The appearance of biofilms on the tooth surface is associated with complex host-bacterial interactions with dietary constituents found in the oral cavity, which may also modulate the development of pathogenic biofilms related to the disease of dental caries. The combination of sucrose and starch is highly cariogenic
in vivo [6]–
[8], and their simultaneous consumption may be linked with caries activity in adolescent population
[33]. The interactions of starch and sucrose with salivary α-amylase and streptococcal Gtfs could enhance the formation and virulence of biofilms by modulating exopolysaccharides synthesis, sugar metabolism and acidogenicity of
S. mutans [10],
[14],
[15],
[16]. To further advance our previous findings, we conducted a detailed and comprehensive global transcript analysis in biofilms at distinct developmental stages using cDNA microarray in conjunction with a computational tool (MDV) for data mining.
The results indicate that the presence of starch and sucrose resulted in dynamic remodeling of the transcriptome of
S. mutans within biofilms, which may be related to changing environmental conditions associated with gradual digestion of starch by amylase in the salivary pellicle (as would occur
in vivo). Initially, the hydrolysates are mostly large oligosaccharides with average DP and MW of 132.5 and 21.5 kDa (after 1 h digestion) that are further digested to 14.4 kDa (between 1–2 h) and then to smaller 1.45 kDa oligomers. Concomitantly, the proportions of maltose and maltotriose rapidly increase overtime; sucrose, of course is readily available for bacterial metabolism in the culture medium. The 10 to 20 kDa oligosaccharides present at the early stages of starch digestion can be incorporated during glucan synthesis by GtfB in the presence of sucrose through acceptor-reactions
[9],
[10],
[34]. The presence of additional acceptors could be sensed by
S. mutans resulting in upregulation of
gtfB in suc+st-biofilms since the starch oligomers act as primers for glucan synthesis by GtfB but not for other Gtf enzymes
[10], which corroborates with lack of effect on
gtfC and
gtfD expression
[16]. The increased synthesis of GtfB-type insoluble glucans triggers the formation of microcolonies by
S. mutans [21], which increase the coherence and thickness of the biofilms, and thereby influencing their architecture, diffusion properties and pathogenicity
[16],
[21],
[23],
[35].
Conversely, the increasing availability of maltose and maltotriose released from continuous starch hydrolysis could explain the elevated levels of expression of genes related to maltose uptake (e.g. malE, msmK) as the biofilms transit from 21 to 30 h of development. The increased availability of metabolizable carbohydrates contributes with the acidification of the suc+st-biofilms overtime which may also influence the expression of gtfB. Furthermore, as the environmental pH falls due to acid production by S. mutans and glucans are synthesized, the pathways required for optimal metabolism and survival of S. mutans in biofilms may be switched leading to extensive changes of the gene expression profile at 30 h of biofilms formation when compared to other time-points.
The microarray analysis identified four major themes by which
S. mutans in biofilm-mode responds to changing environmental conditions
in situ as a result of the interplay of host-diet-bacterial factors: (1) modulation of genes associated with extracellular matrix assembly-development, (2) sugar uptake and glycogen metabolism, (3) stress responses and (4) regulation of a large number of uncharacterized genes. Here, we focused our data analysis on sucrose and starch influences on extracellular matrix development and sugar metabolism in order to connect with our previous findings
[15],
[16], and because these processes are critical for
S. mutans virulence.
lytT and extracellular matrix formation in the presence of sucrose and starch
Our data indicate that upregulation of
lytT may be associated with release of eDNA and its potential role on the development of extracellular matrix in suc+st-biofilms. The
lytT gene encodes for the response regulator of the LytST TCS and has been implicated in bacterial autolysis
[29],
[30] and subsequent release of DNA to the extracellular environment. The TCS LytST (encoded by genes SMU.576 and SMU.577) is required for the activation of expression of
lrgAB genes, which are part of
S. mutans arsenal to control autolysis and biofilm formation, and may be regulated according to availability of different carbohydrates sources via CcpA (carbon catabolite protein A)
[30]. The
ccpA gene was also upregulated in suc+st-biofilm at 30 h indicating that the presence of undigested starch, starch hydrolysates and sucrose may be modulating autolysis (and DNA release), in part through simultaneous expression of
lytT and
ccpA genes.
Notably, eDNA was established as a critical structural component of biofilm matrix for several bacterial pathogens, including
Pseudomonas aeruginosa [27],
[31],
[32]. We found that the presence of DNAse I significantly disrupted the biomass and further accumulation of the biofilm in the presence of sucrose and starch (but not in sucrose grown-biofilm). The data agree well with previous findings showing that eDNA enhances
S. mutans adhesion, surface aggregation and strengthens the matrix
[36],
[37]. Clearly, eDNA from
S. mutans may play an important role in the establishment and integrity of extracellular matrix of suc+st-biofilms.
The combined effects of starch and sucrose on DNA release and enhanced synthesis of GtfB-insoluble glucans could explain the formation of a distinctive extracellular matrix in suc+st-biofilms
[21], which display more cross-linked (web-like) exopolysaccharides tightly attached to bacterial cells (vs. suc-biofilms). The eDNA could be incorporated during extracellular matrix development by binding to bacterial cell and to exopolymers
[36],
[37], possibly bridging them and allowing further glucan deposition. The interplay between
lytT and
gtfB may explain the formation of a thicker and highly cohesive biofilms containing large microcolonies enmeshed in EPS-rich matrix in the presence of suc+st (vs. sucrose grown-biofilms) at later stages of development
[21]. Such structural organization could create chemical gradients because of the differential diffusion of nutrients, metabolic products and oxygen, affecting the microenvironmental conditions in the biofilms
[38],
[39].
