The present study has uncovered specific microorganisms in mixed dental plaque that display potent gluten-degrading activity. The most efficient cleaving strains were identified as Rothia mucilaginosa and Rothia aeria. The data present evidence that even in the absence of gliadin pretreatment with mammalian digestive enzymes, gliadins (and by inference glutens) serve as a good substrate for Rothia associated bacterial enzymes and are rapidly cleaved. Importantly, major immunogenic epitopes that play a key role in celiac disease are also targeted by Rothia enzymes. The colonization of the oral cavity with microorganisms that produce glutamine endoproteases may not be surprising given that salivary proline-rich proteins as well as dietary wheat gluten proteins are prominent and abundant substrates in the oral cavity and an important factor in driving microbial colonization is nutrient substrate availability. The observations made suggest that Rothia bacteria may contribute to the digestive processing of immunogenic gluten proteins.
The human body is a major reservoir of a wide variety of microorganisms and their contribution to overall health and well-being of the host, including aspects of digestion, become more and more recognized
[28]. The human microbiome project, a multidisciplinary international research initiative, is aimed at characterizing the microbial composition of the entire human body
[29]. Among all human organ- and body-site specific microbiomes, the oral microbiome has been characterized most extensively (accessible at
www.homd.org)
[30]. The known microbiome of the oral cavity and its anatomically contiguous regions to date contains 619 taxa, derived from 13 phyla: Recently, an additional 36,043 gene clones were sequenced, identifying an additional 434 novel oral taxa which are candidates for addition to the database after validation
[31]. Among all oral microbial clones sequenced to date,
R. mucilaginosa ot 681 and
R. aeria ot 188 rank at #170 and #221 in order of abundance. Evidently, the selective GA plating approach applied in our study has significantly enriched for the
Rothia bacteria in the mixed oral samples.
R. mucilaginosa and
R. aeria belong to the
Rothia genus under the
Actinobacteria phyla.
Rothia species are Gram-positive bacteria, ovoid in shape and form clusters of cocci.
R. aeria, named after its isolation from air in the Russian space laboratory Mir
[32], is an oral colonizer
[31].
R. mucilaginosa also primarily colonizes the oral cavity
[33] but has furthermore been isolated from other body sites, including the upper respiratory tract and the duodenum
[34],
[35],
[36]. Colonization of the duodenum with gluten-degrading
Rothia species is of particular interest in view of the fact that mucosal damage in celiac disease is largely restricted to this region of the GI tract. Bacterial speciation of 2,247 clones recovered from 63 duodenal biopsies obtained from healthy and celiac patients showed that
R. mucilaginosa comprised ~6% of the clones and was present in ~65% of the biopsies, identifying it as a true colonizer of the duodenum
[36]. No significant differences were found in the number of
R. mucilaginosa clones from healthy and celiac patients (6.5% and 5.9% of clones, respectively). Likewise, the percent of healthy and celiac biopsies being positive for
R. mucilaginosa did not differ significantly from each other (64% and 67%, respectively)
[36]. It thus appears that
R. mucilaginosa colonizes the healthy and celiac-afflicted duodenum to the same extent. It will be of interest to also investigate
Rothia concentration differences in human saliva in view of the fact that the microbial colonization levels in the oral cavity far exceed those of the duodenum, and a large volume of saliva is swallowed each day (approximately 0.8–1.0 L).
The discovery of salivary microorganisms degrading dietary proteins
in vitro prompts the question to what extent such microorganisms play a role in food processing
in vivo. During mastication (chewing) foods are mixed with whole saliva helping to accelerate the break-down by digestive enzymes during the residency time in the oral cavity. Oral microorganisms in the swallowed food bolus may or may not survive and/or continue to exert proteolytic activities during or after gastric passage. Our
in vitro data with
R. aeria show that its enzymes are not abolished at acidic pH values, and are optimally active under more basic pH conditions.
In vivo, this could mean that during gastric passage the enzymes will neither be active nor destroyed, and that enzymatic reactivation would occur upon transfer to the duodenum. With regard to duodenal
Rothia enzyme activity, it is relevant that
R. mucilaginosa gains a foothold in the duodenum
[36]. This offers the intriguing possibility that
Rothia may colonize the duodenum and perform proteolytic activities locally in conjunction with mammalian-derived enzymes to degrade gluten.
From a therapeutical perspective, the identified
Rothia enzymes differ in three major aspects from the major glutenase enzymes that are currently being tested in clinical trials (SC-PEP and EP-B2; Alvine Pharmaceuticals, and AN-PEP; DSM). First, the enzyme source is a resident human body-associated oral commensal bacterium. Second, the cleavage site specificity of the
Rothia enzymes is unique in that they cleave XPQ↓ as well as LPY↓. The latter cleavage specificity is not exerted by prolyl endopeptidases, which hydrolyze peptide bonds C-terminal to proline residue
[11],
[12]), and is also not observed for EP-B2
[13]. Thus the
Rothia specificities supplement those of enzymes under investigation for celiac disease therapy. Cleavage after the LPY↓ tripeptide is highly relevant since it is present in three copies throughout the immunogenic 33-mer sequence. The third feature that sets the
Rothia enzymes apart is their wide pH activity range spanning from pH 4.0 (appreciable activity) to pH 10.0. While at this stage of our investigation we are unable to assign the activity to one or to several enzymes in the
Rothia cell suspension, the potential of
Rothia to serve as a valuable natural source of gluten-degrading enzymes is demonstrated.
With regard to the suggested
in vivo usefulness of the
Rothia enzymes as a treatment for celiac disease, it is imperative to establish if gliadin fragmentation by
Rothia is beneficial or harmful to the host, in particular, to the celiac host. While immunogenic domains in the α-2, α-9 and γ-gliadin epitopes were cleaved by the
Rothia enzymes, digestion of these regions by
Rothia was incomplete as evidenced by the finding that by-products of the digestion still contained immunogenic peptide sequences such as
QLQPFPQPQLPY [37],
PFPQPQLPY and
PQPQLPYPQ [7] ( and
Figure S2B). By virtue of their smaller size, these peptides may reach the lamina propria more easily than larger immunogenic fragments
[38]. Furthermore, most of the degradation fragments identified are theoretically of sufficient length to bind to HLA-DQ2 after deamidation by tissue transglutaminase
[39], an essential step in the pathway towards T-cell activiation
[40]. To test this, we measured TG2-mediated cross-linking of peptides in the
Rothia-33-mer and
Rothia-26-mer degradation mixtures to monodansyl cadaverine as a measure for deamidation and T cell stimulatory potential. A surprisingly strong correlation was observed between 33-mer or 26-mer degradation and loss of TG crosslinking. These results indicated that the degradation fragments are not good substrates for deamidation by TG2, suggesting loss of immunotoxicity
[41]. T-cell proliferation assays are planned to validate these observations.
Gluten-degrading microorganisms in the GI tract may play a hitherto unappreciated role in the digestion/detoxification of dietary gluten. They open promising new avenues in the search for novel therapies to neutralize the deleterious effects of gluten in patients with celiac disease. Furthermore, to exploit these bacteria or their enzymes is highly attractive, since they belong to the normal flora of the upper GI tract.