rhesus monkeys which were immunized subcutaneously with Streptococcus mutans serotype c in Freund's incomplete adjuvant. Monkeys immunized with killed whole organisms developed significantly less caries than control animals. Monkeys immunized with pronase-treated cell walls developed significantly more caries than control animals while monkeys immunized with untreated cell walls showed no such enhancement of caries. Haemagglutinating and complement-fixing antibodies to cell walls and culture supernatant antigens (SN Ag) of S. mutans developed in the sera of all immunized animals to a similar degree. Antibodies to lipoteichoic acid and to an insoluble dextran preparation were found in all immunized animals and showed no relationship to the prevalence of caries. Antibodies to the serotype c polysaccharide were also found in animals immunized with whole cells and pronase-treated cell walls. However, precipitating antibody levels to partially purified antigens I/II and II, derived from SN Ag, but present also in cells, were related to the development of caries. Animals immunized with whole cells and with untreated cell walls developed a brisk antibody response to antigen I/II, while those immunized with pronase-treated cell walls responded more slowly. The results suggest that immunization may induce both caries reduction and enhancement, depending on the antibody response which is developed.     

Immunization with purified protein antigens from Streptococcus mutans against dental caries in rhesus monkeys.

Protein antigens I, I/II, II, and III were prepared from Streptococcus mutans (serotype c). Their immunogenicities and protective effects against dental caries were investigated in 40 rhesus monkeys kept entirely on a human-type diet, containing about 15% sucrose. Antigens I, I/II and, to a lesser extent, antigen II induced significant reductions in dental caries, as compared with sham-immunized monkeys. This was achieved with 1 or 2 doses of antigen, the first of which was administered with adjuvant (Freund incomplete adjuvant or aluminum hydroxide). There was no reduction in caries in monkeys immunized with antigen III. The reduction in caries in the animals immunized with antigens I or I/II was comparable to that in monkeys immunized with whole cells. Protection against caries was associated predominantly with serum and gingival crevicular fluid immunoglobulin G antibodies, which appeared to be directed against the antigen I determinant, but antibodies to antigen II, though not to antigen III, were also protective.     

Protection of gnotobiotic rats against dental caries by passive immunization with bovine milk antibodies to Streptococcus mutans.

A multivalent vaccine consisting of whole cell antigens of seven strains, representing four serotypes (b, c, d and g), of mutans streptococci was used to hyperimmunize a group of cows. Serum samples from these animals contained immunoglobulin G1 (IgG1) antibody activity to seven serotypes (a to g) of mutans streptococci. Whey obtained from the animal with the highest serum antibody activity, which also contained high levels of IgG1 antibody, was used in passive caries immunity studies. Gnotobiotic rats monoinfected with Streptococcus mutans MT8148 serotype c or Streptococcus sobrinus OMZ176 (d) or 6715 (g) and provided a caries-promoting diet containing immune whey had lower plaque scores, numbers of streptococci in plaque, and degree of caries activity than similarly infected animals given a diet containing control whey obtained from nonimmunized cows. To establish the nature of the protective component(s) present in the immune whey, an ultrafiltrate fraction of the whey was prepared. This preparation contained higher levels of IgG1 anti-S. mutans antibody activity than the immune whey. Rats monoinfected with S. mutans MT8148 and provided with a diet supplemented with 0.1% of this fraction exhibited a degree of caries protection similar to that seen in animals provided a diet containing 100% immune whey. In fact, a diet containing as little as 0.01% of the ultrafiltrate fraction gave some degree of protection against oral S. mutans infection. The active component in the immune whey was the IgG1 anti-S. mutans antibody, since rats monoinfected with S. mutans MT8148 and provided a diet supplemented with purified immune whey IgG1 had significantly reduced plaque scores, numbers of S. mutans in plaque, and caries activity compared with control animals. Prior adsorption of the IgG fraction with killed S. mutans MT8148 whole cells removed antibody activity and abrogated caries protection.     

