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Oscarsson J, Bao K, Shiratsuchi A, Grossmann J, Wolski W, Aung KM, Lindholm M, Johansson A, Mowsumi FR, Wai SN, Belibasakis GN, Bostanci N. Bacterial symbionts in oral niche use type VI secretion nanomachinery for fitness increase against pathobionts. iScience 2024; 27:109650. [PMID: 38650989 PMCID: PMC11033201 DOI: 10.1016/j.isci.2024.109650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/09/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Microbial ecosystems experience spatial and nutrient restrictions leading to the coevolution of cooperation and competition among cohabiting species. To increase their fitness for survival, bacteria exploit machinery to antagonizing rival species upon close contact. As such, the bacterial type VI secretion system (T6SS) nanomachinery, typically expressed by pathobionts, can transport proteins directly into eukaryotic or prokaryotic cells, consequently killing cohabiting competitors. Here, we demonstrate for the first time that oral symbiont Aggregatibacter aphrophilus possesses a T6SS and can eliminate its close relative oral pathobiont Aggregatibacter actinomycetemcomitans using its T6SS. These findings bring nearer the anti-bacterial prospects of symbionts against cohabiting pathobionts while introducing the presence of an active T6SS in the oral cavity.
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Affiliation(s)
- Jan Oscarsson
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Kai Bao
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 14104 Huddinge, Stockholm, Sweden
| | - Akiko Shiratsuchi
- Department of Liberal Arts and Sciences, Graduate School of Medicine, Sapporo Medical University, Sapporo, Hokkaido 060-8556, Japan
| | - Jonas Grossmann
- Functional Genomics Center Zurich, ETH Zürich and University of Zürich, Zürich, Switzerland
- Swiss Institute of Bioinformatics (SIB) Quartier Sorge-Batiment Amphipole, 1015 Lausanne, Switzerland
| | - Witold Wolski
- Functional Genomics Center Zurich, ETH Zürich and University of Zürich, Zürich, Switzerland
- Swiss Institute of Bioinformatics (SIB) Quartier Sorge-Batiment Amphipole, 1015 Lausanne, Switzerland
| | - Kyaw Min Aung
- Department of Molecular Biology and the Umeå Centre for Microbial Research (UCMR), and the Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187 Umeå, Sweden
| | - Mark Lindholm
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 14104 Huddinge, Stockholm, Sweden
| | - Anders Johansson
- Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Sun Nyunt Wai
- Department of Molecular Biology and the Umeå Centre for Microbial Research (UCMR), and the Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå University, 90187 Umeå, Sweden
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 14104 Huddinge, Stockholm, Sweden
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 14104 Huddinge, Stockholm, Sweden
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2
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Riben Grundström C, Lund B, Kämpe J, Belibasakis GN, Hultin M. Systemic antibiotics in the surgical treatment of peri-implantitis: A randomized placebo-controlled trial. J Clin Periodontol 2024. [PMID: 38699828 DOI: 10.1111/jcpe.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/22/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
AIM To study the clinical, radiographic and microbiological outcomes after surgical treatment of peri-implantitis, with or without adjunctive systemic antibiotics. MATERIALS AND METHODS Eighty-four patients (113 implants) with peri-implantitis were randomized into three groups (A, amoxicillin and metronidazole; B, phenoxymethylpenicillin and metronidazole; or C, placebo). Treatment included resective surgery and implant surface decontamination with adjunctive antibiotics or placebo. Primary outcomes were probing pocket depth (PPD) reduction and marginal bone level (MBL) stability. Secondary outcomes were treatment success (defined as PPD ≤ 5 mm, bleeding on probing [BOP] ≤ 1site, absence of suppuration on probing [SOP] and absence of progressive bone loss of >0.5 mm), changes in BOP/SOP, mucosal recession (REC), clinical attachment level (CAL), bacterial levels and adverse events. Outcomes were evaluated for up to 12 months. The impact of potential prognostic indicators on treatment success was evaluated using multilevel logistic regression analysis. RESULTS A total of 76 patients (104 implants) completed the study. All groups showed clinical and radiological improvements over time. Statistically significant differences were observed between groups for MBL stability (A = 97%, B = 89%, C = 76%), treatment success (A = 68%, B = 66%, C = 28%) and bacterial levels of Aggregatibacter actinomycetemcomitans and Tannerella forsythia, favouring antibiotics compared to placebo. Multiple regression identified antibiotic use as potential prognostic indicator for treatment success. Gastrointestinal disorders were the most reported adverse events in the antibiotic groups. CONCLUSIONS Adjunctive systemic antibiotics resulted in additional improvements in MBL stability. However, the potential clinical benefits of antibiotics need to be carefully balanced against the risk of adverse events and possible antibiotic resistance.
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Affiliation(s)
- Caroline Riben Grundström
- Department of Periodontology, Specialist Clinic Kaniken, Public Dental Health Service, Uppsala, Sweden
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Bodil Lund
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Department for Oral and Maxillofacial Surgery and Jaw Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Kämpe
- Department of Plastic and Oral and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | | | - Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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3
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Belibasakis GN, Senevirantne CJ, Jayasinghe RD, Vo PTD, Bostanci N, Choi Y. Bacteriome and mycobiome dysbiosis in oral mucosal dysplasia and oral cancer. Periodontol 2000 2024. [PMID: 38501658 DOI: 10.1111/prd.12558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/20/2024]
Abstract
It has long been considered that the oral microbiome is tightly connected to oral health and that dysbiotic changes can be detrimental to the occurrence and progression of dysplastic oral mucosal lesions or oral cancer. Improved understanding of the concepts of microbial dysbiosis together with advances in high-throughput molecular sequencing of these pathologies have charted in greater microbiological detail the nature of their clinical state. This review discusses the bacteriome and mycobiome associated with oral mucosal lesions, oral candidiasis, and oral squamous cell carcinoma, aiming to delineate the information available to date in pursuit of advancing diagnostic and prognostic utilities for oral medicine.
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Ruwan Duminda Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Phuc Thi-Duy Vo
- Department of Immunology and Molecular Microbiology, School of Dentistry, Seoul, Korea
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Youngnim Choi
- Department of Immunology and Molecular Microbiology, School of Dentistry, Seoul, Korea
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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5
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Liu CC, Dixit N, Hatz CR, Janson TM, Bastendorf K, Belibasakis GN, Cosgarea R, Karoussis IK, Mensi M, O'Neill J, Spahr A, Stavropoulos A, Schmidlin PR. Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting. Clin Exp Dent Res 2024; 10:e855. [PMID: 38345462 PMCID: PMC10860664 DOI: 10.1002/cre2.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/02/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases. MATERIAL AND METHODS In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively. RESULTS An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept. CONCLUSIONS In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.
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Affiliation(s)
- Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Neha Dixit
- Department of Clinical Affairs and Medical EducationElectro Medical Systems SANyonSwitzerland
| | - Christian R. Hatz
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | - Tobias M. Janson
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
| | | | - Georgios N. Belibasakis
- Department of Dental Medicine, Division of Oral DiseasesKarolinska InstitutetStockholmSweden
| | - Raluca Cosgarea
- Department of Periodontology, Cariology and Preventive DentistryUniversity of BonnBonnGermany
| | - Ioannis K. Karoussis
- Department of Periodontology, Faculty of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Magda Mensi
- Section of Periodontics, Department of Surgical Specialities, Radiological Science and Public Health, School of DentistryUniversity of BresciaBresciaItaly
| | - Jessica O'Neill
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
- Division of Conservative Dentistry and PeriodontologyUniversity Clinic of Dentistry, Medical University of ViennaViennaAustria
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri‐implant Diseases, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
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Manoil D, Cerit EE, Fang H, Durual S, Brundin M, Belibasakis GN. Profiling Antibiotic Susceptibility among Distinct Enterococcus faecalis Isolates from Dental Root Canals. Antibiotics (Basel) 2023; 13:18. [PMID: 38247577 PMCID: PMC10812444 DOI: 10.3390/antibiotics13010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Enterococcus faecalis, a leading multi-resistant nosocomial pathogen, is also the most frequently retrieved species from persistently infected dental root canals, suggesting that the oral cavity is a possible reservoir for resistant strains. However, antimicrobial susceptibility testing (AST) for oral enterococci remains scarce. Here, we examined the AST profiles of 37 E. faecalis strains, including thirty-four endodontic isolates, two vanA-type vancomycin-resistant isolates, and the reference strain ATCC-29212. Using Etest gradient strips and established EUCAST standards, we determined minimum inhibitory concentrations (MICs) for amoxicillin, vancomycin, clindamycin, tigecycline, linezolid, and daptomycin. Results revealed that most endodontic isolates were susceptible to amoxicillin and vancomycin, with varying levels of intrinsic resistance to clindamycin. Isolates exceeding the clindamycin MIC of the ATCC-29212 strain were further tested against last-resort antibiotics, with 7/27 exhibiting MICs matching the susceptibility breakpoint for tigecycline, and 1/27 reaching that of linezolid. Both vanA isolates confirmed vancomycin resistance and demonstrated resistance to tigecycline. In conclusion, while most endodontic isolates remained susceptible to first-line antibiotics, several displayed marked intrinsic clindamycin resistance, and MICs matched tigecycline's breakpoint. The discovery of tigecycline resistance in vanA isolates highlights the propensity of clinical clone clusters to acquire multidrug resistance. Our results emphasize the importance of implementing AST strategies in dental practices for continued resistance surveillance.
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Affiliation(s)
- Daniel Manoil
- Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Ender Efe Cerit
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Hong Fang
- Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
| | - Stéphane Durual
- Biomaterials Laboratory, Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, 901 87 Umeå, Sweden;
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, Campus Huddinge, 141 52 Stockholm, Sweden;
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Claesson R, Johansson A, Belibasakis GN. Age-Related Subgingival Colonization of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Parvimonas micra-A Pragmatic Microbiological Retrospective Report. Microorganisms 2023; 11:1434. [PMID: 37374936 DOI: 10.3390/microorganisms11061434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of this study was to compare data about the prevalence and proportions of the bacterial species Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Parvimonas micra in periodontitis pocket samples collected from young, <35 years, and old, >35-year-old patients, YP and OP, respectively. The results from the analyses of a total of 3447 subgingival plaque samples analyzed for clinical diagnosis purposes by cultivation regarding the proportions of these species were collected from a database and elucidated. The prevalence of A. actinomycetemcomitans was found to be more than twice as high (OR = 2.96, 95% CI; 2.50-3.50) in samples from the younger (42.2%) than the older group (20.4%) (p < 0.001). The prevalence of P. micra was significantly lower in samples from the younger age group (OR = 0.43, 95%) (p < 0.001), whereas P. gingivalis was similarly distributed (OR = 0.78, 95%) in the two age groups (p = 0.006). A similar pattern was noticed for A. actinomycetemcomitans and P. gingivalis when high proportions (>50%) of the samples of these bacterial species were elucidated. In contrast, the proportion of samples containing >50% with P. micra was lower compared with the two other bacterial species. Furthermore, it was noted that the proportion of samples from old patients containing A. actinomycetemcomitans in combination with P. micra was almost three times higher than in samples when P. micra was replaced by P. gingivalis. In conclusion, A.actinomycetemcomitans showed an increased presence and proportion in samples from young patients compared with the old patients, while P. gingivalis was similarly distributed in the two age groups. P. micra showed an increased presence and proportion in samples from old patients compared with the young patients.
