Nattokinase, a Subtilisin-like Alkaline-Serine Protease, Reduces Mutacin Activity by Inactivating the Competence-Stimulating Peptide in Streptococcus mutans

Streptococcus mutans is a major cariogenic organism because of its ability to form biofilms on tooth surfaces. Bacteriocins produced by S. mutans (known as mutacins) are indirect pathogenic factors that play a role in the persistence of this microbe in the oral environment. Nattokinase, a subtilisin-like alkaline serine protease, potently inhibits biofilm formation without affecting S. mutans growth. However, effective strategies utilizing nattokinase to control mutacin production by S. mutans are lacking. In this study, we evaluated the effect of nattokinase on mutacin activity in 46 strains of S. mutans with different mutacin genotypes isolated from the dental plaques of pediatric patients with caries. Nattokinase reduced the activity of mutacin against oral streptococci at a concentration of 1 mg/mL in all clinical isolates. Furthermore, nattokinase reduced the expression of non-lantibiotic mutacin structural genes (nlmABCD) and inactivated the extracellular competence-stimulating peptide involved in comDE activation, which regulates non-lantibiotic mutacin gene expression. These results suggest that nattokinase may reduce the virulence of S. mutans and could potentially be used as a new caries-preventive agent as an alternative to conventional drug treatments.

The Effect of Probiotics Use on Salivary Cariogenic Bacteria in Orthodontic Patients with Various Caries Risk Status

Background: The purpose of this study was to evaluate the change in intraoral cariogenic bacteria density after probiotic use in patients with orthodontic treatment, and to compare the impact of probiotics in patients with various caries risk status. Methods: Patients that planned to receive orthodontic treatment were recruited according to this study’s inclusion/exclusion criteria. A probiotic prescription (Lactobacteria 3 mg, Glycobacteria 2 mg) was started one month after the initial orthodontic treatment. Saliva sampling and cultures using a CRT kit (caries risk test) were performed at three time points (T0, T1, T2). Mutans streptococci (MS) and Lactobacilli (LB) density were evaluated and scored using the interpretation chart in the CRT kit to evaluate the change in bacteria density at three time points, to define the high and low caries risk prior to orthodontic treatment, and to evaluate if there were differences in probiotics between the high and low caries risk groups. Results: Thirty-three orthodontic patients were enrolled, twenty-two classified as high caries risk and eleven as low caries risk. After undergoing treatment for one month, the densities of MS and LB increased significantly (p = 0.011, p = 0.001); probiotics for one month decreased the density of MS and LB, but the differences were statistically nonsignificant (p = 0.109, p = 0.109). Patients classified as low risk of caries demonstrated an increase in MS and LB density one month after orthodontic treatment (p = 0.024, p = 0.001), probiotic use did not result in a significant reduction in bacteria density (p = 1000, p = 0.933). In patients with high caries risk, there were no statistically significant changes in MS count between the three time points (p = 0.127); a significant change in LB density occurred at T0–T1 (p = 0.011) only. Conclusions: Supplemental use of probiotic oral tablets during orthodontic treatment aimed at reducing cariogenic bacteria count in saliva did not achieve significant differences, regardless of patients’ risk status for caries.

Sulfated vizantin inhibits biofilm maturation by Streptococcus mutans

Streptococcus mutans is the main pathogen of dental caries and adheres to the tooth surface via soluble and insoluble glucans produced by the bacterial glucosyltransferase enzyme. Thus, the S. mutans glucosyltransferase is an important virulence factor for this cariogenic bacterium. Sulfated vizantin effectively inhibits biofilm formation by S. mutans without affecting its growth. In this study, less S. mutans biofilm formation occurred on hydroxyapatite discs coated with sulfated vizantin than on noncoated discs. Sulfated vizantin showed no cytotoxicity against the human gingival cell line Ca9-22. Sulfated vizantin dose-dependently inhibited the extracellular release of cell-free glucosyltransferase from S. mutans and enhanced the accumulation of cell-associated glucosyltransferase, compared with that observed with untreated bacteria. Sulfated vizantin disrupted the localization balance between cell-associated glucosyltransferase and cell-free glucosyltransferase, resulting in inhibited biofilm maturation. These results indicate that sulfated vizantin can potentially serve as a novel agent for preventing dental caries.