Genetic classification of severe early childhood caries by use of subtracted DNA fragments from Streptococcus mutans

Streptococcus mutans is one of several members of the oral indigenous biota linked with severe early childhood caries (S-ECC). Because most humans harbor S. mutans, but not all manifest disease, it has been proposed that the strains of S. mutans associated with S-ECC are genetically distinct from those found in caries-free (CF) children. The objective of this study was to identify common DNA fragments from S. mutans present in S-ECC but not in CF children. Using suppressive subtractive hybridization, we found a number of DNA fragments (biomarkers) present in 88 to 95% of the S-ECC S. mutans strains but not in CF S. mutans strains. We then applied machine learning techniques including support vector machines and neural networks to identify the biomarkers with the most predictive power for disease status, achieving a 92% accurate classification of the strains as either S-ECC or CF associated. The presence of these gene fragments in 90 to 100% of the 26 S-ECC isolates tested suggested their possible functional role in the pathogenesis of S. mutans associated with dental caries.     

Effective immunity to dental caries: protection of malnourished rats by local injection of Streptococcus mutans.

When rats from dams fed a low-protein diet were injected with whole, killed Strepococcus mutans 6715 cells in the region of the submandibular gland, they developed serum and salivary agglutinins to this microorganism. Titers of agglutinins in malnourished rats were similar to those observed in rats from dams fed a nutritionally adequate diet that were locally injected with S. mutans. Furthermore, both groups of immunized rats subsequently infected with cariogenic S. mutans 6715 had lower mean caries scores than infected, nonimmunized rats. This reduced incidence of caries scores than infected, nonimmunized rats. This reduced incidence of caries was evident on all molar surfaces. The mean body weights of immunized and nonimmunized, protein-deficient rats were not significantly different; likewise, both immunized and nonimmunize normally nourished rats exhibited similar weight gains. Malnourished rats, not immunized but infected with S. mutans, had significantly more caries than normal, nonimmunized infected rats. Both dietary groups of noninfected rats had very few carious lesions. These results suggest that carious lesions observed in these rats resulted from S. mutans 6715 infection. Furthermore, protein-malnourished rats, injected in the region of the submandibular gland with whole, killed S. mutans elicit an immune response and are protected against S. mutans-induced caries.     

Correlation of level and duration of Streptococcus mutans infection with incidence of dental caries.

The caries incidence at various levels of Streptococcus mutans infection was analyzed in a control group and a test group. In the control group, the incidence of caries and the duration of S. mutans infection were significantly correlated. In the test group, the S. mutans infection was suppressed by antimicrobial measures when the number of S. mutans exceeded 250 X 10(3) CFU per ml of saliva. The results illustrate that the level and duration of the S. mutans infection are strongly correlated to the incidence of caries. The findings support the concept of S. mutans as a key cariogenic microorganism and illustrate the value of antimicrobial treatment in the prevention of caries.     

Evaluation of bacterial adhesion of Streptococcus mutans on dental restorative materials

Bacterial adhesion to the surface of composite resins and other dental restorative materials is an important parameter in the aetiology of secondary caries formation. The aim of the present study was to investigate the adhesion of a Streptococcus mutans strain (ATCC 25175) on the surface of different restorative materials. The test materials examined included three flowable composites (Filtek Flow, Tetric Flow, and Arabesk Flow), three microhybrid composites (Clearfil APX, Solitaire 2, and Z250), two glass-ionomers (Fuji IX, Fuji IX fast), a compomer (F2000), an ormocer (Admira), and a control reference material (tissue culture grade, surface treated polystyrene). The adhesion tests were carried out in 24-well plates. Quantitative turbidimetric measurements were finally performed in order to indirectly evaluate the amount of bacteria retained on the material surface after in vitro exposure to the bacteria suspension. Under these conditions, with the exception of the Admira ormocer and the Fuji IX fast glass ionomer, which were found to be more adhesive, all the other material surfaces showed a similar susceptibility to bacterial adhesion, exhibiting values not significantly different than the reference polystyrene control. Furthermore, the release of fluoride from some of the test surfaces did not appear capable to reduce early bacterial adhesion.     

Effective immunity to dental caries: dose-dependent studies of secretory immunity by oral administration of Streptococcus mutans to rats.

