Effect of triclosan on interleukin-1 beta production in human gingival fibroblasts challenged with tumor necrosis factor alpha

Triclosan toothpaste as an adjunct therapy to plaque control in children from periodontitis families: a crossover clinical trial

OBJECTIVES

Studies have demonstrated that children from aggressive periodontitis (AgP) parents presented precocious alterations in their periodontal condition, and the use of chemical agents in association to plaque control could be useful to control these alterations. This study aimed to evaluate the effect of Triclosan toothpaste to modulate the clinical and subgingival condition in children from AgP parents.

METHODS

Fifteen children from AgP parents and 15 from periodontally healthy parents were included in this crossover placebo study. Children were randomly allocated into triclosan or placebo therapy, using selected toothpaste for 45 days. After 15 days of wash-out, groups were crossed, changing the used toothpaste. Clinical examination and saliva, crevicular gingival fluid (GCF), and subgingival biofilm collection were performed at baseline and 45 days of each phase. GCF cytokines' levels were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens' levels by qPCR.

RESULTS

At baseline, AgP group presented higher plaque index (PI), gingival index (GI), and bleeding on probing (BoP), higher Aggregatibacter actinomycetemcomitans (Aa) abundance in saliva and subgingival biofilm, and lower levels of INF-ɣ, IL-4, and IL-17 in GCF. Placebo therapy only reduced PI in both groups. Triclosan toothpaste reduced PI and GI in both groups. Triclosan promoted reduction of BoP and probing depth (PD), Aa salivary, and IL-1β levels in AgP group. In health group, triclosan reduced INF-ɣ and IL-4 concentration.

CONCLUSION

Triclosan toothpaste demonstrated to be more effective than placebo toothpaste to control the periodontal condition in children from AgP parents, by reducing the BoP, PD, salivary Aa, and IL-1β.

CLINICAL RELEVANCE

Triclosan toothpaste can improve oral conditions in higher-risk population for AgP.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov with the identifier NCT03642353.

Triclosan: An Update on Biochemical and Molecular Mechanisms

Triclosan (TCS) is a synthetic, chlorinated phenolic antimicrobial agent commonly used in commercial and healthcare products. Items made with TCS include soaps, deodorants, shampoos, cosmetics, textiles, plastics, surgical sutures, and prosthetics. A wealth of information obtained from in vitro and in vivo studies has demonstrated the therapeutic effects of TCS, particularly against inflammatory skin conditions. Nevertheless, extensive investigations on the molecular aspects of TCS action have identified numerous adversaries associated with the disinfectant including oxidative injury and influence of physiological lifespan and longevity. This review presents a summary of the biochemical alterations pertaining to TCS exposure, with special emphasis on the diverse molecular pathways responsive to TCS that have been elucidated during the present decade.

Clinical effect of a dentifrice containing three kinds of bactericidal ingredients on periodontal disease: a pilot study in patients undergoing supportive periodontal therapy

Objective

This study aimed to evaluate clinically the effect of a novel dentifrice containing three kinds of bactericidal ingredients on periodontal disease.

Results

This was a single-arm, prospective clinical study that enrolled patients with periodontitis undergoing supportive periodontal therapy. Periodontal examination, microbiological testing of saliva samples, and evaluation of inflammatory markers (IL-1β, IL-6, IL-8, TNF-α) in gingival crevicular fluid were performed. After 4 weeks of the use of test dentifrice, these parameters were re-evaluated. The use of dentifrice was also subjectively evaluated by clinicians and participants. Among 30 participants, there were significant improvements in the periodontal and microbiological parameters, and the level of interleukin-1β in the gingival crevicular fluid, following the use of the test dentifrice. In clinicians’ subjective evaluation of the overall usefulness of the dentifrice, ‘mild’ and ‘moderate’ improvement accounted for 83% of the total responses. In the participants’ subjective evaluation, the majority indicated their experience of the use as favorable. Within the limitations of this study, it is suggested that the progression of periodontal disease during the supportive periodontal therapy can be prevented by the use of the test dentifrice.

Trial registration UMIN Clinical Trials Registry (UMIN-CTR) 000023175. Date of formal registration: July 14, 2016 (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026716)

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3216-x) contains supplementary material, which is available to authorized users.