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Affiliation(s)
- Rolf Claesson
- Department of Odontology, Umeå University, 901 87 Umeå, Sweden
| | | | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14152 Huddinge, Sweden
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Bostanci N, Belibasakis GN. Precision periodontal care: from omics discoveries to chairside diagnostics. Clin Oral Investig 2023; 27:971-978. [PMID: 36723713 PMCID: PMC9985578 DOI: 10.1007/s00784-023-04878-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/22/2023] [Indexed: 02/02/2023]
Abstract
The interface of molecular science and technology is guiding the transformation of personalized to precision healthcare. The application of proteomics, genomics, transcriptomics, and metabolomics is shaping the suitability of biomarkers for disease. Prior validation of such biomarkers in large and diverse patient cohorts helps verify their clinical usability. Incorporation of molecular discoveries into routine clinical practice relies on the development of customized assays and devices that enable the rapid delivery of analytical data to the clinician, while the patient is still in session. The present perspective review addresses this topic under the prism of precision periodontal care. Selected promising research attempts to innovate technological platforms for oral diagnostics are brought forward. Focus is placed on (a) the suitability of saliva as a conveniently sampled biological specimen for assessing periodontal health, (b) proteomics as a high-throughput approach for periodontal disease biomarker identification, and (c) chairside molecular diagnostic assays as a technological funnel for transitioning from the laboratory benchtop to the clinical point-of-care.
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Affiliation(s)
- Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels alle 8, 141 52, Huddinge, Stockholm, Sweden.
| | - Georgios N Belibasakis
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels alle 8, 141 52, Huddinge, Stockholm, Sweden.
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Belibasakis GN, Belstrøm D, Eick S, Gursoy UK, Johansson A, Könönen E. Periodontal microbiology and microbial etiology of periodontal diseases: Historical concepts and contemporary perspectives. Periodontol 2000 2023. [PMID: 36661184 DOI: 10.1111/prd.12473] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/21/2022] [Accepted: 09/06/2022] [Indexed: 01/21/2023]
Abstract
This narrative review summarizes the collective knowledge on periodontal microbiology, through a historical timeline that highlights the European contribution in the global field. The etiological concepts on periodontal disease culminate to the ecological plaque hypothesis and its dysbiosis-centered interpretation. Reference is made to anerobic microbiology and to the discovery of select periodontal pathogens and their virulence factors, as well as to biofilms. The evolution of contemporary molecular methods and high-throughput platforms is highlighted in appreciating the breadth and depth of the periodontal microbiome. Finally clinical microbiology is brought into perspective with the contribution of different microbial species in periodontal diagnosis, the combination of microbial and host biomarkers for this purpose, and the use of antimicrobials in the treatment of the disease.
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Belstrøm
- Section for Clinical Oral Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ulvi K Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | | | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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10
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Parga A, Manoil D, Brundin M, Otero A, Belibasakis GN. Gram-negative quorum sensing signalling enhances biofilm formation and virulence traits in gram-positive pathogen Enterococcus faecalis. J Oral Microbiol 2023; 15:2208901. [PMID: 37187675 PMCID: PMC10177678 DOI: 10.1080/20002297.2023.2208901] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Acyl-homoserine lactones (AHLs) are typical quorum-sensing molecules of gram-negative bacteria. Recent evidence suggests that AHLs may also affect gram-positives, although knowledge of these interactions remains scarce. Here, we assessed the effect of AHLs on biofilm formation and transcriptional regulations in the gram-positive Enterococcus faecalis. Five E. faecalis strains were investigated herein. Crystal violet was employed to quantify the biomass formed, and confocal microscopy in combination with SYTO9/PI allowed the visualisation of biofilms' structure. The differential expression of 10 genes involved in quorum-sensing, biofilm formation and stress responses was evaluated using reverse-transcription-qPCR. The AHL exposure significantly increased biofilm production in strain ATCC 29212 and two isolates from infected dental roots, UmID4 and UmID5. In strains ATCC 29212 and UmID7, AHLs up-regulated the quorum-sensing genes (fsrC, cylA), the adhesins ace, efaA and asa1, together with the glycosyltransferase epaQ. In strain UmID7, AHL exposure additionally up-regulated two membrane-stress response genes (σV, groEL) associated with increased stress-tolerance and virulence. Altogether, our results demonstrate that AHLs promote biofilm formation and up-regulate a transcriptional network involved in virulence and stress tolerance in several E. faecalis strains. These data provide yet-unreported insights into E. faecalis biofilm responses to AHLs, a family of molecules long-considered the monopole of gram-negative signalling.
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Affiliation(s)
- Ana Parga
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Division of cariology and endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- CONTACT Daniel Manoil Division of cariology and endodontics, University Clinics of Dental Medicine, Michel-Servet 1, Geneva1205, Switzerland
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, Umeå, Sweden
| | - Ana Otero
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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11
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Belibasakis GN, Andrukhov O, Allaker RP. Editorial: Highlights in oral infections and microbes 2021/2. Front Oral Health 2022; 3:1040789. [PMID: 36407657 PMCID: PMC9666692 DOI: 10.3389/froh.2022.1040789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden,Correspondence: Georgios N. Belibasakis
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Robert P. Allaker
- Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
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12
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Bao K, Claesson R, Belibasakis GN, Oscarsson J. Extracellular Vesicle Subproteome Differences among Filifactor alocis Clinical Isolates. Microorganisms 2022; 10:microorganisms10091826. [PMID: 36144428 PMCID: PMC9503520 DOI: 10.3390/microorganisms10091826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Filifactor alocis is a Gram-positive asaccharolytic, obligate anaerobic rod of the Firmicutes phylum, which has recently been implicated in oral infections. Extracellular vesicles (EVs) are crucial conveyors of microbial virulence in bacteria and archaea. Previously, in highly purified EVs from the F. alocis reference strain ATCC 35896 (CCUG 47790), 28 proteins were identified. The present study aimed to use label-free quantification proteomics in order to chart these EV proteins, in the reference strain, and in nine less-well-characterized clinical F. alocis isolates. In total, 25 of the EV proteins were identified and 24 were quantified. Sixteen of those were differentially expressed between the ten strains and the novel FtxA RTX toxin and one lipoprotein were among them. Consistent expression was observed among ribosomal proteins and proteins involved in L-arginine biosynthesis and type IV pilin, demonstrating a degree of EV protein expression preservation among strains. In terms of protein–protein interaction analysis, 21 functional associations were revealed between 19 EV proteins. Interestingly, FtxA did not display predicted interactions with any other EV protein. In conclusion, the present study charted 25 EV proteins in ten F. alocis strains. While most EV proteins were consistently identified among the strains, several of them were also differentially expressed, which justifies that there may be potential variations in the virulence potential among EVs of different F. alocis strains.
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Affiliation(s)
- Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden
| | - Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden
| | - Jan Oscarsson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden
- Correspondence:
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13
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Claesson R, Johansson A, Belibasakis GN. Clinical laboratory diagnostics in dentistry: Application of microbiological methods. Front Oral Health 2022; 3:983991. [PMID: 36160119 PMCID: PMC9493047 DOI: 10.3389/froh.2022.983991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/10/2022] [Indexed: 12/05/2022] Open
Abstract
Diagnosis and treatment in dentistry are based on clinical examination of the patients. Given that the major oral diseases are of microbial biofilm etiology, it can be expected that performing microbiological analysis on samples collected from the patient could deliver supportive evidence to facilitate the decision-making process by the clinician. Applicable microbiological methods range from microscopy, to culture, to molecular techniques, which can be performed easily within dedicated laboratories proximal to the clinics, such as ones in academic dental institutions. Periodontal and endodontic infections, along with odontogenic abscesses, have been identified as conditions in which applied clinical microbiology may be beneficial for the patient. Administration of antimicrobial agents, backed by microbiological analysis, can yield more predictable treatment outcomes in refractory or early-occurring forms of periodontitis. Confirming a sterile root canal using a culture-negative sample during endodontic treatment may ensure the longevity of its outcome and prevent secondary infections. Susceptibility testing of samples obtained from odontogenic abscesses may facilitate the selection of the appropriate antimicrobial treatment to prevent further spread of the infection.
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Affiliation(s)
- Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
- *Correspondence: Rolf Claesson
| | - Anders Johansson
- Division of Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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14
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Manoil D, Parga A, Hellesen C, Khawaji A, Brundin M, Durual S, Özenci V, Fang H, Belibasakis GN. Photo-oxidative stress response and virulence traits are co-regulated in E. faecalis after antimicrobial photodynamic therapy. J Photochem Photobiol B 2022; 234:112547. [PMID: 36030693 DOI: 10.1016/j.jphotobiol.2022.112547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/23/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Knowledge of photo-oxidative stress responses in bacteria that survive antimicrobial photodynamic therapy (aPDT) is scarce. Whereas aPDT is attracting growing clinical interest, subsequent stress responses are crucial to evaluate as they may lead to the up-regulation of pathogenic traits. Here, we aimed to assess transcriptional responses to sublethal aPDT-stress and identify potential connections with virulence-related genes. Six Enterococcus faecalis strains were investigated; ATCC 29212, three dental root-canal isolates labelled UmID1, UmID2 and UmID3 and two vancomycin-resistant isolates labelled A1 and A2. TMPyP was employed as a photosensitiser. A viability dose-response curve to increasing concentrations of TMPyP was determined by culture plating. Differential expression of genes involved in oxidative stress responses (dps and hypR), general stress responses (dnaK, sigma-factorV and relA), virulence-related genes (ace, fsrC and gelE) and vancomycin-resistance (vanA) was assessed by reverse-transcription qPCR. TMPyP-mediated aPDT inactivated all strains with comparable efficiencies. TMPyP at 0.015 μM was selected to induce sublethal photo-oxidative stress. Despite heterogeneities in gene expression between strains, transcriptional profiles revealed up-regulations of transcripts dps, hypR as well as dnaK and sigma factorV after exposure to TMPyP alone and to light-irradiated TMPyP. Specifically, the alternative sigma factorV reached up to 39 ± 113-fold (median ± IQR) (p = 0.0369) in strain A2. Up-regulation of the quorum sensing operon, fsr, and its downstream virulence-related gelatinase gelE were also observed in strains ATCC-29212, A1, A2 and UmID3. Finally, photo-oxidative stress induced vanA-type vancomycin-resistance gene in both carrier isolates, reaching up to 3.3 ± 17-fold in strain A2 (p = 0.015). These findings indicate that, while aPDT successfully inactivates vancomycin-resistant and naïve strains of E. faecalis, subpopulations of surviving cells respond by co-ordinately up-regulating a network of genes involved in stress survival and virulence. This includes the induction of vancomycin-resistance genes in carrier isolates. These data may provide the mechanistic basis to circumvent bacterial responses and improve future clinical protocols.