Rats (COBS/CD) provided Formalin-killed Streptococcus mutans 6715, C211 in their drinking water (10(8) to 10(9) equivalent colony-forming units [CFU] per ml) had high levels of specific antibodies in saliva, colostrum, and milk. Rats provided a lower concentration of S. mutans antigen (10(7) CFU per ml) in water had agglutinin titers in secretions that were similar to those in controls. Gnotobiotic rats provided S. mutans antigen in food (10(7) to 10(8) equivalent CFU per g of diet) manifested a secretory immune response as evidenced by the presence of specific immunoglobulin A antibodies in saliva, colostrum, and milk. Gnotobiotic rats provided a higher concentration of antigen (10(9) CFU per g) in food had levels of specific antibodies in their secretions that were similar to those in controls. No significant antibody activity to S. mutans was observed in sera of any group of animals. Furthermore, the presence of specific salivary immunoglobulin A antibodies in gnotobiotic rats correlated with a reduction in the level of plaque, numbers of viable S. mutans in plaque, and levels of S. mutans-induced dental caries. This paper discusses the importance of antigen dosage for induction of a secretory immune response that is protective against S. mutans-induced dental caries.     

Effective immunity to dental caries: passive transfer to rats to antibodies to Streptococcus mutans elicits protection.

Rat dams, given intravenous injections of heat-killed Streptococcus mutans 6715, mutant C211 demonstrated significant agglutinin activity to the homologous S. mutans in colostrum, milk, and serum. This antibody activity was associated with the immunoglobulin G (IgG) class. High titers of anti-S. mutans antibody associated with the IgG class were also exhibited in the sera and saliva of the offspring that suckled these dams. After challenge with the homologous, live S. mutans, these offspring developed significantly fewer caries on all molar surfaces than did nonimmunized infected controls. A secretory immune response (manifested by the presence of specific IgA antibody to S. mutans in colostrum and milk) was elicited (i) in rat dams locally injected, in the region of the mammary gland, with heat-killed S. mutans antigen, and (ii) in other rat dams that were provided formalin-killed S. mutans in their drinking water. Offspring suckling these dams were challenged with virulent S. mutans before weaning and developed significantly fewer caries than did their infected controls. These findings clearly suggest that passively derived IgG or IgA antibodies to S. mutans are protective against dental caries.     

Experimental immunization of rats with a Streptococcus mutans 59-kilodalton glucan-binding protein protects against dental caries.

Glucan-binding proteins (GBPs) are theoretically important in the molecular pathogenesis of dental caries caused by Streptococcus mutans. The present study evaluated the ability of antibody induced by the S. mutans 59-kDa GBP (GBP59) to affect dental caries caused by experimental infection with S. mutans in a rodent model. Groups of 20-day-old rats were injected twice at 9-day intervals subcutaneously in the salivary gland vicinity with GBP59, glucosyltransferase (GTF), or phosphate-buffered saline (sham injection), each incorporated in an adjuvant. Two weeks after the second injection, GBP59- and GTF-injected rats contained significant levels of salivary immunoglobulin A and serum immunoglobulin G antibody to the respective injected antigens. However, cross-reacting antibody to S. mutans GTF or GBP59 was not induced by the respective antigen. Rats were then orally infected with S. mutans. After 71 days of infection, GBP59- and GTF-injected groups had smaller numbers of S. mutans on their molar surfaces, compared with the sham-injected infected group. Total, sulcal, and smooth-surface molar caries in the GBP59- and GTF-immunized S. mutans-infected groups were each significantly lower (P < or = 0.003) than the respective measures of caries in the sham injected infected group. The results of this investigation demonstrate that immunization with S. mutans GBP59 induces an immune response in rats that can interfere with the accumulation of S. mutans and can reduce the level of dental caries caused by this cariogenic streptococcus. Furthermore, the protective immunity induced by either GBP59 or GTF appears to result from antibodies to independent epitopes since these two S. mutans components do not have a close antigenic relationship.     

A sequential bacteriological and serological investigation of Rhesus monkeys immunised against dental caries with Streptococcus mutans.

