CONCLUSIONS
1. Zinc is a potent inhibitor of respiration, especially that involving NADH oxidase
in oral streptococci and is also an inhibitor of oxygen metabolism of the oral anaerobe F.
nucleatum.
2. Zinc is an inhibitor for a number of enzymes considered to be protective against
oxidative damage and appears to have an overall pro-oxidant action on oral bacteria.
3. Zinc is concentrated from the environment by S. mutans UA 159 in a pH dependent manner that mimics the pH dependence of anti-bacteria action with high potency at
pH 7.0 and declining potency at the pH value was lowered to 4.0.
4. Zinc has multiple targets for inhibition of oral bacteria, and as shown here, these
targets include enzymes involved in oxidative metabolism.
Acknowledgements. This work was supported by awards R01 DE 13683 and R01 DE
06127 from the U.S. National Institute of Dental and Craniofacial R
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Advances in Natural Sciences, Vol. 7, No. 1& 2 (2006) (131– 138)
Biotechnology
ZINC EFFECTS ON OXIDATIVE PHYSIOLOGY OF ORAL
BACTERIA
Nguyen Thi Mai Phuong
Institute of Biotechnology, VAST
Phan Tuan Nghia
Vietnam National University
Robert E. Marquis
University of Rochester Medical Center, New York, USA
Abstract. Zinc is used as an anti-gingivitis agent in oral care products and affects multiple tar-
gets in oral bacteria. We found that it acts also to suppress respiration of oral streptococci and of
Fusobacterium nucleatum, an organism associated with development of gingivitis. Zinc as either
the sulfate or citrate chelate was a potent inhibitor of respiration of the oral streptococci Strep-
tococus mutans GS-5 or UA 159 and S. sanguis NCTC 10904. 50% inhibitory concentrations for
intact cells in suspensions were below 0.3 mM with nearly complete inhibition of O2 metabolism
at higher zinc levels. 1.0 mM Zn2+ inhibited O2 utilization by F. nucleatum ATCC 25586 by some
50%, but almost 40% of O2 metabolism by the anaerobe was not Zn sensitive. NADH oxidase
plays the major role on O2 utilization by oral streptococci and is also important for F. nucleatum.
In cell extracts of streptococci, the 50% inhibitory concentration (IC50) of Zn
2+ for NADH oxidase
activity ranged from ca. 2.1 mM for S. sanguis NCTC 10904 to 3.0 mM for the GS-5 strains of S.
mutans. The enzyme in extracts of F. nucleatum was somewhat more Zn sensitive with an IC50
value of 1.4 mM. S. sanguis is a major generator of H2O2 in dental plaque. Zn
2+acted to reduce
peroxide production assessed with use of horseradish-peroxidase and leuco-crystal violet. 0.1 mM
ZnSO4 was more than 50% inhibitory for cells in suspensions or mono-organism biofilms. Zinc is
primarily bacteriostatic rather than bactericidal, and inhibition was at least partially reversible
after zinc removal. Zinc was inhibitory also for the protective enzymes thiolperoxidase (IC50= 0.1
mM), hypothiocyanite reductase (IC50 = 0.1 mM) and glutathione reductase (IC50 = 0.4 mM).
Zinc acted mainly as a pro-oxidant for oral bacteria inhibiting NADH oxidase, considered to be
protective against oxidative stress, and also other protective enzymes. This view is supported by
findings of zinc enhanced peroxide killing of the organisms.
Abbreviations. Reactive oxygen species (ROS), NADH oxidase (NOX), NADH hypothiocyanite
reductase (NHOR), glutathione reductase (GR), thiolperoxidase (TSA), catalase (CAT), pseudo-
catalase (PCAT), superoxide dismutase (SOD), 50% inhibitory concentration (IC50).
1. INTRODUCTION
Bacteria in dental plaque are subjected to oxidative stress caused by reactive oxy-
gen species (ROS), including hydrogen peroxide, produced as a result of plaque oxygen
metabolism or contained in oral care products (Marquis, 1995). Oxygen itself has only
minimal capacity directly to cause oxidative damage to cells, although it can be damaging
for iron-sulfur clusters in some organisms (Imlay, 2003). However, metabolism of oxygen
generally results in production of a variety of toxic oxygen species such as superoxide
radical (O−2 ) and hydrogen peroxide (H2O2). Hydrogen peroxide and superoxide radical
132 Nguyen Thi Mai Phuong, Phan Tuan Nghia, and Robert E. Marquis
can take part in the Fenton reactions to yield the highly toxic hydroxyl radical (OH·).