Subinhibitory concentrations of triclosan promote Streptococcus mutans biofilm formation and adherence to oral epithelial cells

Triclosan is a general membrane-active agent with a broad-spectrum antimicrobial activity that is commonly used in oral care products. In this study, we investigated the effect of sub-minimum inhibitory concentrations (MICs) of triclosan on the capacity of the cariogenic bacterium Streptococcus mutans to form biofilm and adhere to oral epithelial cells. As quantified by crystal violet staining, biofilm formation by two reference strains of S. mutans was dose-dependently promoted, in the range of 2.2- to 6.2-fold, by 1/2 and 1/4 MIC of triclosan. Observations by scanning electron microscopy revealed the presence of a dense biofilm attached to the polystyrene surface. Growth of S. mutans in the presence of triclosan at sub-MICs also increased its capacity to adhere to a monolayer of gingival epithelial cells. The expression of several genes involved in adherence and biofilm formation in S. mutans was investigated by quantitative RT-PCR. It was found that sub-MICs of triclosan significantly increased the expression of comD, gtfC, and luxS, and to a lesser extent of gtfB and atlA genes. These findings stress the importance of maintaining effective bactericidal concentrations of therapeutic triclosan since sub-MICs may promote colonization of the oral cavity by S. mutans.

The effect of a dentifrice containing Magnolia extract on established plaque and gingivitis in man: a six-month clinical study

AIM

The aim was to evaluate the clinical effect of a dentifrice containing 0.3% Magnolia extract on dental plaque and gingivitis.

MATERIAL AND METHODS

The trial was a 6-month double-blind, stratified, randomized and 2-armed parallel group study. Forty-six subjects in the test group brushed their teeth with a dentifrice containing 0.3% Magnolia extract and 48 subjects in the control group brushed with a placebo dentifrice. Plaque and gingivitis were assessed at baseline, 3 and 6 months.

RESULTS

There was a significantly larger gingivitis reduction in the Magnolia group than in the control group (0.26 ± 0.11 versus 0.11 ± 0.12) (P < 0.001). There was a greater increase in the total number of healthy gingival units Gingival Index (GI score 0) in the Magnolia group than in the control group (149% versus 31%) and a larger reduction in inflamed gingival units (GI score 2/3) (60% versus 30%). Furthermore, at sites with similar amounts of plaque, less clinical signs of gingival inflammation were observed in the Magnolia group than in the control group.

CONCLUSION

Six months' unsupervised use of a dentifrice containing 0.3% Magnolia extract resulted in significantly greater gingivitis reduction than a corresponding control dentifrice.

The clinical efficacy of triclosan/copolymer and other common therapeutic approaches to periodontal health

The maintenance of an effective level of oral hygiene is the cornerstone of all attempts to prevent and control periodontal disease, and yet the widespread prevalence of the disease indicates the inability of most people to maintain a level of plaque control commensurate with periodontal health. The inclusion of antibacterial agents, such as chlorhexidine and triclosan, in oral care products has provided a means to improve oral health. Randomised, controlled clinical trials have demonstrated that the unsupervised use of a dentifrice (toothpaste) containing triclosan/copolymer significantly improves gingival health, prevents the onset of periodontitis and reduces further progression of tissue destruction. The delivery of such benefits has positive implications for the oral health of individuals and populations.

Effects of Triclosan on Mytilus galloprovincialis hemocyte function and digestive gland enzyme activities: possible modes of action on non target organisms