In a serial investigation of the effects of immunisation with S. mutans in rhesus monkeys maintained on a "human" type of cariogenic diet, the numbers of S. mutans in cervical plaque, crevicular-fluid washings, fissures of teeth, and in saliva were lower in immunised animals than in sham-immunised controls. Immunisation also caused a delay in initial colonisation and a slowing of the rate of colonisation with S. mutans. These bacteriological changes were associated with a reduction in the smooth-surface-caries score. No relationship was found between the presence of S. sanguis and caries, but there was an inverse relationship between the proportions of S. mutans and S. sanguis isolated. Increased titres of complement-fixing, haemagglutinating and precipitating antibodies to S. mutans were found in the sera of immunised but not of control monkeys. A significant increase in salivary haemagglutinating antibodies was not detected. The results suggest that immunisation with S. mutans causes an increase in serum antibodies and a reduction in the number of S. mutans in the oral flora, and that these are associated with a reduction in dental caries.     

Identification and characterization of an autolysin-encoding gene of Streptococcus mutans

We identified a gene (atlA) encoding autolytic activity from Streptococcus mutans Xc. The AtlA protein predicted to be encoded by atlA is composed of 979 amino acids with a molecular weight of 107,279 and has a conserved beta-1,4-N-acetylmuramidase (lysozyme) domain in the C-terminal portion. Sodium dodecyl sulfate extracts of strain Xc showed two major bacteriolytic bands with molecular masses of 107 and 79 kDa, both of which were absent from a mutant with inactivated atlA. Western blot analysis revealed that the 79-kDa band was derived from the 107-kDa peptide by cleavage of its N-terminal portion. The inactivation of atlA resulted in a marked decrease in autolysis and the formation of very long chains of cells compared to the case for the parent strain. Although both the parent and mutant strains formed biofilms in the presence of sucrose, the biofilms formed by the mutant had a sponge-like architecture with large gaps and contained 30% less biomass than those formed by the parent strain. Furthermore, strain Xc formed glucose-dependent, loose biofilms in the absence of sucrose, but the mutant lost this ability. These results suggest that AtlA may play an important role in biofilm formation by S. mutans. The antibody produced against the C-terminal peptide containing the beta-1,4-N-acetylmuramidase domain drastically inhibited the autolytic activity of strain Xc. This inhibition was specific among the oral streptococci to S. mutans. These results indicate that the catalytic domain of AtlA is located at the C terminus, suggesting that further characterization of this domain may provide a means to control cariogenic dental plaque formation.     

Immunisation of rhesus monkeys with Streptococcus mutans, Lactobacillus acidophilus and lipoteichoic acid for protection against dental caries

An attempt was made to protect rhesus monkeys from dental caries by immunisation with Streptococcus mutans, Lactobacillus acidophilus and lipoteichoic acid (LTA). The vaccine composed of S. mutans gave significant protection against caries, a decrease in the number of S. mutans, an increase in IgG antibodies and a moderate increase in complement-fixing antibodies to LTA. When LTA was used as immunogen, there was only a small reduction in caries, without any detectable antibodies to LTA and a slight increase in IgG antibodies to cell of S. mutans. Vaccines of L. acidophilus or L. fermentum gave no protection. A combined vaccine of S. mutans and L. acidophilus did not reduce the incidence of caries but the antibody titre to cells of S. mutans was raised to a level comparable with that in the S. mutans-immunised monkeys. The results of this investigation in a subhuman primate confirm that immunisation with S. mutans induces protection against caries, unlike the attempt to immunise with two selected strains of lactobacilli. More studies are required to establish the role of specific serotypes of lactobacilli in the development of dental caries.     

Construction and characterization of an effector strain of Streptococcus mutans for replacement therapy of dental caries