The ROS can react with proteins, nucleic acids and lipids with resulting oxidative dam-
age. A variety of protective enzymes act during oxidative stress to eliminate ROS or to
repair oxidative damage, including superoxide dismutase, NADH peroxidase, glutathione
reductase, thiolperoxidase and NADH hypothiocyanide reductase. NADH oxidase also is
considered to be a protective enzyme if water rather than H2O2 is the end product.
Zinc is used in oral healthcare, mainly as zinc citrate, as an anti-gingivitis agent
against bacteria such as Fusobacterium nucleatum and Prevotella intermedia, and also
against caries caused by mutans streptococci. Zinc also has been found to be effective
against oral anaerobes involved in periodontal diseases. Levels of zinc in dental plaque
have been found to be about 2.5 mmole/g or 2.5 mmole/ml after use of zinc-containing
toothpaste (Creeth, 1993). Moreover, zinc is considered to be a major antioxidant for an-
imal cells (Powell, 2000; Zago and Oteiza, 2001). Mechanisms for its antioxidant actions
include interactions with sulfhydryl groups to protect them against oxidation and compe-
tition between zinc and reduced transition metal cations resulting in reduced production
of hydroxyl radicals. Zinc can act as an antioxidant also for bacterial cells. For example,
Gaballa and Helmann (2002) found that increased intracellular levels of zinc protected
cells of Bacillus subtilis against agents such as thiol-oxidizing diamide. Zinc also pro-
tected the cells against damage by hydrogen peroxide but protection depended very much
on catalase, which was upregulated in association with a peroxide-induced PerR regulon.
However, an antioxidant role of zinc in oral bacteria has not been identified .
The focus of our study is on zinc effects on the oxidative metabolism of oral strep-
tococci associated with dental caries and of Fusobacterium nucleatum associated with
gingivitis.
2. MATERIALS AND METHODS
2.1. Zinc uptake by S. mutans UA 159 in suspension
Cells were harvested from early stationary-phase cultures and washed once with salt
solution containing 50 mM KCl and 1mM MgCl2. The cells were resuspended in 20 mM
Tris-HCl or acetate buffer at the indicated pH values. At intervals, 1 ml of cell suspension
was mixed with silicone oil and centrifuged. Zinc in the pellets were extracted with 0.3 M
HCl solution and assayed by means of atomic absorption spectrophotometry.
2.2. Oxygen metabolism by oral bacteria
For suspensions, cells were prepared as for zinc uptake experiments and resuspended
in 20 mM Tris-HCl buffer, pH 7.0, containing 0.1% glucose. Oxygen levels were measured
with a standard oxygen electrode (VWR) as described by Caldwell and Marquis (1999).
Biofilms of S. mutans UA 159 were formed on glass slides in medium containing 3%
tryptone, 0.5% yeast extract and 1% sucrose. The intact biofilms were washed with
salt solution and placed in 20 mM Tris-HCl buffer, pH 7.0, plus 0.2% glucose. Oxygen
metabolism was measured with a standard oxygen electrode as for cells in suspensions.
Zinc Effects on Oxidative Physiology of Oral Bacteria 133
2.3. H2O2 production by S. sanguis ATCC 10904
Cells in suspensions and biofilms were prepared as for respiration assays in 20 mM
Tris-HCl buffer, pH 7.0. H2O2 levels were assessed with use of horseradish peroxidase and
leuco-crystal violet (Motolla et al, 1970).
2.4. Killing of S. mutans UA 159
Cells for the killing assay were suspended in 1% peptone at pH value of 7.0. The
treated cells were sampled at intervals and diluted immediately in 1% peptone broth before
plating on Difco tryptic soy agar as described by Dunning et al. (1998).
2.5. Enzymes assays
NADH oxidase (Pool and Claiborne., 1986.), SOD (McCord and Fridovich., 1969),
CAT and PCAT (Thibodeau and Keef, 1990), NHOR (Courtois and Pourtois, 1996), GR
(Bazzichi et al., 2002), TSA (Park., 2000).
3. RESULT AND DISCUSSION
3.1. Uptake of zinc by oral bacteria
It is noted that zinc is transported into cell cytoplasm where it reacts with multiple
targets and consequently, results in the damage of the cells. Zinc is usually taken up into
the cells by vehicles like chelators or transport systems. We have studied the uptake of zinc
by S. mutans UA159 using AAS. Initial experiments were performed with cells of S. mutans
UA159 grown in suspension cultures with excess glucose. The data in Fig.1A, showed that
zinc was taken up by the organism by a saturable process. In the concentration range
from 0 to about 1 mmolar, the rate of uptake at pH 7 increased linearly with increasing
initial concentration of zinc sulfate. Then, at higher concentrations, the uptake diminished
relative to further increases in initial concentration of zinc sulfate to level off at about 2.5
µmol Zn2+ taken up per minute per mg cell dry weight. The uptake of zinc from zinc
citrate did not differ appreciably from that of zinc sulfate (data not shown). The uptake
was pH sensitive with greater uptake at pH 7.0, compared with that at pH values of 6.0,
5.0 or 4.0 (Fig. 1B). Zinc has generally been found to have greatest antimicrobial activity
at pH values close to neutrality and to have somewhat diminished activity at more acid
pH values. At least part of this decline in antimicrobial activity is likely to be due to
reduced uptake of the metal.