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Affiliation(s)
- Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden; Division of Cariology and Endodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Ana Parga
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden; Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cecilia Hellesen
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Arwa Khawaji
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, Umeå, Sweden
| | - Stéphane Durual
- Biomaterials Laboratory, Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Volkan Özenci
- Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Huddinge, Stockholm, Sweden
| | - Hong Fang
- Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Huddinge, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
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15
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Ozuna H, Snider I, Belibasakis GN, Oscarsson J, Johansson A, Uriarte SM. Aggregatibacter actinomycetemcomitans and Filifactor alocis: Two exotoxin-producing oral pathogens. Front Oral Health 2022; 3:981343. [PMID: 36046121 PMCID: PMC9420871 DOI: 10.3389/froh.2022.981343] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/27/2022] [Indexed: 12/22/2022] Open
Abstract
Periodontitis is a dysbiotic disease caused by the interplay between the microbial ecosystem present in the disease with the dysregulated host immune response. The disease-associated microbial community is formed by the presence of established oral pathogens like Aggregatibacter actinomycetemcomitans as well as by newly dominant species like Filifactor alocis. These two oral pathogens prevail and grow within the periodontal pocket which highlights their ability to evade the host immune response. This review focuses on the virulence factors and potential pathogenicity of both oral pathogens in periodontitis, accentuating the recent description of F. alocis virulence factors, including the presence of an exotoxin, and comparing them with the defined factors associated with A. actinomycetemcomitans. In the disease setting, possible synergistic and/or mutualistic interactions among both oral pathogens might contribute to disease progression.
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Affiliation(s)
- Hazel Ozuna
- Department of Microbiology and Immunology, School of Medicine, University of Louisville, Louisville, KY, United States
| | - Ian Snider
- Department of Biology, School of Arts and Sciences, University of Louisville, Louisville, KY, United States
| | | | - Jan Oscarsson
- Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Silvia M. Uriarte
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, United States,*Correspondence: Silvia M. Uriarte
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16
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Geissel FJ, Platania V, Gogos A, Herrmann IK, Belibasakis GN, Chatzinikolaidou M, Sotiriou GA. Antibiofilm activity of nanosilver coatings against Staphylococcus aureus. J Colloid Interface Sci 2022; 608:3141-3150. [PMID: 34815083 DOI: 10.1016/j.jcis.2021.11.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
Implant infections due to bacterial biofilms constitute a major healthcare challenge today. One way to address this clinical need is to modify the implant surface with an antimicrobial nanomaterial. Among such nanomaterials, nanosilver is arguably the most powerful one, due to its strong and broad antimicrobial activity. However, there is still a lack of understanding on how physicochemical characteristics of nanosilver coatings affect their antibiofilm activity. More specifically, the contributions of silver (Ag)+ ion-mediated vs. contact-based mechanisms to the observed antimicrobial activity are yet to be elucidated. To address this knowledge gap, we produce here nanosilver coatings on substrates by flame aerosol direct deposition that allows for facile control of the coating composition and Ag particle size. We systematically study the effect of (i) nanosilver content in composite Ag silica (SiO2) coatings from 0 (pure SiO2) up to 50 wt%, (ii) the Ag particle size and (iii) the coating thickness on the antibiofilm activity against Staphylococcus aureus (S. aureus), a clinically-relevant pathogen often present on the surface of surgically-installed implants. We show that the Ag+ ion concentration in solution largely drives the observed antibiofilm effect independently of Ag size and coating thickness. Furthermore, co-incubation of both pure SiO2 and nanosilver coatings in the same well also reveals that the antibiofilm effect stems predominantly from the released Ag+ ions, which is especially pronounced for coatings featuring the smallest Ag particle sizes, rather than direct bacterial contact inhibition. We also examine the biocompatibility of the developed nanosilver coatings in terms of pre-osteoblastic cell viability and proliferation, comparing it to that of pure SiO2. This study lays the foundation for the rational design of nanosilver-based antibiofilm implant coatings.
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Affiliation(s)
- Felix J Geissel
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Varvara Platania
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece
| | - Alexander Gogos
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Switzerland and Particles Biology Interactions Laboratory, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland
| | - Inge K Herrmann
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Switzerland and Particles Biology Interactions Laboratory, Swiss Federal Laboratories for Materials Science and Technology (Empa), St. Gallen, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Chatzinikolaidou
- Department of Materials Science and Technology, University of Crete, Heraklion, Greece; Institute of Electronic Structure and Laser (IESL), Foundation for Research and Technology Hellas (FORTH), Heraklion, Greece
| | - Georgios A Sotiriou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
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17
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Belibasakis GN, Hajishengallis G. Frontiers in Oral Mucosal Immunity and the Microbiome. Front Oral Health 2022; 2:821148. [PMID: 35048081 PMCID: PMC8757874 DOI: 10.3389/froh.2021.821148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022] Open
Abstract
The 2nd International Conference on Oral Mucosal Immunity and the Microbiome (OMIM) took place at the Grecotel Kos Imperial Hotel, Kos, Greece, between 25th and 30th September 2021, under the auspices of the Aegean Conferences. This has only been the second Aegean Conference of this thematic, the first one having taken place in 2018 in Crete, during the same period of the year. Given the hardships in travel and heightened infection transmission risks amid the COVID-19 pandemic, the Conference was well attended by 29 international speakers across the world. For many of the participants, this was the first conference travel in the post-pandemic era, and quite significant that it has taken place on the island of Hippocrates. Stringent regional health and safety regulations had to be followed to accomplish for this in-person Conference to take place. Frontiers in Oral Health has hosted papers from presentations of the Conference, whereas the present article serves as the proceedings of the Conference with summaries of the presentations.
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - George Hajishengallis
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States
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18
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Zhou P, Manoil D, Belibasakis GN, Kotsakis GA. Veillonellae: Beyond Bridging Species in Oral Biofilm Ecology. Front Oral Health 2022; 2:774115. [PMID: 35048073 PMCID: PMC8757872 DOI: 10.3389/froh.2021.774115] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/05/2021] [Indexed: 12/28/2022] Open
Abstract
The genus Veillonella comprises 16 characterized species, among which eight are commonly found in the human oral cavity. The high abundance of Veillonella species in the microbiome of both supra- and sub-gingival biofilms, and their interdependent relationship with a multitude of other bacterial species, suggest veillonellae to play an important role in oral biofilm ecology. Development of oral biofilms relies on an incremental coaggregation process between early, bridging and later bacterial colonizers, ultimately forming multispecies communities. As early colonizer and bridging species, veillonellae are critical in guiding the development of multispecies communities in the human oral microenvironment. Their ability to establish mutualistic relationships with other members of the oral microbiome has emerged as a crucial factor that may contribute to health equilibrium. Here, we review the general characteristics, taxonomy, physiology, genomic and genetics of veillonellae, as well as their bridging role in the development of oral biofilms. We further discuss the role of Veillonella spp. as potential “accessory pathogens” in the human oral cavity, capable of supporting colonization by other, more pathogenic species. The relationship between Veillonella spp. and dental caries, periodontitis, and peri-implantitis is also recapitulated in this review. We finally highlight areas of future research required to better understand the intergeneric signaling employed by veillonellae during their bridging activities and interspecies mutualism. With the recent discoveries of large species and strain-specific variation within the genus in biological and virulence characteristics, the study of Veillonella as an example of highly adaptive microorganisms that indirectly participates in dysbiosis holds great promise for broadening our understanding of polymicrobial disease pathogenesis.
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Affiliation(s)
- Peng Zhou
- Translational Periodontal Research Lab, Department of Periodontics, School of Dentistry, UT Health San Antonio, San Antonio, TX, United States
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios A Kotsakis
- Translational Periodontal Research Lab, Department of Periodontics, School of Dentistry, UT Health San Antonio, San Antonio, TX, United States
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19
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Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges. Front Oral Health 2022; 2:672887. [PMID: 35048015 PMCID: PMC8757850 DOI: 10.3389/froh.2021.672887] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The oral cavity is the habitat of several hundreds of microbial taxa that have evolved to coexist in multispecies communities in this unique ecosystem. By contrast, the internal tissue of the tooth, i.e., the dental pulp, is a physiologically sterile connective tissue in which any microbial invasion is a pathological sign. It results in inflammation of the pulp tissue and eventually to pulp death and spread of inflammation/infection to the periradicular tissues. Over the past few decades, substantial emphasis has been placed on understanding the pathobiology of root canal infections, including the microbial composition, biofilm biology and host responses to infections. To develop clinically effective treatment regimens as well as preventive therapies, such extensive understanding is necessary. Rather surprisingly, despite the definitive realization that root canal infections are biofilm mediated, clinical strategies have been focused more on preparing canals to radiographically impeccable levels, while much is left desired on the debridement of these complex root canal systems. Hence, solely focusing on "canal shaping" largely misses the point of endodontic treatment as the current understanding of the microbial aetiopathogenesis of apical periodontitis calls for the emphasis to be placed on "canal cleaning" and chemo-mechanical disinfection. In this review, we dissect in great detail, the current knowledge on the root canal microbiome, both in terms of its composition and functional characteristics. We also describe the challenges in root canal disinfection and the novel strategies that attempt to address this challenge. Finally, we provide some critical pointers for areas of future research, which will serve as an important area for consideration in Frontiers in Oral Health.
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Affiliation(s)
- Jasmine Wong
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Peggy Näsman
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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20
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Baumgartner D, Johannsen B, Specht M, Lüddecke J, Rombach M, Hin S, Paust N, von Stetten F, Zengerle R, Herz C, Peham JR, Paqué PN, Attin T, Jenzer JS, Körner P, Schmidlin PR, Thurnheer T, Wegehaupt FJ, Kaman WE, Stubbs A, Hays JP, Rusu V, Michie A, Binsl T, Stejskal D, Karpíšek M, Bao K, Bostanci N, Belibasakis GN, Mitsakakis K. OralDisk: A Chair-Side Compatible Molecular Platform Using Whole Saliva for Monitoring Oral Health at the Dental Practice. Biosensors (Basel) 2021; 11:bios11110423. [PMID: 34821641 PMCID: PMC8615610 DOI: 10.3390/bios11110423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 05/04/2023]
Abstract
Periodontitis and dental caries are two major bacterially induced, non-communicable diseases that cause the deterioration of oral health, with implications in patients' general health. Early, precise diagnosis and personalized monitoring are essential for the efficient prevention and management of these diseases. Here, we present a disk-shaped microfluidic platform (OralDisk) compatible with chair-side use that enables analysis of non-invasively collected whole saliva samples and molecular-based detection of ten bacteria: seven periodontitis-associated (Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) and three caries-associated (oral Lactobacilli, Streptococcus mutans, Streptococcus sobrinus). Each OralDisk test required 400 µL of homogenized whole saliva. The automated workflow included bacterial DNA extraction, purification and hydrolysis probe real-time PCR detection of the target pathogens. All reagents were pre-stored within the disk and sample-to-answer processing took < 3 h using a compact, customized processing device. A technical feasibility study (25 OralDisks) was conducted using samples from healthy, periodontitis and caries patients. The comparison of the OralDisk with a lab-based reference method revealed a ~90% agreement amongst targets detected as positive and negative. This shows the OralDisk's potential and suitability for inclusion in larger prospective implementation studies in dental care settings.
