Invasion of human aortic endothelial cells by oral viridans group streptococci and induction of inflammatory cytokine production

Nagata, Emi; Toledo, Andrés; Oho, Takahiko

doi:10.1111/j.2041-1014.2010.00597.x

Cited by 52 publications

(60 citation statements)

References 35 publications

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“…S. aureus forms vegetations by adhering to the endothelial cell surface and subsequently aggregating in the presence of plasma (34). Recently, viridans group streptococci have been reported to display properties of adhesion to and invasion of human vascular endothelial cells (35,36). S. mutans, classified as a viridans group streptococcus, also showed properties of high levels of adhesion to endothelial cells, which was mainly observed in CBP-positive S. mutans strains, with the distribution of such strains being approximately 10 to 20% of all S. mutans strains (9,21).…”

Section: Discussionmentioning

confidence: 99%

Contribution of Streptococcus mutans Strains with Collagen-Binding Proteins in the Presence of Serum to the Pathogenesis of Infective Endocarditis

et al. 2017

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Streptococcus mutans, a major pathogen of dental caries, is considered one of the causative agents of infective endocarditis (IE). Recently, bacterial DNA encoding 120-kDa cell surface collagen-binding proteins (CBPs) has frequently been detected from S. mutans-positive IE patients. In addition, some of the CBP-positive S. mutans strains lacked a 190-kDa protein antigen (PA), whose absence strengthened the adhesion to and invasion of endothelial cells. The interaction between pathogenic bacteria and serum or plasma is considered an important virulence factor in developing systemic diseases; thus, we decided to analyze the pathogenesis of IE induced by S. mutans strains with different patterns of CBP and PA expression by focusing on the interaction with serum or plasma. CBP-positive (CBP ϩ )/PA-negative (PA Ϫ ) strains showed prominent aggregation in the presence of human serum or plasma, which was significantly greater than that with CBP ϩ /PA-positive (PA ϩ ) and CBP-negative (CBP Ϫ )/PAϩ strains. Aggregation of CBP ϩ /PA Ϫ strains was also observed in the presence of a high concentration of type IV collagen, a major extracellular matrix protein in serum. In addition, aggregation of CBP ϩ /PA Ϫ strains was drastically reduced when serum complement was inactivated. Furthermore, an ex vivo adherence model and an in vivo rat model of IE showed that extirpated heart valves infected with CBP ϩ /PA Ϫ strains displayed prominent bacterial mass formation, which was not observed following infection with CBP ϩ /PA ϩ and CBP Ϫ /PA ϩ strains. These results suggest that CBP ϩ /PA Ϫ S. mutans strains utilize serum to contribute to their pathogenicity in IE. KEYWORDS Streptococcus mutans, blood, infective endocarditisG ram-positive cocci, such as Staphylococcus aureus and viridans group streptococci, are major pathogens in infective endocarditis (IE) (1, 2). One of the important steps for the pathogenesis of IE is invasion of pathogenic bacteria into the bloodstream (1). Viridans group streptococci invade the bloodstream following professional dental treatment as well as routine daily oral care (3, 4) and are associated with a risk for IE in subjects with underlying heart disorders, though these bacteria are predominantly phagocytosed and eliminated in healthy humans (5).Streptococcus mutans, classified as a viridans group streptococcus, is a major pathogen of dental caries and is occasionally isolated from the blood of IE patients (6). In 1993, approximately 10 to 20% of S. mutans strains were demonstrated to possess collagen-binding activity, which was regarded to be advantageous for binding to collagenous tissue, such as dentin (7). Thereafter, 120-kDa collagen-binding proteins (CBPs), which were classified as Cnm and Cbm, were identified on the cell surfaces of some S. mutans strains in 2004 and 2012, respectively (8, 9).

