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Mutans streptococci (MS) are generally considered to be the principal etiological agent of dental caries. MS have two important virulence factors: cell- surface protein PAc and glucosyltransferases (GTFs). GTFs have two functional domains: an N-terminal catalytic sucrose-binding domain (CAT) and a C-terminal glucan-binding domain (GLU). A fusion anti-caries DNA vaccine, pGJA-P/VAX, encoding two important antigenic domains, PAc and GLU, of S. mutans, was successful in reducing the levels of dental caries caused by S. mutans in gnotobiotic animals. However, its protective effect against S. sobrinus infection proved to be weak. Does the DNA vaccine need an antigen of S. sobrinus to enhance its ability to inhibit infection? To answer this question, in this study, we cloned the catalytic (cat) fragment of S. sobrinus gtf-I, which demonstrated its ability to inhibit water-insoluble glucan synthesis by S. sobrinus, into pGJA-P/VAX to produce a new anti-caries DNA vaccine.

Glucosyltransferases (GTFs) and A cell-surface protein (PAc) are two important virulence factors of the cariogenic organism Streptococcus mutans. They may mediate sucrose-independent or sucrose-dependent attachment of Streptococcus mutans to tooth surfaces, respectively. Thus, inhibiting both virulence factors is predicted to provide better protection against caries than inhibiting a single factor. To develop a highly efficient vaccine against caries, we constructed a fusion DNA vaccine, pGLUA-P, by cloning the GLU region of GTF into a DNA vaccine, pCIA-P, which encodes two highly conservative regions of PAc. In this report, we provide evidence that fewer caries lesions were observed in rats following subcutaneous injection of pGLUA-P, compared with pCIA-P, near the submandibular gland. Our findings suggest that a multigenic DNA vaccine may be more caries-preventive than a single-gene DNA vaccine.

Four hybrid cell lines secreting monoclonal antibodies (McAbs) against glucosyltransferase synthesizing water-insoluble glucan (GTase-I) were generated by fusion of myeloma cells (P3U1) with splenocytes from mice immunized with GTase-I from Streptococcus sobrinus B13-N. Cell lines 29E7, 21GC7, and 42HB8 were found to secrete an IgG2a-type immunoglobulin, and 29EG, an IgM-type immunoglobulin. These two isotypes of McAbs were used for the determination of the binding sites on the GTase molecule, with use of an enzyme-linked immunosorbent assay. The binding site for McAb 29EG was different from the site that bound other McAbs. McAb 29EG was found to inhibit water-insoluble glucan synthesis by GTase-I by 50%, and 29E7 was found to inhibit it weakly. However, other McAbs did not show any inhibitory effect in spite of binding to GTase-I. McAb 42HB8 strongly inhibited GTase-I-mediated adherence of heat-killed cells of S. sobrinus B-13N to glass surfaces. When the McAbs were tested for their cross-reactivity among GTase preparations from different mutans streptococci, McAb 29EG reacted with S. cricetus and S. sobrinus, but not with other mutans streptococci. Three other McAbs, 21GC7, 29E7, and 42HB8, were found to react only with the enzyme from S. sobrinus. These findings indicated that the specificity of the McAbs studied varied with respect to the antigenic sites on the GTase-I molecule, and that some of the sites differed in their functions.

Streptococcus mutans possesses the abilities to adhere to pellicle-coated tooth surfaces and to form acids - two characteristics associated with the cariogenicity of this micro-organism. De novo synthesis of insoluble glucan by S. mutans glucosyltransferase from sucrose is essential in the adherence process. Therefore, agents which interfere with the adherence ability of S. mutans would be useful for controlling dental caries. In the present report, we have summarized our recent findings concerning virulence factors of S. mutans and means for prevention of S. mutans-induced dental caries.

The feasibility of immunizing monkeys with enzymes from oral streptococci in an attempt to reduce dental caries was investigated. Forty rhesus monkeys, Macaca mulatta, were used. Cariogenic streptococci, S mutans, were implanted into all the monkeys' mouths. There was no pathological effect resulting from immunization. Of the 40 animals, 30 retained the implanted flora throughout the experiment; the remaining 10 were reimplanted until the streptococci remained. In six months, gross carious lesions were evident with plaque. Inhibitiors present in the monkey sera after immunization inhibited glucosyltransferase, fructosyltransferase, and neuraminidase activities. It was presumed the inhibitors were antibodies. There was a reduction of 68.6% in the total carious lesions in the animals immunized intraorally with glucosyltransferase, 62.4% reduction in those injected with fructosyltransferase, and 57.4% reduction in total lesions in those immunized with glycosidic hydrolases after 19 months, as compared to the control group. There were no gross lesions apparent in the group immunized with glycosidic hydrolases. It appears that immunization with enzymes significantly reduces carries and is feasible in a primate model.