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Affiliation(s)
- Desirée Baumgartner
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Mara Specht
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Jan Lüddecke
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Markus Rombach
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Sebastian Hin
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Felix von Stetten
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Christopher Herz
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Johannes R. Peham
- AIT Austrian Institute of Technology, Molecular Diagnostics, Giefinggasse 4, 1210 Wien, Austria; (C.H.); (J.R.P.)
| | - Pune N. Paqué
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Joël S. Jenzer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Philipp Körner
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Florian J. Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; (P.N.P.); (T.A.); (J.S.J.); (P.K.); (P.R.S.); (T.T.); (F.J.W.)
| | - Wendy E. Kaman
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Andrew Stubbs
- Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands;
| | - John P. Hays
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre Rotterdam (Erasmus MC), 3015 CN Rotterdam, The Netherlands; (W.E.K.); (J.P.H.)
| | - Viorel Rusu
- Magtivio B.V., Daelderweg 9, 6361 HK Nuth, The Netherlands;
| | - Alex Michie
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - Thomas Binsl
- ClinicaGeno Ltd., 11 Station Approach, Coulsdon CR5 2NR, UK; (A.M.); (T.B.)
| | - David Stejskal
- Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300 Ostrava, Czech Republic;
- Institute of Laboratory Diagnostics, University Hospital Ostrava, 17. Listopadu 1790/5, 70800 Ostrava, Czech Republic
| | - Michal Karpíšek
- BioVendor-Laboratorní Medicína a.s., Research & Diagnostic Products Division, Karasek 1767/1, Reckovice, 62100 Brno, Czech Republic;
- Faculty of Pharmacy, Masaryk University, Palackeho trida 1946/1, 61242 Brno, Czech Republic
| | - Kai Bao
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Section of Oral Health and Periodontology, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (N.B.); (G.N.B.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany; (B.J.); (M.S.); (J.L.); (M.R.); (S.H.); (N.P.); (F.v.S.); (R.Z.)
- Laboratory for MEMS Applications, IMTEK–Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Correspondence: (K.M.); (D.B.); Tel.: +49-761-203-73252 (K.M.); +49-761-203-98724 (D.B.)
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21
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Leite FRM, Nascimento GG, Møller HJ, Belibasakis GN, Bostanci N, Smith PC, López R. Cytokine profiles and the dynamic of gingivitis development in humans. J Clin Periodontol 2021; 49:67-75. [PMID: 34664296 DOI: 10.1111/jcpe.13565] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 12/25/2022]
Abstract
AIM To investigate the relationship between cytokine profiles and "fast" and "slow" patterns of gingival inflammation development. MATERIALS AND METHODS Forty-two adults participated in an experimental gingivitis study, comprising a 2-week hygiene phase (clinical examination and professional cleaning); a 3-week induction phase (absence of oral hygiene); and a 2-week resolution phase (re-establishment of oral hygiene). Plaque and gingival inflammation scores were assessed. Interferon-gamma (IFN-γ), interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, and tumour necrosis factor-alpha (TNF-α) from gingival crevicular fluid were collected and measured by multiplex ELISA. Group-based-trajectory-modelling (GBTM) was used to model cytokine profiles over the induction phase. The effect of gingival inflammation on cytokine levels over time was estimated with mixed-effects modelling. RESULTS GBTM analysis revealed two cytokine profiles, "non-organized response" (IL-4, IL-6, IL-8, IL-12, and IL-13) and "organized response" (IL-2, IL-10, and TNF-α). Among the "slow" responders, neither cytokine profile was associated with gingivitis. In contrast, a "fast" response was associated with a higher "non-organized response" factor (coef. 0.14) and a lower "organized response" factor (coef. -0.03). CONCLUSION A "fast" gingivitis development was associated with a higher "non-organized response" and a lower "organized response", which may elucidate the role of individual variability in gingivitis susceptibility.
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Affiliation(s)
- Fábio R M Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Holger J Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Georgios N Belibasakis
- Section of Periodontology and Preventive Medicine, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nagihan Bostanci
- Section of Periodontology and Preventive Medicine, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patricio C Smith
- School of Dentistry, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo López
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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22
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Zehnder M, Belibasakis GN. A critical analysis of research methods to study clinical molecular biomarkers in Endodontic research. Int Endod J 2021; 55 Suppl 1:37-45. [PMID: 34655496 PMCID: PMC9298367 DOI: 10.1111/iej.13647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/14/2021] [Indexed: 12/22/2022]
Abstract
The authors of this narrative review aimed to address various experimental methods and make recommendations for how research should move forward in the context of studying biomarkers in clinical Endodontic research. The approach adopted is exemplified using two prominent clinical problems, namely (a) the ‘reversible’ versus ‘irreversible’ pulpitis conundrum and (b) persistent idiopathic dentoalveolar pain (PIDAP). Pulpitis under deep caries or dentinal cracks is understood from a histological perspective, but clinical assessment tools to indicate irreversibly inflamed aspects of the dental pulp are elusive. PIDAP, on the other hand, is a diagnosis of exclusion; its pathophysiology is complex and not understood sufficiently to avoid unnecessary dental treatments. This review addresses how diagnostic biomarkers could further our understanding of those and other clinical problems, and how issues can be tackled from a methodological point of view. Hence, different methodological approaches to identify suitable diagnostic biomarker(s) or use known biomarkers are presented. The importance of asking a relevant research question, collecting the most suitable fluid and using the ideal collection vehicle for the research question under investigation is discussed based on the defined clinical problems.
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Affiliation(s)
- Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zürich Center of Dental Medicine, Zürich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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23
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Ng E, Tay JRH, Ong MMA, Bostanci N, Belibasakis GN, Seneviratne CJ. Probiotic therapy for periodontal and peri-implant health - silver bullet or sham? Benef Microbes 2021; 12:215-230. [PMID: 34057054 DOI: 10.3920/bm2020.0182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Probiotics are thought to be beneficial microbes that influence health-related outcomes through host immunomodulation and modulation of the bacteriome. Its reported success in the treatment of gastrointestinal disorders has led to further research on its potential applicability within the dental field due to similarities such as a polymicrobial aetiology and disease associated microbial-shifts. Although the literature is replete with studies demonstrating its efficacy, the use of probiotics in dentistry continues to polarise opinion. Here, we explore the evidence for probiotics and its effect on periodontal and peri-implant health. MEDLINE, EMBASE, and CENTRAL were systemically searched from June 2010 to June 2020 based on a formulated search strategy. Of 1,956 potentially relevant articles, we selected 27 double-blinded randomised clinical trials in the areas of gingivitis, periodontitis, residual pockets during supportive periodontal therapy, and peri-implant diseases, and reviewed their efficacy in these clinical situations. We observed substantial variation in treatment results and protocols between studies. Overall, the evidence for probiotic therapy for periodontal and peri-implant health appears unconvincing. The scarcity of trials with adequate power and follow-up precludes any meaningful clinical recommendations. Thus, the routine use of probiotics for these purposes are currently unsubstantiated. Further multi-centre trials encompassing a standardised investigation on the most promising strains and administration methods, with longer observation times are required to confirm the benefits of probiotic therapy for these applications.
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Affiliation(s)
- E Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore
| | - J R H Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore
| | - M M A Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - N Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, P.O. Box 4064, 14104 Huddinge, Sweden
| | - G N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, P.O. Box 4064, 14104 Huddinge, Sweden
| | - C J Seneviratne
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, 169857, Singapore.,Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Centre Singapore, Second Hospital Ave, 168938, Singapore
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24
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Bostanci N, Krog MC, Hugerth LW, Bashir Z, Fransson E, Boulund F, Belibasakis GN, Wannerberger K, Engstrand L, Nielsen HS, Schuppe-Koistinen I. Dysbiosis of the Human Oral Microbiome During the Menstrual Cycle and Vulnerability to the External Exposures of Smoking and Dietary Sugar. Front Cell Infect Microbiol 2021; 11:625229. [PMID: 33816334 PMCID: PMC8018275 DOI: 10.3389/fcimb.2021.625229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/11/2021] [Indexed: 12/18/2022] Open
Abstract
Physiological hormonal fluctuations exert endogenous pressures on the structure and function of the human microbiome. As such, the menstrual cycle may selectively disrupt the homeostasis of the resident oral microbiome, thus compromising oral health. Hence, the aim of the present study was to structurally and functionally profile the salivary microbiome of 103 women in reproductive age with regular menstrual cycle, while evaluating the modifying influences of hormonal contraceptives, sex hormones, diet, and smoking. Whole saliva was sampled during the menstrual, follicular, and luteal phases (n = 309) of the cycle, and the participants reported questionnaire-based data concerning their life habits and oral or systemic health. No significant differences in alpha-diversity or phase-specific clustering of the overall microbiome were observed. Nevertheless, the salivary abundances of genera Campylobacter, Haemophilus, Prevotella, and Oribacterium varied throughout the cycle, and a higher species-richness was observed during the luteal phase. While the overall community structure maintained relatively intact, its functional properties were drastically affected. In particular, 11 functional modules were differentially abundant throughout the menstrual cycle, including pentose phosphate metabolism, and biosynthesis of cobalamin and neurotransmitter gamma-aminobutyric acid. The menstrual cycle phase, but not oral contraceptive usage, was accountable for greater variations in the metabolic pathways of the salivary microbiome. Further co-risk factor analysis demonstrated that Prevotella and Veillonella were increased in current smokers, whereas high dietary sugar consumption modified the richness and diversity of the microbiome during the cycle. This is the first large study to systematically address dysbiotic variations of the oral microbiome during the course of menstrual cycle, and document the additive effect of smoking and sugar consumption as environmental risk factors. It reveals the structural resilience and functional adaptability of the oral microbiome to the endogenous hormonal pressures of the menstrual cycle, while revealing its vulnerability to the exogenous exposures of diet and smoking.
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Affiliation(s)
- Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Christine Krog
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Luisa W Hugerth
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Zahra Bashir
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Holbæk Hospital, Holbæk, Denmark
| | - Emma Fransson
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Fredrik Boulund
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Lars Engstrand
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
| | - Henriette Svarre Nielsen
- The Recurrent Pregnancy Loss Units, Copenhagen University Hospitals, Rigshospitalet and Hvidovre Hospital, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ina Schuppe-Koistinen
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Science for Life Laboratory, Stockholm, Sweden
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25
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Donos N, Calciolari E, Brusselaers N, Goldoni M, Bostanci N, Belibasakis GN. The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. J Clin Periodontol 2021; 47 Suppl 22:199-238. [PMID: 31834951 DOI: 10.1111/jcpe.13232] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/10/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Considering the role of the inflammatory host response in the pathogenesis of periodontitis, different host modulators have been proposed to enhance the outcomes of non-surgical periodontal therapy (NSPT), but their efficacy has not been fully clarified. OBJECTIVES This systematic review investigated the efficacy of host modulators combined with NSPT in reducing probing pocket depth (PPD) in periodontitis patients. MATERIALS AND METHODS Placebo-controlled RCTs with ≥6 months follow-up were searched. Meta-analysis was conducted when ≥5 studies using the same host modulator were identified. RESULTS Fifty eight studies met the inclusion criteria. After 6 months, local administration of 1.2% statin gels as adjuncts to NSPT significantly improved PPD reduction (1.83 mm) in infrabony defects and systemic administration of sub-antimicrobial dose doxycycline (SDD) in addition to NSPT improved PPD reduction of deep pockets. Administration of probiotics conferred limited clinical benefits. Local bisphosphonate and metformin gels showed potential for clinical use in infrabony defects, which needs to be confirmed. CONCLUSIONS Local delivery of statins in infrabony defects and systemic SDD for deep pockets may confer additional clinical benefits to NSPT. Their long-term effectiveness and safety need to be confirmed in independent multi-centred studies. Further studies are needed to confirm the benefit of other host modulators.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nele Brusselaers
- Centre of Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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26
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Leira Y, Fragkiskos D, Orlandi M, Suvan J, Nibali L, Tonetti MS, Belibasakis GN, Bostanci N, D'Aiuto F. Severe Periodontitis and Biomarkers of Bacterial Burden. Results From a Case-Control and Intervention Clinical Trial. Front Oral Health 2021; 2:615579. [PMID: 35047991 PMCID: PMC8757820 DOI: 10.3389/froh.2021.615579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background and aims: Periodontitis is an inflammatory-infectious disease. Identifying markers of systemic exposure of periodontitis might be of interest to study its interaction with other conditions. Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is upregulated during bacterial infections. Our aim was therefore to investigate whether periodontitis and its treatment are associated with bacterial endotoxin and sTREM-1. Methods: Fifty patients with severe periodontitis and 50 age-matched controls were included in a case-control study (all never smokers). A secondary analysis of a previously published intervention study was performed, in which included 69 patients with severe periodontitis were randomized to receive either intensive (IPT) or control periodontal therapy (CPT) and monitored over 6 months. Serum levels of bacterial endotoxin and sTREM-1 were determined at one time point (case-control study) and at baseline, 1 day, 1 and 6 months after periodontal treatment (intervention study). Results: Severe periodontitis was associated with elevated circulating endotoxin levels when cases (22.9 ± 2.2 EU/ml) were compared to controls (3.6 ± 0.5 EU/ml, p < 0.001) and with sTREM-1 levels (1302.6 ± 47.8 vs. 870.6 ± 62.0 pg/ml, p < 0.001). A positive correlation was observed between sTREM-1 and endotoxin levels (r = 0.4, p < 0.001). At 6 months after treatment, IPT significantly decreased serum levels of sTREM-1 compared to CPT (adjusted mean difference of 500.2 pg/ml, 95% CI: 18.9–981.4; p = 0.042). No substantial differences were noted in endotoxin levels at any time point after treatment between groups. Conclusions: Severe periodontitis is linked to increased circulating endotoxin and sTREM-1 levels and following IPT a reduction in sTREM-1 levels is observed.