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Section: Discussionmentioning

confidence: 99%

Contribution of Streptococcus mutans Strains with Collagen-Binding Proteins in the Presence of Serum to the Pathogenesis of Infective Endocarditis

et al. 2017

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“…27 A recent survey showed that oral viridans group streptococci are capable of invading human aortic endothelial cells and triggering the production of inflammatory cytokines and monocyte chemoattractant proteins. 28 Thrombogenic properties of viridans streptococci have also been investigated. Oral streptococci may initiate or contribute to platelet aggregation in coronaries.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Signatures in Thrombus Aspirates of Patients With Myocardial Infarction

et al. 2013

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Background-Infectious agents, especially bacteria and their components originating from the oral cavity or respiratory tract, have been suggested to contribute to inflammation in the coronary plaque, leading to rupture and the subsequent development of coronary thrombus. We aimed to measure bacterial DNA in thrombus aspirates of patients with STsegment-elevation myocardial infarction and to check for a possible association between bacteria findings and oral pathology in the same cohort. Methods and Results-Thrombus aspirates and arterial blood from patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (n=101; 76% male; mean age, 63.3 years) were analyzed with real-time quantitative polymerase chain reaction with specific primers and probes to detect bacterial DNA from several oral species and Chlamydia pneumoniae. The median value for the total amount of bacterial DNA in thrombi was 16 times higher than that found in their blood samples. Bacterial DNA typical for endodontic infection, mainly oral viridans streptococci, was measured in 78.2% of thrombi, and periodontal pathogens were measured in 34.7%. Bacteria-like structures were detected by transmission electron microscopy in all 9 thrombus samples analyzed; whole bacteria were detected in 3 of 9 cases. Monocyte/macrophage markers for bacteria recognition (CD14) and inflammation (CD68) were detected in thrombi (8 of 8) by immunohistochemistry. Among the subgroup of 30 patients with myocardial infarction examined by panoramic tomography, a significant association between the presence of periapical abscesses and oral viridans streptococci DNA-positive thrombi was found (odds ratio, 13.2; 95% confidence interval, 2.11-82.5; P=0.004). Conclusions-Dental

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“…(7,21) However, it appears that oral hygiene involving 2% chlorhexidine and toothbrushing alone does not prevent VAP in heterogeneous populations of severely ill, intubated patients and thus should be performed in combination with other preventative measures. (10) One such set of preventative measures reduced pneumonia in 89.7% of the studied patients.…”

Section: Discussionmentioning

confidence: 99%

Uso de clorexidina 2% gel e escovação mecânica na higiene bucal de pacientes sob ventilação mecânica: efeitos na pneumonia associada a ventilador

Meinberg¹,

Cheade²,

Miranda³

et al. 2012

Rev. bras. ter. intensiva

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ObjectiveTo evaluate the effects of oral chlorhexidine hygiene with toothbrushing on the rate of ventilator-associated pneumonia in a mixed population of critically ill patients under prolonged mechanical ventilation. MethodsProspective, randomized, and placebo-controlled pilot study. Patients who were receiving mechanical ventilation, had been admitted less than 24 hours prior, and were anticipated to require mechanical ventilation for more than 72 hours were included in the study. The patients were randomly divided into one of the following groups: chlorhexidine hygiene with toothbrushing or a placebo group (gel with the same color and consistency and toothbrushing). ResultsThe planned interim analysis was conducted using 52 patients, and the study was terminated prematurely. In total, 28 patients were included in the chlorhexidine / toothbrushing group, and 24 patients were included in the placebo group. Ventilator-associated pneumonia occurred in 45.8% of the placebo group and in 64.3% of the chlorhexidine hygiene with toothbrushing group (RR=1.4; 95% CI=0.83-2.34; p=0.29). ConclusionBecause the study was terminated due to futility, it was not possible to evaluate the impact of oral hygiene using 2% chlorhexidine and toothbrushing on the incidence of ventilator-associated pneumonia in this heterogeneous population of critical patients receiving long-term mechanical ventilation, and no beneficial effect was observed for this intervention.

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Invasion of human aortic endothelial cells by oral viridans group streptococci and induction of inflammatory cytokine production

Cited by 52 publications

References 35 publications

Contribution of Streptococcus mutans Strains with Collagen-Binding Proteins in the Presence of Serum to the Pathogenesis of Infective Endocarditis

Contribution of Streptococcus mutans Strains with Collagen-Binding Proteins in the Presence of Serum to the Pathogenesis of Infective Endocarditis

Bacterial Signatures in Thrombus Aspirates of Patients With Myocardial Infarction

Uso de clorexidina 2% gel e escovação mecânica na higiene bucal de pacientes sob ventilação mecânica: efeitos na pneumonia associada a ventilador

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