Our data show that suc+st-biofilm at 30 h of development may be under decreased O
2 availability for
S. mutans cells as indicated by downregulation of TCA cycle genes (
citBZC), which are transcriptionally repressed under anaerobic conditions
[40]. In addition, the downregulation of these genes favors the fermentation process, as shown by the upregulation of
pdhA. In
S. mutans,
pdhA expression responds to conditions favorable to heterofermentation, and may be associated with aciduricity of this bacterium
[40]. Moreover, it has been established that high insoluble glucan content in the EPS matrix acts as a diffusion barrier, trapping acid near the tooth surface and thereby increasing the extent of the acidification period
[41],
[42] and the cariogenicity of human plaque
[43]. Consequently,
S. mutans growing in the presence of sucrose and gradual availability of starch hydrolysates may display enhanced aciduricity/growth efficiency as the redox potential and oxygen levels fall, and low pH microenvironments are created over the course of biofilm maturation
[44]. We are currently examining the exact location of eDNA in the matrix, and how the interplay between
gtfB and
lytT affect the development and diffusion properties of the extracellular matrix in suc+st-biofilms.
glg may be linked with enhanced intracellular polysaccharide storage in suc+st-biofilms
We observed an association between sugar uptake and intracellular polysaccharide (IPS) storage, possibly connecting the upregulation of gene
glg with increased amount of IPS in biofilms formed in the presence of starch and sucrose. Although the exact role of
glg in
S. mutans physiology is unknown, this gene encodes a glycogen phosphorylase, an enzyme that has been implicated in IPS formation
[45],
[46]. This finding is clinically relevant because this glycogen-like storage polymer is important for
S. mutans virulence and is associated with the pathogenesis of dental caries
[45]–
[47]. The IPS provide
S. mutans with endogenous source of carbohydrates which can be metabolized when exogenous fermentable substrate have been depleted in the oral cavity; as a result, IPS can promote the formation of dental caries in animals and humans by prolonging the exposure of tooth surfaces to organic acids and a concomitant lower fasting pH in the matrix of the plaque-biofilm
[45]–
[47]. Also, the reduction of IPS by therapeutic agents effectively reduced cariogenicity of
S. mutans in vivo [19],
[48]. Thus, the increased accumulation of IPS in addition to changes of the extracellular matrix composition-structure would contribute to the overall acidification at the biofilm-tooth enamel interface. Further studies shall elucidate the precise mechanisms by which starch and sucrose modulate IPS accumulation considering that genes of
glgPADCB operon (also involved with IPS metabolism) were not detected as differentially expressed in suc+st-biofilms suggesting a different pathway.
In addition to modulating these critical processes, the simultaneous presence of sucrose, undigested starch and varying types/amounts of starch hydrolysates may also act as environmental stressors for
S. mutans (osmotic stress), as shown by upregulation of
trkB (potassium uptake protein B) and
pacL (cation-transporting P-ATPase) genes
[49],
[50]; the activation of potassium uptake, for example, is related to an increase in medium osmolarity
[50]. By triggering these responses,
S. mutans can efficiently cope and rapidly adapt to changing conditions during the biofilm development observed in our model. This trait is highly relevant in the oral cavity, a dynamic habitat where the bacteria must deal with constant variations in the local environment conditions dictated by extrinsic and intrinsic factors (e.g. exposure of nutrients from host diet)
[2],
[51].
Clearly, the unique interaction of host- and bacterial-derived enzymes with dietary carbohydrates (sucrose and starch) resulted in extensive remodeling of S. mutans-transcriptome over the course of biofilm formation. These complex changes may induce the development of pathogenic biofilms by at least four interconnected ways: 1) increasing production of insoluble glucans and release of DNA which may be acting in concert for the development of a structurally cohesive extracellular matrix; 2) inducing the accumulation of IPS; 3) increasing activation of sugar uptake transport systems (e.g. maltose and maltotriose) which can be further metabolized into acids; and 4) modulating the expression of genes associated with osmotic stress, TCA cycle and fermentation. The combined effects would result in biofilms with increased biomass with low oxygen and highly acidic environment that are cohesive and tightly adherent to the surface, thereby enhancing S. mutans survival/persistence and cariogenicity.
Overall, our data provided new information about the remarkable plasticity of the transcriptome of S. mutans and its adaptive response to changing environmental conditions within biofilms, which is the mode of growth associated with virulence of this bacterium in the oral cavity. Our comprehensive analysis may provide new leads for molecular pathogenesis research with S. mutans, especially in the light of the large number of genes with unidentified function that may reveal new metabolic pathways and/or virulence factors associated with cariogenic biofilm formation. Further studies using both parental and/or mutant strains of S. mutans in the presence of α-amylase binding organisms (e.g. S. gordonii) should elucidate the exact role of the uncharacterized genes on their ability to survive and compete in a multispecies system.