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Affiliation(s)
- Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Center, University College London, London, United Kingdom
- Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Dimitrios Fragkiskos
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Center, University College London, London, United Kingdom
| | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Center, University College London, London, United Kingdom
| | - Jeanie Suvan
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Center, University College London, London, United Kingdom
| | - Luigi Nibali
- Periodontology Unit, Center for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Maurizio S. Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong, China
- European Research Group on Periodontology, Genova, Italy
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Center, University College London, London, United Kingdom
- *Correspondence: Francesco D'Aiuto
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27
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Ng E, Tay JRH, Balan P, Ong MMA, Bostanci N, Belibasakis GN, Seneviratne CJ. Metagenomic sequencing provides new insights into the subgingival bacteriome and aetiopathology of periodontitis. J Periodontal Res 2021; 56:205-218. [PMID: 33410172 DOI: 10.1111/jre.12811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/29/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022]
Abstract
"Open-ended" molecular techniques such as 16S rRNA sequencing have revealed that the oral bacteriome of subgingival plaque is more diverse than originally thought. 16S rRNA analysis has demonstrated that constituents of the overall bacterial community are qualitatively similar in health and disease, differing mainly in their relative proportions with respect to each other. Species in low abundance can also act as critical species, leading to the concept of global community dysbiosis which relates to shifts in community structure, rather than shifts in membership. Correlation analysis suggests that coordinated interactions in the community are essential for incipient dysbiosis and disease pathogenesis. The subgingival bacteriome also provides biomarkers that are useful for disease detection and management. Combined with clinical and biological parameters, these may assist clinicians in developing and implementing effective treatment strategies to restore microbial homeostasis and monitor disease. Identification of higher risk groups or poor responders to treatment using unique subgingival bacteriome signatures may also lead to early intervention.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore
| | - John R H Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore
| | - P Balan
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, SingHealth, Singapore, Singapore
| | - Marianne M A Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Chaminda J Seneviratne
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, SingHealth, Singapore, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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28
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Bostanci N, Grant M, Bao K, Silbereisen A, Hetrodt F, Manoil D, Belibasakis GN. Metaproteome and metabolome of oral microbial communities. Periodontol 2000 2020; 85:46-81. [PMID: 33226703 DOI: 10.1111/prd.12351] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The emergence of high-throughput technologies for the comprehensive measurement of biomolecules, also referred to as "omics" technologies, has helped us gather "big data" and characterize microbial communities. In this article, we focus on metaproteomic and metabolomic approaches that support hypothesis-driven investigations on various oral biologic samples. Proteomics reveals the working units of the oral milieu and metabolomics unveils the reactions taking place; and so these complementary techniques can unravel the functionality and underlying regulatory processes within various oral microbial communities. Current knowledge of the proteomic interplay and metabolic interactions of microorganisms within oral biofilm and salivary microbiome communities is presented and discussed, from both clinical and basic research perspectives. Communities indicative of, or from, health, caries, periodontal diseases, and endodontic lesions are represented. Challenges, future prospects, and examples of best practice are given.
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Affiliation(s)
- Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Melissa Grant
- Biological Sciences, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Angelika Silbereisen
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Franziska Hetrodt
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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29
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Belibasakis GN, Lund BK, Krüger Weiner C, Johannsen B, Baumgartner D, Manoil D, Hultin M, Mitsakakis K. Healthcare Challenges and Future Solutions in Dental Practice: Assessing Oral Antibiotic Resistances by Contemporary Point-Of-Care Approaches. Antibiotics (Basel) 2020; 9:E810. [PMID: 33202544 PMCID: PMC7696509 DOI: 10.3390/antibiotics9110810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022] Open
Abstract
Antibiotic resistance poses a global threat, which is being acknowledged at several levels, including research, clinical implementation, regulation, as well as by the World Health Organization. In the field of oral health, however, the issue of antibiotic resistances, as well as of accurate diagnosis, is underrepresented. Oral diseases in general were ranked third in terms of expenditures among the EU-28 member states in 2015. Yet, the diagnosis and patient management of oral infections, in particular, still depend primarily on empiric means. On the contrary, on the global scale, the field of medical infections has more readily adopted the integration of molecular-based systems in the diagnostic, patient management, and antibiotic stewardship workflows. In this perspective review, we emphasize the clinical significance of supporting in the future antibiotic resistance screening in dental practice with novel integrated and point-of-care operating tools that can greatly support the rapid, accurate, and efficient administration of oral antibiotics.
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Affiliation(s)
- Georgios N. Belibasakis
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Bodil K. Lund
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Clinical Dentistry, University of Bergen, 5009 Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, 5021 Bergen, Norway
| | - Carina Krüger Weiner
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
- Department of Oral and Maxillofacial Surgery, Folktandvården Stockholm, Eastman Institutet, 11324 Stockholm, Sweden
| | - Benita Johannsen
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Desirée Baumgartner
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
| | - Daniel Manoil
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Margareta Hultin
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104 Stockholm, Sweden; (B.K.L.); (C.K.W.); (D.M.); (M.H.)
| | - Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
- Laboratory for MEMS Applications, IMTEK—Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany;
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Oscarsson J, Claesson R, Bao K, Brundin M, Belibasakis GN. Phylogenetic Analysis of Filifactor alocis Strains Isolated from Several Oral Infections Identified a Novel RTX Toxin, FtxA. Toxins (Basel) 2020; 12:toxins12110687. [PMID: 33143036 PMCID: PMC7692872 DOI: 10.3390/toxins12110687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
Filifactor alocis is a Gram-positive asaccharolytic, obligate anaerobic rod of the phylum Firmicutes, and is considered an emerging pathogen in various oral infections, including periodontitis. We here aimed to perform phylogenetic analysis of a genome-sequenced F. alocis type strain (ATCC 35896; CCUG 47790), as well as nine clinical oral strains that we have independently isolated and sequenced, for identification and deeper characterization of novel genomic elements of virulence in this species. We identified that 60% of the strains carried a gene encoding a hitherto unrecognized member of the large repeats-in-toxins (RTX) family, which we have designated as FtxA. The clinical infection origin of the ftxA-positive isolates largely varied. However, according to MLST, a clear monophylogeny was reveled for all ftxA-positive strains, along with a high co-occurrence of lactate dehydrogenase (ldh)-positivity. Cloning and expression of ftxA in E. coli, and purification of soluble FtxA yielded a protein of the predicted molecular size of approximately 250 kDa. Additional functional and proteomics analyses using both the recombinant protein and the ftxA-positive, and -negative isolates may reveal a possible role and mechanism(s) of FtxA in the virulence properties of F.alocis, and whether the gene might be a candidate diagnostic marker for more virulent strains.
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Affiliation(s)
- Jan Oscarsson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
- Correspondence:
| | - Rolf Claesson
- Division of Oral Microbiology, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
| | - Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (G.N.B.)
| | - Malin Brundin
- Division of Endodontics, Department of Odontology, Umeå University, 90187 Umeå, Sweden;
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden; (K.B.); (G.N.B.)
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Bao K, Li X, Poveda L, Qi W, Selevsek N, Gumus P, Emingil G, Grossmann J, Diaz PI, Hajishengallis G, Bostanci N, Belibasakis GN. Proteome and Microbiome Mapping of Human Gingival Tissue in Health and Disease. Front Cell Infect Microbiol 2020; 10:588155. [PMID: 33117738 PMCID: PMC7566166 DOI: 10.3389/fcimb.2020.588155] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022] Open
Abstract
Efforts to map gingival tissue proteomes and microbiomes have been hampered by lack of sufficient tissue extraction methods. The pressure cycling technology (PCT) is an emerging platform for reproducible tissue homogenisation and improved sequence retrieval coverage. Therefore, we employed PCT to characterise the proteome and microbiome profiles in healthy and diseased gingival tissue. Healthy and diseased contralateral gingival tissue samples (total n = 10) were collected from five systemically healthy individuals (51.6 ± 4.3 years) with generalised chronic periodontitis. The tissues were then lysed and digested using a Barocycler, proteins were prepared and submitted for mass spectrometric analysis and microbiome DNA for 16S rRNA profiling analysis. Overall, 1,366 human proteins were quantified (false discovery rate 0.22%), of which 69 proteins were differentially expressed (≥2 peptides and p < 0.05, 62 up, 7 down) in periodontally diseased sites, compared to healthy sites. These were primarily extracellular or vesicle-associated proteins, with functions in molecular transport. On the microbiome level, 362 species-level operational taxonomic units were identified. Of those, 14 predominant species accounted for >80% of the total relative abundance, whereas 11 proved to be significantly different between healthy and diseased sites. Among them, Treponema sp. HMT253 and Fusobacterium naviforme and were associated with disease sites and strongly interacted (r > 0.7) with 30 and 6 up-regulated proteins, respectively. Healthy-site associated strains Streptococcus vestibularis, Veillonella dispar, Selenomonas sp. HMT478 and Leptotrichia sp. HMT417 showed strong negative interactions (r < −0.7) with 31, 21, 9, and 18 up-regulated proteins, respectively. In contrast the down-regulated proteins did not show strong interactions with the regulated bacteria. The present study identified the proteomic and intra-tissue microbiome profile of human gingiva by employing a PCT-assisted workflow. This is the first report demonstrating the feasibility to analyse full proteome profiles of gingival tissues in both healthy and disease sites, while deciphering the tissue site-specific microbiome signatures.