Pharmaceuticals and Personal Care Products (PPCPs) are a class of emerging environmental pollutants with the potential of affecting various aquatic organisms through unexpected modes of action. Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) (TCS), is a common antibacterial agent that is found in significant amounts in the aquatic environment. In this work, the possible effects and modes of action of TCS were investigated in the marine bivalve Mytilus galloprovincialis Lam. In mussel immune cells, the hemocytes, in vitro short-term exposure to TCS in the low microM range reduced lysosomal membrane stability (LMS) and induced extracellular release of lysosomal hydrolytic enzymes. The effects on LMS were mediated by activation of ERK MAPKs (Extracellularly Regulated Mitogen Activated Protein Kinases) and PKC (protein kinase C) alpha and betaII isoforms, as demonstrated by both specific kinase inhibitors and Western blotting with specific anti-phospho-antibodies. The effects of TCS were confirmed in vivo, in the hemocytes of mussels injected with different concentrations of TCS (corresponding to 0.29, 2.9 and 29 ng/g dry weight) and sampled at 24 h post-injection. The possible in vivo effects of TCS were also evaluated on the activity of different enzymes in the digestive gland, the tissue mainly involved in accumulation and metabolism of organic contaminants in mussels. Significant increases were observed in the activity of the glycolytic enzymes PFK (phosphofructokinase) and PK (pyruvate kinase), as well as of GST (GSH transferase) and GSR (GSSG reductase), whereas a decrease in catalase activity was observed. The results demonstrate that in mussels TCS can act on kinase-mediated cell signalling, lysosomal membranes and redox balance in different systems/organs. Although further studies are needed in order to evaluate possible consequences of environmental exposure to TCS on mussel health, the results represent the first data on the possible modes of action of this widespread antibacterial in aquatic invertebrates.

A study into the plaque-inhibitory activity of experimental toothpaste formulations containing antimicrobial agents

BACKGROUND/AIMS

The use of specific antimicrobial agents in toothpastes may help reduce plaque and gingivitis. There would also appear to be some value in formulating products that contain combinations of such agents that may potentiate any activity present. The aims of this exploratory and pragmatic study were twofold: (1) Exploratory: to compare the effects on plaque re-growth of two zinc citrate/triclosan formulations, one of which contained bromochlorophene and hence demonstrate any additional beneficial effects produced by the addition of the phenol. (2) Pragmatic: to assess whether both pastes were significantly better than a benchmark control, proprietary fluoride toothpaste at inhibiting plaque formation.

METHODS

Following an initial prophylaxis to remove all plaque and calculus, toothpaste slurry rinses were used over a 96 h period by 24 volunteers, while omitting all other oral hygiene procedures. After 24, 48 and 96 h, plaque was measured by plaque area and by plaque index. For comparative purposes, a conventional commercial fluoride toothpaste rinse was also used as a benchmark control in this triple cross-over double-blind study.

RESULTS

With one exception, comparisons between the three pastes failed to show any significant differences in plaque accumulation at 96 h whether assessed by plaque index or area. At this time period, significantly more plaque was seen with the zinc citrate paste without bromochlorophene, compared with that of the control paste.

CONCLUSIONS

The findings from this study failed to demonstrate a plaque-inhibitory action from the two novel formulations beyond that of a conventional benchmark toothpaste, although overall levels of plaque formed by the volunteers, especially on the control paste were generally lower than in previous studies. Nevertheless, it remains to be determined whether the test formulations could exert a direct anti-inflammatory action against gingivitis by way of the triclosan delivery system. Neither test formulation was subsequently marketed.

Uptake, distribution and release of 14C-triclosan in human gingival fibroblasts

Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) is an antibacterial agent included in dentifrices and mouth rinses. Previously, we reported that triclosan reduces the production of the inflammatory mediators in gingival fibroblasts. The aim of this study was to investigate the uptake, distribution, and release of (14)C-triclosan in gingival fibroblasts. Time-course studies showed that the uptake of (14)C-triclosan in cytoplasmic and nuclear fraction started within the first minute of incubation, increased gradually, and reached constant levels after 1 h in the nuclear fraction and slightly increased in the cytoplasmic fraction between 3 and 24 h. The distribution of (14)C-triclosan in the cytoplasmic and the nuclear fractions was, on an average, 84 and 16%, respectively. Autoradiographic results based on transmission electron microscopy confirmed the distribution of (14)C-triclosan in the cytoplasm and nucleus of the cell. The release of (14)C-triclosan showed that the radioactivity of the agent in the medium gradually increased during the first hour of incubation and then reached steady-state levels. After repeated washing of preloaded fibroblasts, the level of (14)C-triclosan in the cytoplasmic fraction decreased by 77% whereas the level in the nuclear fraction remained unchanged. Our results demonstrate that triclosan is distributed in the cytoplasm and remains associated with the nucleus of gingival fibroblasts, suggesting that the agent may affect the intracellular signal pathways involved in the production of inflammatory mediators.