An effector strain has been constructed for use in the replacement therapy of dental caries. Recombinant DNA methods were used to make the Streptococcus mutans supercolonizing strain, JH1140, lactate dehydrogenase deficient by deleting virtually all of the ldh open reading frame (ORF). To compensate for the resulting metabolic imbalance, a supplemental alcohol dehydrogenase activity was introduced by substituting the adhB ORF from Zymomonas mobilis in place of the deleted ldh ORF. The resulting clone, BCS3-L1, was found to produce no detectable lactic acid during growth on a variety of carbon sources, and it produced significantly less total acid due to its increased production of ethanol and acetoin. BCS3-L1 was significantly less cariogenic than JH1140 in both gnotobiotic- and conventional-rodent models. It colonized the teeth of conventional rats as well as JH1140 in both aggressive-displacement and preemptive-colonization models. No gross or microscopic abnormalities of major organs were associated with oral colonization of rats with BCS3-L1 for 6 months. Acid-producing revertants of BCS3-L1 were not observed in samples taken from infected animals (reversion frequency, <10(-3)) or by screening cultures grown in vitro, where no revertants were observed among 10(5) colonies examined on pH indicator medium. The reduced pathogenic potential of BCS3-L1, its strong colonization potential, and its genetic stability suggest that this strain is well suited to serve as an effector strain in the replacement therapy of dental caries in humans.     

Identification of a fibronectin binding protein from Streptococcus mutans

The interaction of viridans streptococci with components of the extracellular matrix (ECM) plays an important role in the pathogenesis of infective endocarditis. We have identified a surface protein of Streptococcus mutans which binds the ECM constituent fibronectin (Fn). Initially, we found that S. mutans could adsorb soluble Fn in plasma, but with lower efficiency than Streptococcus pyogenes. In addition, S. mutans could bind immobilized Fn in a dose-dependent manner when tested using an enzyme-linked immunosorbent assay. Crude extracts of cell wall-associated proteins or extracellular proteins from S. mutans MT8148 specifically bound Fn through a protein with the molecular mass of ca. 130 kDa, as detected by far-Western immunoblotting. The candidate Fn binding protein (FBP-130) was purified to near homogeneity by using Fn coupled Sepharose 4B affinity column chromatography. A rabbit polyclonal antibody against FBP-130 reacted specifically with a protein of molecular mass of ca. 130 kDa in both cell wall and extracellular fractions, and the abundance of FBP was higher in the former than in the latter fractions. The purified FBP bound specifically to immobilized Fn, whereas the binding of soluble Fn to coated FBP could only be detected in the presence of high concentrations of Fn. The purified FBP, as well as anti-FBP immunoglobulin G, inhibited the adherence of S. mutans to immobilized Fn and endothelial cells (ECV304) in a dose-dependent manner. These results demonstrated that FBP-130 mediated the adherence of S. mutans specifically to Fn and endothelial cells in vitro. The characteristics of S. mutans and FBP-130 in binding Fn confirmed that viridans streptococci adopt different strategies in their interaction with ECM.     

An In vitro microbial-caries model used to study the efficacy of antibodies to Streptococcus mutans surface proteins in preventing dental caries

The first step for a pathogenic bacterium to initiate infection is via attachment (i.e., through surface determinants) to a suitable receptor. An in vitro microbial artificial-mouth model was used to test the efficacy of polyclonal antibodies to Streptococcus mutans cell surface proteins (CsAb) and a cell surface 59-kDa protein (59Ab) in preventing S. mutans colonization and carious lesion formation. In study 1, groups of 12 human teeth specimens were inoculated with S. mutans, which were incubated with different concentrations of CsAb (A1 [positive control], sterile saline, no antibody; A2, 0.007 mg of antibody protein/ml; and A3, 0.7 mg of antibody protein/ml) for 1 h at 37 degrees C. The negative control group (B1) was not infected and was incubated with Trypticase soy broth (TSB) without dextrose supplemented with 5% sucrose (TSBS). In study 2, the same study design was used except that 59Ab was used instead of CsAb, normal rabbit serum was used in the positive control group (A1), and TSB supplemented with 1% glucose was used as the nutrient to control for sucrose-dependent colonization. All groups were exposed for 4 days to circulating cycles of TSBS and TSB (study 1 and study 2, respectively; 30 min each, three times per day) and a mineral washing solution (21 h per day). Prior to each nutrient cycle, 1 ml of the appropriate CsAb or 59Ab solution was administered to each group and allowed to mix for 30 min before cycling was resumed. Data obtained by confocal laser scanning microscopy demonstrated the presence of a significantly smaller (P < 0.05) lesion area and a smaller total lesion fluorescence in group A3 than in group A1 for both studies. In study 1, group A2 had significantly smaller values than A1 for lesion depth and area. There were no significant differences between groups A2 and A3 for lesion area or between groups A1 and A2 for total lesion fluorescence. In study 2, there were no significant differences among groups A1 and A2 for lesion depth or between groups A2 and A3 for all of the parameters studied. In both studies, there were no significant differences between S. mutans plaque CFU numbers among any of the groups. These studies demonstrated the efficacy of CsAb and 59Ab in reducing primary caries development in this model, although the underlying mechanism remains unclear.     