3.2. Zinc inhibition of respiration by oral bacteria
Oral streptococci are capable of high levels of respiration (oxygen metabolism) but
do not have electron transport systems in their membranes to be able to carry out oxidative
phosphorylation. The need for respiration unconnected to oxidative phosphorylation is still
somewhat of a mystery, although it may have to do with cell needs for oxidized NAD+
to act as an electron acceptor, for example, in glycolysis. Other oral bacteria would be
expected to have at least moderate respiratory capacities, including obligate anaerobes.
As shown by the graphs presented in Fig. 2, zinc sulfate inhibited respiration of intact
cells of S. mutans UA159, S. sanguis NCTC 10904, S. mutans GS-5 or F. nucleatum
134 Nguyen Thi Mai Phuong, Phan Tuan Nghia, and Robert E. Marquis
(a) (b)
Fig. 1. Zinc uptake from zinc sulfate by S. mutans UA159 in suspension. (a): Up-
take is a saturable process. (b): Uptake is sensitive to pH.
ATCC 25586. The mutans streptococci (Fig. 2A) appeared to be the most sensitive with
50% inhibitory concentrations of about 0.3 mM and with only a low level of respiration
largely insensitive to zinc. Respiration of S. sanguis showed a more complex response to
zinc with part of respiration as sensitive as that of the mutans streptococci, part with
intermediate sensitivity and a significant component with low zinc sensitivity. Respiration
of F. nucleatum (Fig. 2B) showed both zinc sensitive and zinc insensitive components.
About 60% of O2 utilization by this organism was inhibited by Zn while the remaining
40% was not. This may account for the higher IC50 (ca.1 mM) for respiration rate of
this organism. The data show that mutans streptococci are the most sensitive with 50%
inhibitory concentration (IC50) of ca. 0.3 mM, while IC50 of F. nucleatum was 1.0 mM.
The same patterns for inhibition of respiration were obtained with zinc citrate (data not
shown). The cells on biofilms were also sensitive to zinc sulfate with IC50 of about 75 mM,
much higher compared to suspension cells (Fig. 2C).
NADH oxidase plays the major role in O2 utilization by oral streptococci (Higuchi
et al, 1999) and also is important for F. nucleatum. This enzyme is very active in this
anaerobe and thought to be the key enzyme for the growth of F. nucleatum in oxygen
conditions as well as for producing a reducing environment for growth of obligately anaer-
obic organisms like P. gingivalis and P. intermedia (Diaz et al, 2002). The data (Fig 3.)
showed that NADH oxidase of oral bacteria was sensitive to zinc with IC50 of about 1.4
mM for F. nucleatum, 2.1 mM for S. sanguis and 3.0 mM for S. mutans. The cells in
biofilms were also sensitive to zinc, but higher zinc concentrations were required for the
same level of inhibition compared to cells in suspensions (data not shown). The results
suggest that the repressed respiration of cells in suspensions and biofilms is due mainly to
inhibition of NADH oxidase. Respiration is source of toxic products such as ROS. ROS is
considered to be toxic for host cells. The finding that zinc inhibits the respiration of oral
bactreria indicated that zinc reduced ROS and therefore is an anti-oxidant in terms of in-
hibition of respiration. However, respiration is in part dependent on zinc-sensitive NADH
Zinc Effects on Oxidative Physiology of Oral Bacteria 135
(a) (b) (c)
Fig. 2. Zinc inhibition of respiration of oral bacteria. (a): Streptococci; (b): F.
nucleatum ATCC 25586; (c): Biofilms of S. mutans UA159. 100% respiration =
6.4, 3.7, 2.1, 1.7 0.66 nmoles O2 utilized/min/mg cell dry weight, respectively for
S. mutans GS-5, S. mutans UA 159, S. sanguis NCTC 10904 and F. nucleatum
ATCC 25586 and biofilms of S. mutans UA159.
oxidase, which function in recycling NADH back into metabolism as NAD+, which can
then serve as a receptor for reducing equivalents from glycolysis. Therefore, the sensitivity
of NADH oxidase could cause metabolic problems.