Effect of a triclosan-containing dental gel on the levels of prostaglandin I2 and interleukin-1beta in gingival crevicular fluid from adolescents with fixed orthodontic appliances

The effect of a triclosan-containing (0.3%) dental gel on inflammatory mediators in gingival crevicular fluid (GCF) was evaluated in 14 healthy adolescents undergoing orthodontic treatment with fixed appliances. A double-blind randomized split-mouth study design was used with color-coded experimental and placebo gels. The gel was self-applied for 5 min twice daily for 14 days in custom-made soft plastic trays. Clinic al data (visible plaque index (VPI) and gingival bleeding index (GBI) and samples of GCF were collected at baseline and after 1, 2, 4, and 6 weeks. The concentrations of prostaglandin I2 (PGI2) and interleukin-1beta (IL-1beta were determined by radioimmuno- and enzyme-linked immunosorbent assays, respectively. No clinical effects of the gel applications regarding amount of plaque or gingival bleeding were unveiled. Neither the experimental nor the placebo gel applications caused any statistically significant alterations in the inflammatory mediators, PGI2 and IL-1beta, compared to baseline. In conclusion, the present study did not reveal any beneficial cffects of the triclosan-containing gel regimen on mild gingivitis in adolescents with fixed orthodontic appliances.

Interaction of triclosan with eukaryotic membrane lipids

The possibility that triclosan and PVM/MA (polyvinylmethyl ether/maleic acid) copolymer, additives to dentrifrices, could interact with eukaryotic membrane lipids was studied by two methods: first, by determining the pressure/molecular area isotherms at 37 degrees C of glycerophospholipid monolayers, using the Langmuir technique; and second, by phase-transition parameters in liposomes of the same lipids, using differential scanning calorimetry (DSC). Triclosan interacted, in a concentration-independent manner, with monolayers of saturated phosphatidylcholines (PC; i.e. markers of the outer membrane leaflet of eukaryotic cells). Triclosan and PVM/MA copolymer mixtures were shown to clearly interact in a concentration-dependent manner with PC. Triclosan was found to interact with liposomes of saturated and unsaturated phosphatidylcholines and phosphatidylserines (PS; i.e. markers of the inner membrane leaflet of eukaryotic cells), and saturated ethanolamines (PE; i.e. markers of the inner membrane leaflet of eukaryotic cells), resulting in a decrease of the lipid melting temperature (Tm). PVM/MA copolymer changed the Tm of PS, PC, and PE in different manners. By adding PVM/MA or triclosan-PVM/MA copolymer mixtures to 1-stearoyl-2-oleoyl-sn-glycero-3-phosphoserine (SOPS) no lipid transitions were detected. A biphasic change of the PC transition temperature resulted when triclosan or triclosan PVM/MA copolymer mixtures were added, indicating domain formation and change of the lipid polymorphism.

Will triclosan in toothpaste select for resistant oral streptococci?

The aims of the study were to determine the in vitro sensitivity of triclosan against viridans streptococci and the impact of triclosan on the normal oral microflora. Nine subjects used a triclosan-containing toothpaste for 2 weeks. Saliva samples were collected on days 0 and 14 and were analyzed quantitatively. The minimum inhibitory concentrations of triclosan and of several antimicrobial agents were determined for the streptococci isolated on days 0 and 14. No major changes occurred in the normal oral microflora during the study period. There were no differences in susceptibility between streptococcal strains collected at days 0 and 14 against triclosan or antimicrobial agents. Short-term use of triclosan has no major impact on normal oral microflora or on streptococcal susceptibility of antimicrobial agents. The effects of long-term use should be evaluated.

The effect of a SCN-/H2O2 toothpaste compared to a commercially available triclosan-containing toothpaste on oral hygiene and gingival health -- a 6-month home-use study

OBJECTIVES

The aim of the study was to compare the gingival health benefits of a thiocyanate/carbamide peroxide toothpaste to that of a triclosan toothpaste in home use.