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Affiliation(s)
- Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Insitutet, Huddinge, Sweden
| | - Xiaofei Li
- Department of Basic and Translational Sciences, School of Dental Medicine, Philadelphia, PA, United States
| | - Lucy Poveda
- Functional Genomic Centre, ETH Zurich and University of Zurich, Zürich, Switzerland
| | - Weihong Qi
- Functional Genomic Centre, ETH Zurich and University of Zurich, Zürich, Switzerland
| | | | - Pinar Gumus
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Gulnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Jonas Grossmann
- Functional Genomic Centre, ETH Zurich and University of Zurich, Zürich, Switzerland
| | - Patricia I Diaz
- Department of Oral Biology, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - George Hajishengallis
- Department of Basic and Translational Sciences, School of Dental Medicine, Philadelphia, PA, United States
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Insitutet, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Insitutet, Huddinge, Sweden
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Bostanci N, Silbereisen A, Bao K, Grossmann J, Nanni P, Fernandez C, Nascimento GG, Belibasakis GN, Lopez R. Salivary proteotypes of gingivitis tolerance and resilience. J Clin Periodontol 2020; 47:1304-1316. [PMID: 32777086 PMCID: PMC7692908 DOI: 10.1111/jcpe.13358] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/19/2020] [Accepted: 08/05/2020] [Indexed: 12/18/2022]
Abstract
Aim This study aimed to characterize the salivary proteome during the induction and resolution of gingival inflammation in the course of human experimental gingivitis (EG), and to cluster the proteomic profiles based on the clinically defined “slow” and “fast” response patterns. Materials and Methods A total of 50 unstimulated whole saliva were obtained from the EG model which was induced over 21 days (days 0, 7, 14 and 21), followed by a two‐week resolution phase (day 35). Label‐free quantitative proteomics using liquid chromatography–tandem mass spectrometry was applied. Regulated proteins were subject to Gene Ontology enrichment analysis. Results A total of 804 human proteins were quantified by ≥ 2 peptides. Principal component analysis depicted significant differences between “fast” and “slow” responders. Despite gingival and plaque scores being similar at baseline among the two groups, “fast” responders presented with 48 proteins that were at > 4‐fold higher levels than “slow” responders. These up‐regulated proteins showed enrichment in “antigen presentation” and “proteolysis.” Conclusions Together, these findings highlight the utility of integrative systems‐level quantitative proteomic approaches to unravel the molecular basis of “salivary proteotypes” associated with gingivitis dubbed as “fast” and “slow” responders. Hence, these differential responses may help prognosticate individual susceptibility to gingival inflammation.
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Affiliation(s)
- Nagihan Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Angelika Silbereisen
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kai Bao
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Grossmann
- Functional Genomic Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Paolo Nanni
- Functional Genomic Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia Fernandez
- Functional Genomic Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Georgios N Belibasakis
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rodrigo Lopez
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Manoil D, Bostanci N, Mumcu G, Inanc N, Can M, Direskeneli H, Belibasakis GN. Novel and known periodontal pathogens residing in gingival crevicular fluid are associated with rheumatoid arthritis. J Periodontol 2020; 92:359-370. [PMID: 32737880 PMCID: PMC8048861 DOI: 10.1002/jper.20-0295] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/23/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023]
Abstract
Background Periodontitis is a suspected environmental risk factor for the development of rheumatoid arthritis (RA). However, correlation mechanisms between the two pathologies remain elusive. This study examined potential correlations between detached subgingival bacteria collected in gingival crevicular fluid (GCF) and RA parameters. Methods RA patients (n = 52, F:M = 40:12), patients with Behcet's disease (BD, n = 40, F:M = 29:11) as another systemic inflammatory disease were studied along with a systemically healthy control group (HC, n = 57, F:M = 40:17). All participants were non‐smokers. Full mouth periodontal parameters were recorded. RA activity was assessed using the 28‐joint Disease Activity Score (DAS‐28). Rheumatoid factors (RFs)‐IgM and ‐IgA were measured by ELISA. GCF samples were investigated by means of fluorescent in situ hybridization for 10 different bacterial taxa. Results The taxa TM7, Synergistetes cluster B, Leptotrichia, Megasphaera, Anaeroglobus geminatus, and Tannerella forsythia displayed significantly differential abundances between the groups. Whereas abundances of Megasphaera and A. geminatus were significantly increased in the RA group, only Porphyromonas gingivalis displayed significant correlations with plaque scores, bleeding on probing, and RF‐IgA. RA patients displaying RF‐IgA levels >75 IU/mL exhibited five‐fold more abundant P. gingivalis levels than patients below the threshold. This association with RF‐IgA levels appeared even more pronounced, by six‐fold more P. gingivalis (P = 0.025), in patients with a DAS‐28 score >3.2, indicative of moderate/very active RA. Conclusions Unattached GCF bacteria may mediate the association between periodontitis and RA, and monitoring the bacterial composition of GCF might inform on RA activity. The role of newly identified bacterial taxa in RA warrants further investigations.
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Affiliation(s)
- Daniel Manoil
- Department of Dental Medicine, Division of Oral Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Nagihan Bostanci
- Department of Dental Medicine, Division of Oral Diseases, Karolinska Institutet, Stockholm, Sweden.,Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Gonca Mumcu
- Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Nevsun Inanc
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Meryem Can
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Medipol University, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Georgios N Belibasakis
- Department of Dental Medicine, Division of Oral Diseases, Karolinska Institutet, Stockholm, Sweden.,Center of Dental Medicine, University of Zürich, Zürich, Switzerland
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Abstract
Osseointegrated dental implants are a revolutionary tool in the armament of reconstructive dentistry, employed to replace missing teeth and restore masticatory, occlusal, and esthetic functions. Like natural teeth, the orally exposed part of dental implants offers a pristine nonshedding surface for salivary pellicle-mediated microbial adhesion and biofilm formation. In early colonization stages, these bacterial communities closely resemble those of healthy periodontal sites, with lower diversity. Because the peri-implant tissues are more susceptible to endogenous oral infections, understanding of the ecological triggers that underpin the microbial pathogenesis of peri-implantitis is central to developing improved prevention, diagnosis, and therapeutic strategies. The advent of next-generation sequencing (NGS) technologies, notably applied to 16S ribosomal RNA gene amplicons, has enabled the comprehensive taxonomic characterization of peri-implant bacterial communities in health and disease, revealing a differentially abundant microbiota between these 2 states, or with periodontitis. With that, the peri-implant niche is highlighted as a distinct ecosystem that shapes its individual resident microbial community. Shifts from health to disease include an increase in diversity and a gradual depletion of commensals, along with an enrichment of classical and emerging periodontal pathogens. Metatranscriptomic profiling revealed similarities in the virulence characteristics of microbial communities from peri-implantitis and periodontitis, nonetheless with some distinctive pathways and interbacterial networks. Deeper functional assessment of the physiology and virulence of the well-characterized microbial communities of the peri-implant niche will elucidate further the etiopathogenic mechanisms and drivers of the disease.
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Affiliation(s)
- G N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - D Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
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Koletsi D, Belibasakis GN, Eliades T. Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials. J Dent Res 2020; 99:1228-1238. [PMID: 32660314 DOI: 10.1177/0022034520943574] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The aim of this systematic review and network meta-analysis was to identify and rank the effectiveness of different interventions used in dental practice to reduce microbial load in aerosolized compounds. Seven electronic databases were searched to April 6, 2020, for randomized controlled trials (RCTs) or nonrandomized prospective studies in the field. Study selection, data extraction, and risk-of-bias assessment were performed for all included studies, while the outcome of interest pertained to differences in bacterial load quantification through the use of different interventions prior to aerosol-generating procedures in dental practices. Random effects frequentist network meta-analysis was performed, with mean difference (MD) and 95% CI as the effect measure. Confidence in the documented evidence was assessed through the newly fueled CINeMA framework (Confidence in Network Meta-analysis) based on the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation). Twenty-nine clinical trials were deemed eligible, 21 RCTs and 8 nonrandomized studies, while 11 RCTs contributed to the network meta-analysis, comprising 10 competing interventions. Tempered chlorhexidine (CHX) 0.2% as compared with nonactive control mouth rinse, prior to routine ultrasonic scaling, was most effective toward reduced postprocedural bacterial load with an MD of -0.92 (95% CI, -1.54 to -0.29) in log10 bacterial CFUs (colony-forming units). For CHX 0.2%, an MD of -0.74 (95% CI, -1.07 to -0.40) was observed as compared with control. Tempered CHX 0.2% presented the highest probabilities of being ranked the most effective treatment (31.2%). Level of confidence varied from very low to moderate across all formulated comparisons. These findings summarize the current state of research evidence in the field of aerosolized bacteria in dentistry. Instigated by the era of SARS-CoV-2 pandemic, the stipulation of a broader evaluation of the aerosolized microbes, including viruses, potentially coupled with disinfectant-based prevention schemes should be prioritized.
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Affiliation(s)
- D Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - G N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - T Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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36
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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37
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Bikker FJ, Nascimento GG, Nazmi K, Silbereisen A, Belibasakis GN, Kaman WE, Lopez R, Bostanci N. Salivary Total Protease Activity Based on a Broad-Spectrum Fluorescence Resonance Energy Transfer Approach to Monitor Induction and Resolution of Gingival Inflammation. Mol Diagn Ther 2020; 23:667-676. [PMID: 31372941 PMCID: PMC6775538 DOI: 10.1007/s40291-019-00421-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Salivary total protease and chitinase activities were measured by a broad-spectrum fluorescence resonance energy transfer approach as predictors of induction and resolution of gingival inflammation in healthy individuals by applying an experimental human gingivitis model. METHODS Dental biofilm accumulated (21 days, Induction Phase) by omitting oral hygiene practices followed by a 2-week Resolution Phase to restore gingival health in an experimental gingivitis study. Plaque accumulation, as assessed by the Turesky Modification of the Quigley-Hein Plaque Index (TQHPI), and gingival inflammation, assessed using the Modified Gingival Index (MGI), scores were recorded and unstimulated saliva was collected weekly. Saliva was analysed for total protein, albumin, total protease activity and chitinase activity (n = 18). RESULTS The TQHPI and MGI scores, as well as total protease activity, increased until day 21. After re-establishment of oral hygiene, gingival inflammation levels returned to values similar to baseline (day 0). Levels of protease activity decreased significantly, but not to baseline values. Furthermore, 'fast' responders, who responded immediately to plaque, exhibited significantly higher proteolytic activity throughout the experimental course than 'slow' responders, who showed a lagged inflammatory response. CONCLUSION The results indicate that differential inflammatory responses encompass inherent variations in total salivary proteolytic activities, which could be further utilised in contemporary diagnostic, prognostic and treatment modalities for periodontal diseases.
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Affiliation(s)
- Floris J Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, Amsterdam, The Netherlands.
| | - Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Kamran Nazmi
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, Amsterdam, The Netherlands
| | - Angelika Silbereisen
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Wendy E Kaman
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Free University of Amsterdam and University of Amsterdam, Amsterdam, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Rodrigo Lopez
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Nagihan Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Zaura E, Brandt BW, Buijs MJ, Emingil G, Ergüz M, Karapinar DY, Pekpinarli B, Bao K, Belibasakis GN, Bostanci N. Dysbiosis of the Oral Ecosystem in Severe Congenital Neutropenia Patients. Proteomics Clin Appl 2020; 14:e1900058. [PMID: 32026584 PMCID: PMC7317524 DOI: 10.1002/prca.201900058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/21/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE To decipher the underlying immunological mechanisms in predisposition to oral microbial dysbiosis in severe congenital neutropenia (SCN) patients. EXPERIMENTAL DESIGN Ten SCN patients (5-23 years old) and 12 healthy controls (5-22 years old) are periodontally examined and provided saliva, subgingival plaque, and gingival crevicular fluid (GCF) samples. The SCN patients received oral hygiene therapy and are re-evaluated after 6 months. Antimicrobial peptides HPN1-3 and LL-37 are assessed in saliva by ELISA. Concentration of 30 cytokines is measured in saliva and GCF by human 30-plex panel, while bacterial profiles of saliva and subgingival plaque are assessed using 16S rDNA amplicon sequencing. RESULTS There is no significant difference in salivary HPN1-3 and LL-37 concentration between the SCN patients and controls. At baseline, clinical, immunological, and microbiological parameters of the patients are indicative of oral ecological dysbiosis. The SCN patients have significantly higher bleeding on probing (BOP)%, GCF volume, and cytokine levels, high bacterial load with low bacterial diversity in saliva. The associations between the microbiome and immunological parameters in the SCN patients differ from those in the healthy individuals. CONCLUSIONS AND CLINICAL RELEVANCE SCN patients have a dysregulated immune response toward commensal oral microbiota, which could be responsible for the observed clinical and microbiological signs of dysbiosis.