Fig. 3. Zinc inhibition of NADH oxidase. 100% activity = 0.056, 0.052, 0.032,
0.041 units/mg proteins, respectively for S. mutans GS-5, S. mutans UA 159, S.
sanguis and F. nucleatum
3.3. Zinc inhibition of H2O2 production by oral bacteria
Streptococci possess two types of NADH oxidase: H2O2-yielding NADH oxidase (is
denoted NOX-1) and H2O yielding NADH oxidase (is denoted NOX-2). In S. mutans GS-
5, NOX-2 is a dominant enzyme and NOX-1 is an AhpCF (alkylhydroperoxide reductase)
meaning that it can both produce and degrade H2O2. H2O2 production offers a competitive
136 Nguyen Thi Mai Phuong, Phan Tuan Nghia, and Robert E. Marquis
advantage for bacteria in dental plaque and net H2O2 producers such as S. sanguis, S.
gordonii, S. mitis. We found that Zn reduced the H2O2 production by S. sanguis 10904
in both planktonic and biofilm cells (Fig 4A). S. sanguis is a major H2O2 generator in
dental plaque, and 0.1 mM zinc was more than 50% inhibitory for H2O2 production by
cells in suspension. Biofilms were more resistant to zinc with IC50 value of ca. 0.5 mM
(Fig. 4B). The inhibition of NADH oxidase of S. sanguis, as shown in Fig. 3, is likely to
be the basis for reduced H2O2 production by this organism.
(a) (b)
Fig. 4. Zinc inhibition of H2O2 production by S. sanguis ATCC 10904.
(a): Suspensions; (b): Biofilms
3.4. Zinc inhibition of protective enzymes in oral bacteria
During oxygen metabolism, oral streptococci release reactive oxygen species includ-
ing superoxide radical and hydrogen peroxide, which can cause oxidative stress for the
bacteria. To protect the cells from the oxidative damage, a variety of protective enzymes
are synthesized. Table 1 presented major protective enzymes in oral bacteria. We exam-
ined the effect of zinc on the main enzymes including NHOR, GR, TSA, CAT, PCAT and
SOD. NOX also considered to be a protective enzyme against O2 toxicity because the final
product is water. The data in Table 1 indicated that not all protective enzymes including
two important enzymes CAT and SOD, were targets of zinc.
3.5. Zinc enhancement of H2O2 killing of oral bacteria
Fig. 5 showed that zinc enhanced H2O2 killing. However, very high levels of zinc
were required for enhancement, and there are some questions regarding the physiological
significance of this type of enhancement. When cells in suspensions were challenged with
H2O2 in presence of Zn, the killing was somewhat enhanced compared to those that were
exposed to H2O2 alone. The potential in enhancing toxicity of H2O2suggest that zinc is a
pro-oxidant and enhance oxidative stress in the bacteria. Data on inhibition of protective
enzyme activity presented above supported this finding.
Zinc Effects on Oxidative Physiology of Oral Bacteria 137
Table 1. Zinc inhibition of protective enzymes against oxidative damage
Enzymes Organisms Inhibition
level
IC50(mM)
NADH oxidase
NADH hypothiocyanite reductase (NHOR)
Glutathione reductase (GR)
Thiolperoxidase (TSA)
Catalase (CAT)
Pseudocatalase (PCAT)
Superoxide dismutase (SOD)
Streptococci
F. nucleatum
S. sanguis
S. mutans
S. mutans
A.viscosus
L. plantarum
Streptococci
+
+
+
+
+
-
-
-
2.1 - 3.0
1.4
0.1
0.4
0.1
Fig. 5. Zinc enhancement of oxidative killing of S. mutans UA 159 in suspension.
4. CONCLUSIONS
1. Zinc is a potent inhibitor of respiration, especially that involving NADH oxidase
in oral streptococci and is also an inhibitor of oxygen metabolism of the oral anaerobe F.
nucleatum.
2. Zinc is an inhibitor for a number of enzymes considered to be protective against
oxidative damage and appears to have an overall pro-oxidant action on oral bacteria.
3. Zinc is concentrated from the environment by S. mutans UA 159 in a pH depen-
dent manner that mimics the pH dependence of anti-bacteria action with high potency at
pH 7.0 and declining potency at the pH value was lowered to 4.0.
4. Zinc has multiple targets for inhibition of oral bacteria, and as shown here, these
targets include enzymes involved in oxidative metabolism.
Acknowledgements. This work was supported by awards R01 DE 13683 and R01 DE
06127 from the U.S. National Institute of Dental and Craniofacial Research.
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Received September 15, 2005.
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