MATERIALS AND METHODS

The study was a two-centre, randomised, double-blind, parallel-group clinical trial, and consisted of a 2-week pre-experimental phase, followed by an experimental period of 6 months. A total of 140 healthy male and female volunteers (70 per group) who had at least 20 natural teeth with no probing depths greater than 5 mm and a mean gingival index (GI) of 1 or more at screening were admitted to the study. The two products were the test toothpaste (RCP) containing 0.5% SCN- (rhodanide), carbamide peroxide (equivalent 0.1% H2O2), and 1450 p.p.m. fluoride, and a control toothpaste (Colgate Total) containing 0.3% triclosan, 2.0% polyvinyl methyl ether maleic acid (PVM/MA), and 1450 p.p.m. fluoride (Triclosan). In the pre-experimental phase, all subjects used a fluoride toothpaste. Plaque (Turesky et al. 1970) and gingivitis (Löe & Silness 1963) were scored prior to beginning the pre-experimental phase, at baseline, and after 6 weeks and 3 and 6 months.

RESULTS

In both the RCP and the Triclosan group, gingival health improved significantly between baseline and the following examinations. Plaque scores decreased significantly between baseline and 6 months in both groups. There were, however, no significant differences between the groups for either gingival index or plaque index.

CONCLUSION

To conclude, this study seems to verify that in normal home use, a toothpaste containing a combination of thiocyanate and carbamide peroxide is as effective in reducing gingival inflammation and supragingival plaque formation as a benchmark control product.

Production of Rantes/CCL5 in human gingival fibroblasts challenged with tumor necrosis factor alpha

Chemokines are small-secreted proteins that stimulate the directional migration of leukocytes and thereby mediate the inflammatory process. The present study investigates the capacity of human gingival fibroblasts to produce the beta chemokine Rantes/CCL5. In situ hybridization, immunohistochemistry and ELISA were used to measure the induction of Rantes/CCL5 at the mRNA and protein levels, both in unstimulated gingival fibroblasts as well as in fibroblasts treated with the proinflammatory cytokines tumor necrosis factor (TNF)alpha or interleukin (IL)-1beta. TNFalpha in different concentrations (0.1-10 ng/ml) induced Rantes/CCL5 mRNA expression and protein production in 24-h cultures of human gingival fibroblasts. The expression of Rantes/CCL5-mRNA and protein production, induced by TNFalpha, was evident at 6 h and thereafter increased continuously during the study period (24 h). IL-1beta (3-300 pg/ml) also enhanced the production of Rantes/CCL5 in gingival fibroblasts. The amount of Rantes/CCL5 induced by IL-1beta (300 pg/ml), however, was less than that induced by TNFalpha (10 ng/ml). The study suggests that human gingival fibroblasts, by producing the chemokine Rantes/CCL5, participate in the regulation of the host response during the inflammatory process in the periodontal tissue.

Induction of interferon gamma in human gingival fibroblasts challenged with phytohaemagglutinin

Interferon gamma (IFN-gamma) is a potential immunoregulatory cytokine, which is secreted mainly by cells of immune origin. In this study, we examined the capacity of human gingival fibroblasts as non-professional immune cells to express IFN-gamma messenger RNA (mRNA) and to produce the protein. Cultures of fibroblast cells were established from gingival biopsies from three children. The expression of mRNA for IFN-gamma was studied by in situ hybridization, and the level of IFN-gamma was determined by cell-released capturing ELISA. Treatment of the cells with phytohaemagglutinin (PHA) (2.5, 5.0, and 10 microg/ml) increased the number of IFN-gamma mRNA expressing cells and the protein production at 1, 6, and 24 h. Non-stimulated cells did not reveal measurable levels of IFN-gamma mRNA or the protein. The inflammatory cytokines interleukin 1beta (IL-1beta) (100 microg/ml) and tumour necrosis factor alpha (TNFalpha) (10 ng/ml) did not affect IFN-gamma mRNA expression or protein production. Treatment of the cells with 1 microM phorbol 12-myristate-13-acetate (PMA) stimulated IFN-gamma mRNA expression but had no effect on IFN-gamma protein production. We conclude that human gingival fibroblasts not only transcribe IFN-gamma mRNA but also produce the IFN-gamma protein in response to PHA. The finding that human gingival fibroblasts, produce the cytokine IFN-gamma, further support the concept that these cells take an active part in the modulation of the inflammatory and immune response in the periodontal tissue.