A demonstration that antiserums from monkeys immunized with fructosyltransferase and glucosyltransferase reduced the activities of the enzymes in producing glucans and levans was done. The nature of the inhibiting factor has not yet been identified. The local immunization of monkeys with glycosidic hydrolases produced a sufficient amount of inhibiting principle, presumably antibody, to inhibit neuraminidase one month after the first immunization and this degree of immunization, which reached degrees of 50%, remained constant throughout 11 months of immunization of these monkeys. The immunizing principle has not yet been found in saliva. A criterion for the feasibility for immunization has been met. A significant reduction in streptoccal glucosyltransferase, fructosyltransferase, and neuraminidase activity was noted after immunization with enzymes.

Antibodies to S. salivarius, S. sanguis, and S. mutans cells and to glucosyltransferases (GTF) prepared from these micro-organisms were measured in the sera of 133 infants and children by enzyme-linked immunosorbent assay (ELISA). IgG antibody activity to each cell type and GTP was present at birth (presumably derived from maternal transfer) and declined significantly thereafter. IgG antibody levels to S. salivarius and S. sanguis were next detected in young children (2 to less than 3 yr group). However, an increase in IgG antibody to S. mutans cells was not seen until children were older (4 to less than 8 yr group), possibly reflecting the later colonization of this organism. In contrast, IgG antibody to GTF of all three streptococcal species remained at low levels throughout the first four years of life. IgG antibody to S. mutans GTF was then the first to appear (4 to less than 8 yr group). Serum IgA antibodies to all GTFs were not detected until after this time. Fifteen sera were used to develop IgG immunoblots with the GTF antigens. Some positive sera (7/12) demonstrated reaction(s) with GTF from each of the three streptococcal species. Individual sera showed IgG antibody bonds to GTF from several serotypes of the mutans streptococci. No immunoblot reaction was observed with GTF and sera (3) from the four-to-seven-year and younger age groups. These results indicate the presence of serum antibody to bacteria and bacterial products associated with plaque formation very early in life and during and after the pre-adolescent years. The potential exists for this serum antibody to modulate bacterial colonization or accumulation in the oral cavity.

Taken together, the immunization experiments which have been performed in the rat caries model system appear to suggest a correlation between the presence of salivary antibody to S mutans and reductions in caries caused by these bacteria. However, the multifactorial nature of this disease does not permit at present the conclusion that the presence of this antibody is both necessary and sufficient to give rise to the demonstrated effects on pathogenesis. To clarify the role of salivary antibody, several refinements may be required in the current model. Immunization procedures that elicit only a local antibody response would both simplify interpretations of effects and would be more desirable for use as a vaccine. Such procedures might include intraductal installation of antigen in the parotid gland which has been demonstrated to result in this type of response. An additional refinement stems from the knowledge that the kinds of immunization procedures currently used stimulated both cellular immune and soluble antibody systems, potentially giving rise to a rather broad spectrum of immune responses. Therefore, it might be useful to study the effects on S mutans pathogenesis in rats in which certain of these responses have been repressed, for example, by thymectomy, antilymphocyte serum, and so on. Also, each of these approaches would be measurably enhanced by more sensitive techniques to monitor immunological events in the oral cavity. Refinements in the selection and use of relevant antigens of S mutans also are necessary to delineate the in vivo mechanism of immunological interference in the pathogenesis of cariogenic streptococci. Approaches involve the use of purified GTF antigens or cell surface antigens both in the investigation of these mechanisms in in vitro models using antibody specifically directed to these antigens and in rat immunization experiments using immunogenic preparations of these materials. In addition, alterations in the diet and challenge dosage of infecting cariogenic organisms might permit more sensitive detection of effects in vivo. Clearly, the evidence suggests immunological interference with S mutans pathogenesis in the rat model system. However, several gaps exist in our basic understanding of this interference and of the appropriate system in which to observe these effects. The potential significance of this phenomenon should spur efforts to fill these gaps to establish definitively the role of immunity as an ecological determinant in the oral cavity.

The distribution of immunoglobulin-containing cells in human tonsils, salivary glands, and inflamed gingiva is described. The cellular localization of J chain indicates that this peptide is a basic gene product of B cells that is expressed only in the early phase of clonal differentiation. Gland-associated immunocytes apparently are derived from this phase, which may be relevant to their local homing mechanism. The selective glandular transport of dimeric or polymeric IgA and 19S IgM may be determined by the content of J chain in these immunoglobulins. A J-chain-dependent configuration seems to be responsible for their noncovalent affinity for SC, and this may explain their specific reception at the epithelial cell membranes. Subsequent stabilization of the Ig-SC complexes takes place during their external transport, probably because of disulfide exchange. The latter process is more efficient for secretory IgA than for secretory IgM. The secretory dynamics of parotid IgA differs from that of other parotid proteins and is highly dependent on the degree of secretory stimulation. The secretion rate (mug/min/gland) seems to be a better measure of an individual's parotid IgA output than the absolute concentration of IgA in the secretion. A low parotid IgA secretion rate is associated with high susceptibility to dental caries, perhaps reflecting inferior resistance to dental plaque formation. It is not known whether such resistance, in part, is determined by specific antibodies to certain bacterial antigens. A potential candidate for an efficient preventive action of salivary antibodies could be the GTF enzyme system of S mutans. However, we were able to demonstrate only extremely rare immunocytes producing antibodies to GTF in human tonsils and gingiva, and none at all in salivary glands.