c Streptococcus oralis, an oral commensal, belongs to the mitis group of streptococci and occasionally causes opportunistic infections, such as bacterial endocarditis and bacteremia. Recently, we found that the hydrogen peroxide (H 2 O 2 ) produced by S. oralis is sufficient to kill human monocytes and epithelial cells, implying that streptococcal H 2 O 2 is a cytotoxin. In the present study, we investigated whether streptococcal H 2 O 2 impacts lysosomes, organelles of the intracellular digestive system, in relation to cell death. S. oralis infection induced the death of RAW 264 macrophages in an H 2 O 2 -dependent manner, which was exemplified by the fact that exogenous H 2 O 2 also induced cell death. Infection with either a mutant lacking spxB, which encodes pyruvate oxidase responsible for H 2 O 2 production, or Streptococcus mutans, which does not produce H 2 O 2 , showed less cytotoxicity. Visualization of lysosomes with LysoTracker revealed lysosome deacidification after infection with S. oralis or exposure to H 2 O 2 , which was corroborated by acridine orange staining. Similarly, fluorescent labeling of lysosome-associated membrane protein-1 gradually disappeared during infection with S. oralis or exposure to H 2 O 2 . The deacidification and the following induction of cell death were inhibited by chelating iron in lysosomes. Moreover, fluorescent staining of cathepsin B indicated lysosomal destruction. However, treatment of infected cells with a specific inhibitor of cathepsin B had negligible effects on cell death; instead, it suppressed the detachment of dead cells from the culture plates. These results suggest that streptococcal H 2 O 2 induces cell death with lysosomal destruction and then the released lysosomal cathepsins contribute to the detachment of the dead cells.
Streptococcus oralis, a commensal bacterium in the oral cavity, belongs to the group of oral inhabitants of the mitis group of streptococci (1-4). Members of this group, including Streptococcus sanguinis and Streptococcus gordonii, are dominant colonizers of human teeth and are involved in dental plaque formation (1-3). Pathogenic streptococcal species, such as Streptococcus pneumoniae and Streptococcus mitis, are also members of the mitis group (2, 4-6). This group has been implicated as a possible cause of human cardiovascular diseases, including infective endocarditis and atherosclerosis. S. oralis is frequently isolated from cases of infective endocarditis (7-10), and ribosomal DNAs of the mitis group were detected in atheromatous plaque (11). The rate of bacteremia caused by members of the mitis group of streptococci is comparable to that caused by group A or B streptococci (12).The members of the mitis group of streptococci produce hydrogen peroxide (H 2 O 2 ) (2, 13, 14), which is important in bacterial competition in microbial communities, such as oral biofilms (13,14). S. sanguinis and S. gordonii produce H 2 O 2 in quantities sufficient to reduce the growth of many oral bacteria, including the cariogenic bacterium Strepto...