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Affiliation(s)
- Egija Zaura
- Department of Preventive DentistryAcademic Centre for Dentistry Amsterdam (ACTA)Vrije Universiteit Amsterdam and University of Amsterdam1600NPAmsterdamThe Netherlands
| | - Bernd W. Brandt
- Department of Preventive DentistryAcademic Centre for Dentistry Amsterdam (ACTA)Vrije Universiteit Amsterdam and University of Amsterdam1600NPAmsterdamThe Netherlands
| | - Mark J. Buijs
- Department of Preventive DentistryAcademic Centre for Dentistry Amsterdam (ACTA)Vrije Universiteit Amsterdam and University of Amsterdam1600NPAmsterdamThe Netherlands
| | - Gülnur Emingil
- Department of PeriodontologySchool of DentistryEge Universityİzmir35100Turkey
| | - Merve Ergüz
- Department of PeriodontologySchool of DentistryEge Universityİzmir35100Turkey
| | | | - Burç Pekpinarli
- Department of PediatricsSchool of DentistryEge Universityİzmir35100Turkey
| | - Kai Bao
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska InstitutetHuddinge14104Sweden
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska InstitutetHuddinge14104Sweden
| | - Nagihan Bostanci
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska InstitutetHuddinge14104Sweden
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Greenwood D, Afacan B, Emingil G, Bostanci N, Belibasakis GN. Salivary Microbiome Shifts in Response to Periodontal Treatment Outcome. Proteomics Clin Appl 2020; 14:e2000011. [DOI: 10.1002/prca.202000011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/20/2020] [Indexed: 12/13/2022]
Affiliation(s)
- David Greenwood
- Division of Oral Diseases, Department of Dental Medicine Karolinska Institutet Huddinge 14104 Sweden
| | - Beral Afacan
- Department of Periodontology, School of DentistryAdnan Menderes University Aydin 09100 Turkey
| | - Gulnur Emingil
- Department of Periodontology, School of DentistryEge University İzmir 35100 Turkey
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine Karolinska Institutet Huddinge 14104 Sweden
| | - Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine Karolinska Institutet Huddinge 14104 Sweden
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40
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Manoil D, Al‐Manei K, Belibasakis GN. A Systematic Review of the Root Canal Microbiota Associated with Apical Periodontitis: Lessons from Next‐Generation Sequencing. Proteomics Clin Appl 2020; 14:e1900060. [DOI: 10.1002/prca.201900060] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/14/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel Manoil
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
| | - Khaled Al‐Manei
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
- Division of EndodonticsDepartment of Restorative Dental ScienceCollege of DentistryKing Saud University Riyadh 11545 Saudi Arabia
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institute Huddinge 14152 Sweden
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Abstract
Caries and periodontitis are the primary non-communicable oral diseases among elderly individuals. The burden of the disease increases with ageing, particularly as the elderly are tending to retain more teeth due to improvement of oral health measures and increased life expectancy. Root caries represents itself as an overlapping pathology, but not necessarily a summation of the two diseases. This narrative commentary discusses the cross-boundary nature of root caries, a periodontal-cariological condition, taking into account the multi-morbidities of ageing. The evidence includes epidemiological and pathophysiological features of root caries, and specific influencing factors of ageing, such as xerostomia, polypharmacy, functional and cognitive impairment and oral ecological alterations. Active or previous history of periodontal disease poses a risk for root caries, whereas the systemic co-morbidities of ageing may also increase the susceptibility to this pathology. It is plausible that root caries is the net outcome of coexisting risk for these conditions. There exists no standardised system for risk assessment and diagnosis that takes into account the interactive effect of caries, periodontitis and the constellation of age-specific influencing factors. As restorative treatment is challenging, cost-effective prevention and diagnosis methods are needed for vulnerable elderly populations. These may include improved clinical registration methods and establishment of individualised prevention and treatment protocols.
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Affiliation(s)
- Nivetha N Gavriilidou
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104, Huddinge, Sweden.
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Alfred Nobels allè 8, 14104, Huddinge, Sweden
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Silbereisen A, Alassiri S, Bao K, Grossmann J, Nanni P, Fernandez C, Tervahartiala T, Nascimento GG, Belibasakis GN, Heikkinen A, Lopez R, Sorsa T, Bostanci N. Label‐Free Quantitative Proteomics versus Antibody‐Based Assays to Measure Neutrophil‐Derived Enzymes in Saliva. Proteomics Clin Appl 2020; 14:e1900050. [DOI: 10.1002/prca.201900050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/20/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Angelika Silbereisen
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Saeed Alassiri
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Kai Bao
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Jonas Grossmann
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Paolo Nanni
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Claudia Fernandez
- Functional Genomics Center Zurich ETH Zurich and University of Zurich Winterthurerstrasse 190 8057 Zurich Switzerland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Gustavo G. Nascimento
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Vennelyst Boulevard 9 8000 Aarhus C Denmark
| | - Georgios N. Belibasakis
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
| | - Anna‐Maria Heikkinen
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Rodrigo Lopez
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Vennelyst Boulevard 9 8000 Aarhus C Denmark
| | - Timo Sorsa
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki University Central Hospital P.O. Box 41 (Mannerheimintie 172) 00014 Helsinki Finland
| | - Nagihan Bostanci
- Section of Periodontology and Dental Prevention Division of Oral Diseases Department of Dental Medicine Karolinska Institutet Alfred Nobels allé 8 14152 Huddinge Stockholm Sweden
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Abstract
The 1st International Conference on Oral Mucosal Immunity and the Microbiome (OMIM) took place at the Avra Imperial Hotel, Chania, Crete, Greece, between 26th and 30th September 2018, under the auspices of the Aegean Conferences. This was the first Aegean Conference of its kind in thematic oral research, and a unique blend of immunological and microbiological perspectives, which attracted leading scientists from around the world to discuss the latest advances in the field. The Conference was divided into eight sessions that spanned across 4 days and included the following topics: (a) mucosal barrier immunity; (b) host response and inflammation; (c) microbiome in homeostasis and dysbiosis; (d) fungal and viral pathogenesis; (e) oral microbiome and proteome; (f) microbial virulence and biofilms; (g) microbiome, cancer, and systemic disease; and (h) microbiota and inflammation. There was substantial thematic overlap among all sessions, which promoted constant involvement of the participating scientists. An important hallmark was the active debate between oral microbiologists and oral immunologists, who explored new ideas and potential research collaborations, a crucial aspect for bridging our understanding of oral diseases in the context of the whole body. Key findings are highlighted and thematically presented in the following sections.
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - George Hajishengallis
- Department of Microbiology, University of Pennsylvania, Penn Dental Medicine, Philadelphia, PA, USA
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Belibasakis GN, Maula T, Bao K, Lindholm M, Bostanci N, Oscarsson J, Ihalin R, Johansson A. Virulence and Pathogenicity Properties of Aggregatibacter actinomycetemcomitans. Pathogens 2019; 8:E222. [PMID: 31698835 PMCID: PMC6963787 DOI: 10.3390/pathogens8040222] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
Aggregatibacter actinomycetemcomitans is a periodontal pathogen colonizing the oral cavity of a large proportion of the human population. It is equipped with several potent virulence factors that can cause cell death and induce or evade inflammation. Because of the large genetic diversity within the species, both harmless and highly virulent genotypes of the bacterium have emerged. The oral condition and age, as well as the geographic origin of the individual, influence the risk to be colonized by a virulent genotype of the bacterium. In the present review, the virulence and pathogenicity properties of A. actinomycetemcomitans will be addressed.
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Affiliation(s)
- Georgios N. Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, S-141 04 Huddinge, Sweden; (G.N.B.); (K.B.); (N.B.)
| | - Terhi Maula
- Department of Biochemistry, University of Turku, FI-20014 Turku, Finland; (T.M.); (R.I.)
| | - Kai Bao
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, S-141 04 Huddinge, Sweden; (G.N.B.); (K.B.); (N.B.)
| | - Mark Lindholm
- Department of Odontology, Umeå University, S-901 87 Umeå, Sweden; (M.L.); (J.O.)
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, S-141 04 Huddinge, Sweden; (G.N.B.); (K.B.); (N.B.)
| | - Jan Oscarsson
- Department of Odontology, Umeå University, S-901 87 Umeå, Sweden; (M.L.); (J.O.)
| | - Riikka Ihalin
- Department of Biochemistry, University of Turku, FI-20014 Turku, Finland; (T.M.); (R.I.)
| | - Anders Johansson
- Department of Odontology, Umeå University, S-901 87 Umeå, Sweden; (M.L.); (J.O.)
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Bostanci N, Abe T, Belibasakis GN, Hajishengallis G. TREM-1 Is Upregulated in Experimental Periodontitis, and Its Blockade Inhibits IL-17A and RANKL Expression and Suppresses Bone loss. J Clin Med 2019; 8:jcm8101579. [PMID: 31581596 PMCID: PMC6832657 DOI: 10.3390/jcm8101579] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 12/17/2022] Open
Abstract
Aim: Triggering receptor expressed on myeloid cells-1 (TREM-1) is a modifier of local and systemic inflammation. There is clinical evidence implicating TREM-1 in the pathogenesis of periodontitis. However, a cause-and-effect relationship has yet to be demonstrated, as is the underlying mechanism. The aim of this study was to elucidate the role of TREM-1 using the murine ligature-induced periodontitis model. Methods: A synthetic antagonistic LP17 peptide or sham control was microinjected locally into the palatal gingiva of the ligated molar teeth. Results: Mice treated with the LP17 inhibitor developed significantly less bone loss as compared to sham-treated mice, although there were no differences in total bacterial load on the ligatures. To elucidate the impact of LP17 on the host response, we analyzed the expression of a number of immune-modulating genes. The LP17 peptide altered the expression of 27/92 genes ≥ two-fold, but only interleukin (IL)-17A was significantly downregulated (4.9-fold). Importantly, LP17 also significantly downregulated the receptor activator of nuclear factor kappa-B-ligand (RANKL) to osteoprotegerin (OPG) ratio that drives osteoclastic bone resorption in periodontitis. Conclusion: Our findings show for the first time that TREM-1 regulates the IL-17A-RANKL/OPG axis and bone loss in experimental periodontitis, and its therapeutic blockade may pave the way to a novel treatment for human periodontitis.
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Affiliation(s)
- Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden.
- Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland.
| | - Toshiharu Abe
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden.
- Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland.
| | - George Hajishengallis
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Bostanci N, Bao K, Greenwood D, Silbereisen A, Belibasakis GN. Periodontal disease: From the lenses of light microscopy to the specs of proteomics and next-generation sequencing. Adv Clin Chem 2019; 93:263-290. [PMID: 31655732 DOI: 10.1016/bs.acc.2019.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Periodontal disease entails the inflammatory destruction of the tooth supporting (periodontal) tissues as a result of polymicrobial colonization of the tooth surface in the form of biofilms. Extensive data collected over the past decades on this chronic disease demonstrate that its progression is infrequent and episodic, and the susceptibility to it can vary among individuals. Physical assessments of previously occurring damage to periodontal tissues remain the cornerstone of detection and diagnosis, whereas traditionally used diagnostic procedures do neither identify susceptible individuals nor distinguish between disease-active and disease-inactive periodontal sites. Thus, more sensitive and accurate "measurable biological indicators" of periodontal diseases are needed in order to place diagnosis (e.g., the presence or stage) and management of the disease on a more rational less empirical basis. Contemporary "omics" technologies may help unlock the path to this quest. High throughput nucleic acid sequencing technologies have enabled us to examine the taxonomic distribution of microbial communities in oral health and disease, whereas proteomic technologies allowed us to decipher the molecular state of the host in disease, as well as the interactive cross-talk of the host with the microbiome. The newly established field of metaproteomics has enabled the identification of the repertoire of proteins that oral microorganisms use to compete or co-operate with each other. Vast such data is derived from oral biological fluids, including gingival crevicular fluid and saliva, which is progressively completed and catalogued as the analytical technologies and bioinformatics tools progressively advance. This chapter covers the current "omics"-derived knowledge on the microbiome, the host and their "interactome" with regard to periodontal diseases, and addresses challenges and opportunities ahead.
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Affiliation(s)
- Nagihan Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Kai Bao
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - David Greenwood
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Angelika Silbereisen
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Section of Periodontology and Dental Prevention, Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Thurnheer T, Karygianni L, Flury M, Belibasakis GN. Fusobacterium Species and Subspecies Differentially Affect the Composition and Architecture of Supra- and Subgingival Biofilms Models. Front Microbiol 2019; 10:1716. [PMID: 31417514 PMCID: PMC6683768 DOI: 10.3389/fmicb.2019.01716] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/11/2019] [Indexed: 12/13/2022] Open
Abstract
Fusobacteria are common obligately anaerobic Gram-negative bacteria of the oral cavity that may act as a bridge between early and late colonizing bacteria in dental plaque and have a role in oral and extra-oral infections. Fusobacterium nucleatum has a crucial role in oral biofilm structure and ecology, as revealed in experimental and clinical biofilm models. The aim of this study was to investigate the impact of various Fusobacterium species on in vitro biofilm formation and structure in three different oral biofilm models namely a supragingival, a supragingival “feeding”, and a subgingival biofilm model. The standard six-species supragingival and “feeding” biofilm models employed contained Actinomyces oris, Candida albicans, Streptococcus mutans, Streptococcus oralis, Veillonella dispar, and Fusobacterium sp. The subgingival biofilm model contained 10 species (A. oris, Campylobacter rectus, F. nucleatum ssp. nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Streptococcus anginosus, S. oralis, Tannerella forsythia, Treponema denticola, and V. dispar). Six different Fusobacterium species or subspecies, respectively, were tested namely F. nucleatum ssp. fusiforme, F. nucleatum ssp. nucleatum, F. nucleatum ssp. polymorphum, F. nucleatum ssp. vincentii, F. naviforme, and F. periodonticum). Biofilms were grown anaerobically on hydroxyapatite disks in 24-well culture dishes. After 64 h, biofilms were either harvested and quantified by culture analysis or proceeded to fluorescent in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM). All Fusobacterium species tested established well in the biofilms, with CFUs ranging from 1.4E+04 (F. nucleatum ssp. fusiforme) to 5.6E+06 (F. nucleatum ssp. nucleatum). The presence of specific Fusobacterium sp./ssp. induced a significant decrease in C. albicans levels in the supragingival model and in V. dispar levels in the “feeding” supragingival model. In the subgingival model, the counts of A. oris, S. oralis, P. intermedia, P. gingivalis, and C. rectus significantly decreased in the presence of specific Fusobacterium sp./ssp. Collectively, this study showed variations in the growing capacities of different fusobacteria within biofilms, affecting the growth of surrounding species and potentially the biofilm architecture. Hence, clinical or experimental studies need to differentiate between Fusobacterium sp./ssp., as their biological properties may well vary.
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Affiliation(s)
- Thomas Thurnheer
- Division of Oral Microbiology and Immunology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Lamprini Karygianni
- Division of Oral Microbiology and Immunology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Manuela Flury
- Division of Oral Microbiology and Immunology, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Müller VJ, Belibasakis GN, Bosshard PP, Wiedemeier DB, Bichsel D, Rücker M, Stadlinger B. Change of saliva composition with radiotherapy. Arch Oral Biol 2019; 106:104480. [PMID: 31325717 DOI: 10.1016/j.archoralbio.2019.104480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the physiological and microbiological changes of saliva from patients with head and neck cancer during and after intensity-modulated radiotherapy (IMRT). DESIGN In this prospective clinical trial saliva samples and oral candida swabs were collected from patients receiving IMRT due to head and neck cancer (examination group). The first measurement was scheduled before radiotherapy, the other measurements during and after radiotherapy up to a one year follow-up. Additionally samples from healthy controls were collected over six weeks. Salivary flow rate and pH were measured. Microbiological analysis of cariogenic and periodontopathogenic taxa was performed by fluorescence in situ hybridization and oral Candida spp occurrence was evaluated by swab tests. RESULTS 11 patients and 19 controls were included. The salivary flow rate and the unstimulated pH of the examination group were significantly reduced during radiotherapy compared with the measurement before radiotherapy and to the control group. Total bacteria, streptococci and lactobacilli numbers slightly increased after radiotherapy, resuming baseline levels after one year. Mutans streptococci, Porphyromonas gingivalis and Treponema denticola were barely detectable, whereas Tannerella forsythia slightly increased following radiotherapy. No differences in Candida levels were observed in the study. CONCLUSIONS Salivary changes in quantitative, qualitative and microbial composition occur during and after radiotherapy, with resumption of the measurements towards baseline levels after one year. While low levels of cariogenic and periodontopathogenic species were detected, the lower pH and salivary flow combined with increased numbers of aciduric and acidogenic lactobacilli corroborates a higher risk for caries, necessitating prevention.
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Affiliation(s)
- Vera J Müller
- Clinic of Cranio- Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Philipp P Bosshard
- Department of Dermatology, University Hospital Zurich and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel B Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Switzerland
| | - Dominique Bichsel
- Clinic of Cranio- Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio- Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio- Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland.
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Belibasakis GN, Bostanci N, Marsh PD, Zaura E. Applications of the oral microbiome in personalized dentistry. Arch Oral Biol 2019; 104:7-12. [PMID: 31153099 DOI: 10.1016/j.archoralbio.2019.05.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/15/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE In the era of personalized medicine, it is imperative that oral health is integrated into this concept. The oral cavity fosters a highly individualized microbiome that has evolved to promote oral health, and which exists in a dynamic balance with the host. Microecological changes to the biology of the mouth [e.g. in the host diet and lifestyle, or status of the immune system] may drive deleterious shifts in the composition or metabolic activity of the oral microbiome ['dysbiosis']. This review aims to explore how knowledge of the oral microbiome may be utilized for personalized dentistry at the point-of-care. DESIGN This is a comprehensive narrative review of the literature, summarizing the perspectives of the authors. RESULTS The huge increase in recent knowledge on the ecology and microbiology of the oral cavity generated by 'OMIC' technologies may indeed be clinically translated to support patient care, in terms of prevention, monitoring, risk classification or early diagnosis. The identified clinical applications may not only include dental caries and periodontal disease, but also dental implants and orthodontics. Population-based applications may include systemic health, pregnancy and elderly populations. CONCLUSIONS Applications of selected oral microbiome and host-related biochemical parameters [e.g. the saliva proteome] for personalized dentistry can be customized for different clinical applications or individual populations, at point-of-care hubs.
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Affiliation(s)
- Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Philip D Marsh
- Department of Oral Biology, School of Dentistry, University of Leeds, UK
| | - Egija Zaura
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands
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Silbereisen A, Hallak AK, Nascimento GG, Sorsa T, Belibasakis GN, Lopez R, Bostanci N. Regulation of PGLYRP1 and TREM-1 during Progression and Resolution of Gingival Inflammation. JDR Clin Trans Res 2019; 4:352-359. [PMID: 31013451 DOI: 10.1177/2380084419844937] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The triggering receptor expressed on myeloid cells 1 (TREM-1) signaling pathway is stimulated by bacteria and, together with its putative ligand peptidoglycan recognition protein 1 (PGLYRP1), propagates proinflammatory responses. OBJECTIVES We aimed to evaluate the TREM-1/PGLYRP1/interleukin (IL)-1β regulation in response to biofilm accumulation and removal in an experimental human gingivitis model. METHODS The study (n = 42 participants, mean age: 23.8 ± 3.7 y) comprised a recruitment step (day -14) followed by experimentally induced biofilm formation (induction [I] phase, day 0 to +21) and a 2-wk resolution (R) phase (day +21 to +35). Plaque was recorded by the Modified Quigley and Hein Plaque Index (TQHPI), while records of gingival inflammation were based on the Modified Gingival Index (MGI). Unstimulated whole saliva supernatants (n = 210, 5 time points) were tested for TREM-1, PGLYRP1, and IL-1β by enzyme-linked immunosorbent assay. RESULTS During the I-phase, concentrations of all analytes showed a tendency for downregulation at day +7 compared to day 0. TREM-1 (P = 0.019) and PGLYRP1 (P = 0.007) increased significantly between day +7 and day +21. Although all analyte levels decreased during the R-phase, the difference was not significant except TREM-1 being at borderline significance (P = 0.058). Moreover, TREM-1, PGLYRP1, and IL-1β showed significant positive correlations (P < 0.0001) with each other. The study participants were grouped into "fast" and "slow" responders based on clinical gingival inflammation scores. At each time point, fast responders showed significantly higher concentrations of TREM-1 (P < 0.025), PGLYRP1 (P < 0.007), and IL-1β (P < 0.025) compared to slow responders. Mixed-effects multilevel regression analyses revealed that PGLYRP1 (P = 0.047) and IL-1β (P = 0.005) showed a significant positive association with the MGI scores. CONCLUSION The study demonstrated that TREM-1 and PGLYRP1 are regulated in response to biofilm accumulation and removal, and fast responders demonstrated higher levels of these analytes compared to slow responders. KNOWLEDGE TRANSFER STATEMENT The results of this study demonstrated the suitability of salivary TREM-1 and PGLYRP1 to reflect biofilm accumulation and removal and PGLYRP1 to monitor the progression and resolution of inflammation in gingivitis-susceptible individuals (fast responders). Combined with conventional risk factors, the molecular toolbox proposed here should be further validated in future studies to confirm whether it can be used for population-based monitoring and prevention of gingivitis.
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Affiliation(s)
- A Silbereisen
- Section of Periodontology and Dental Prevention, Division of Oral Diseases of Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A K Hallak
- Section of Periodontology and Dental Prevention, Division of Oral Diseases of Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - G G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - T Sorsa
- Section of Periodontology and Dental Prevention, Division of Oral Diseases of Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - G N Belibasakis
- Section of Periodontology and Dental Prevention, Division of Oral Diseases of Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - R Lopez
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - N Bostanci
- Section of Periodontology and Dental Prevention, Division of Oral Diseases of Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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