Effects of local immunization with Streptococcus mutans on induction of salivary immunoglobulin A antibody and experimental dental caries in rats

The effect of local immunization with Streptococcus mutans on dental caries in conventional and gnotobiotic rats was studied. Injection of these animals with S. mutans strain 6715 incorporated into complete Freund adjuvant consistently resulted in the presence of antibody in saliva directed to this organism. This antibody was primarily of the immunoglobulin A class as demonstrated by specific antiglobulin augmentation and gel filtration of antibody activity. Serum antibody was also present. Five experiments have been completed in conventional rats and two in gnotobiotic animals. The immunized group of animals always had lower mean caries scores than comparably sham-immunized or nonimmunized control groups. The numbers of lesions were also always lower in the immunized animals, suggesting a possible interference with the formation of new lesions in immunized animals. The reductions in dental caries and lesions were greater on smooth surfaces than on occlusal surfaces. which might be explained as interference with adherence phenomena demonstrated by S. mutans. It is proposed that salivary immunoglobulin A antibody may be viewed as an ecological determinant in the oral cavity by affecting oral microorganisms and possibly their by-products.     

Passive transfer of immunoglobulin Y antibody to Streptococcus mutans glucan binding protein B can confer protection against experimental dental caries

Active immunization with Streptococcus mutans glucan binding protein B (GBP-B) has been shown to induce protection against experimental dental caries. This protection presumably results from continuous secretion of salivary antibody to GBP-B, which inhibits accumulation of S. mutans within the oral biofilm. The purpose of this study was to explore the influence of short-term (9- or 24-day) passive oral administration of antibody to S. mutans GBP-B on the longer-term accumulation and cariogenicity of S. mutans in a rat model of dental caries. Preimmune chicken egg yolk immunoglobulin Y (IgY) or IgY antibody to S. mutans GBP-B was supplied in lower (experiment 1) and higher (experiment 2) concentrations in the diet and drinking water of rats for 9 (experiment 1) or 24 (experiment 2) days. During the first 3 days of IgY feeding, all animals were challenged with 5 x 10(6) streptomycin-resistant S. mutans strain SJ-r organisms. Rats remained infected with S. mutans for 78 days, during which rat molars were sampled for the accumulation of S. mutans SJ-r bacteria and total streptococci. Geometric mean levels of S. mutans SJ-r accumulation on molar surfaces were significantly lower in antibody-treated rats on days 16 and 78 of experiment 2 and were lower on all but the initial (day 5) swabbing occasions in both experiments. Relative to controls, the extent of molar dental caries measured on day 78 was also significantly decreased. The decrease in molar caries correlated with the amount and duration of antibody administration. This is the first demonstration that passive antibody to S. mutans GBP-B can have a protective effect against cariogenic S. mutans infection and disease. Furthermore, this decrease in infection and disease did not require continuous antibody administration for the duration of the infection period. This study also indicates that antibody to components putatively involved only in cellular aggregation can have a significant effect on the incorporation of mutans streptococci in dental biofilm.     

龋齿主要致病菌变形链球菌的生物免疫防治新进展

世界卫生组织调查显示,在全球超过50亿人患过龋齿.龋齿已成为威胁人类口腔健康的全球性问题,而其主要致病菌变形链球菌的生物免疫防治研究如火如荼.到目前为止,在全球除奥丽汀健齿露外,还没其他任何预防龋齿的生物免疫防治产品上市和进入临床阶段.众所周知,大规模的生物免疫防治是治疗和预防龋齿的一种有效途径.了解近年来国内外在变形链球菌生物免疫防治中的主动防疫、被动免疫研究新进展研究可为后期研发出能进入临床试验,并能成功上市的龋齿生物免疫制剂提供指导意义和借鉴.