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Antimicrobial Agents and Chemotherapy, April 2007, p. 1541-1544, Vol. 51, No. 4
0066-4804/07/$08.00+0 doi:10.1128/AAC.00999-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
In Vitro Inhibition of Streptococcus mutans Biofilm Formation on Hydroxyapatite by Subinhibitory Concentrations of Anthraquinones
Tom Coenye,1*
Kris Honraet,1,2
Petra Rigole,1,2
Pol Nadal Jimenez,1 and
Hans J. Nelis1
Laboratorium voor Farmaceutische Microbiologie, Universiteit Gent, Gent,1
Oystershell NV, Drongen, Belgium2
Received 10 August 2006/
Returned for modification 23 October 2006/
Accepted 20 November 2006

ABSTRACT
We report that certain anthraquinones (AQs) reduce
Streptococcus mutans biofilm formation on hydroxyapatite at concentrations
below the MIC. Although AQs are known to generate reactive oxygen
species, the latter do not underlie the observed effect. Our
results suggest that AQs inhibit
S. mutans biofilm formation
by causing membrane perturbation.

TEXT
Dental plaque displays several properties typical of biofilms,
including reduced susceptibility to antimicrobial agents (
9,
13).
Streptococcus mutans is considered to be the primary cariogen
within dental plaque (
12), and prevention or reduction of biofilm
formation by
S. mutans could thus contribute to the prevention
of caries. In the present study we evaluated the abilities of
anthraquinones (AQs) to inhibit
S. mutans biofilm formation
at concentrations below the MIC, as well as their mechanism
of action.
S. mutans LMG 14558T, Micrococcus luteus NRRL B-2618, and Vibrio harveyi strains were routinely grown in brain heart infusion (BHI) broth (Becton Dickinson[BD], Franklin Lakes, NJ) at 37°C, on tryptic soy agar (BD) at 30°C, or on Difco marine agar (BD) at 37°C, respectively. The AQs tested are listed in Table 1. To determine the MIC of each compound, a microdilution assay in 96-well microtiter plates (TPP, Trasadingen, Switzerland) was used (8). S. mutans LMG 14558T biofilms were grown on hydroxyapatite disks in modified Robbins' devices, and the biofilm biomass on each disk was estimated using fluorescent staining with SYTO9 (Invitrogen, Carlsbad, CA) (8). Inhibition of glucosyltransferase by AQs was assessed by an enzymatic assay (16). Induction of reactive oxygen species (ROS) by AQs was measured by two separate assays. In the first assay, MICs were determined in the presence or absence of 1.5 mM glutathione (GSH), 0.025% (wt/vol) cysteine, and 10 mM mannitol (all from Sigma) by using the modified microdilution assay described above. In the second assay, we used the fluorescent probe 2',7'-dichlorofluorescein diacetate (DCF-DA) to quantitate the amount of ROS produced (5, 6). The inhibition of mutacin production can be used as an indirect assay to detect competence-stimulating peptide-based quorum sensing (QS) (22). Mutacin production was determined using M. luteus NRRL B-2618 as an indicator strain. Inhibition of autoinducer-2-based QS was studied using V. harveyi biosensor strains, as described previously (7). Lateral diffusion of fatty acids in the cell membrane was measured by the intermolecular excimerization of the fluorescent probe pyrene (2). To study the rotational diffusion of the fatty acid acyl chains in the interior of the membrane, fluorescence anisotropy was measured using 1,6-diphenyl 1,3,5-hexatriene (DPH) (2). Cellular fatty acid analysis was performed as described previously (21).
The overall mean fluorescence response for
S. mutans biofilms
grown on hydroxyapatite in BHI supplemented with 1% sucrose
(BHIS) (positive controls) (386 disks) after staining with SYTO9
was 13.22
x 10
5 ± 2.83
x 10
5 relative fluorescence units,
which correlates with approximately 5
x 10
8 to 6
x 10
8 cells
per disk (
8). The MICs for various AQs are shown in Table
1.
Most of the AQs tested in the present study exhibited no activity
against planktonic
S. mutans LMG 14558
T cells, with MICs of

250 µg/ml (Table
1). Biofilms grown in the presence of
emodin, hypericin, carminic acid, chrysophanic acid, or quinizarin
(5 µg/ml) revealed significantly lower fluorescence responses
(
P 
0.01) than biofilms grown in BHIS without AQs (Table
1).
For emodin, the most active compound, there was a quasilinear
relationship between its concentration and relative biofilm
formation (Table
1). None of the AQs investigated showed significant
inhibition of glucosyltransferase (data not shown). The addition
of 1.5 mM GSH, 10 mM mannitol, or 0.025% cysteine did not result
in an altered MIC for emodin in M1 medium (
17) (Fig.
1). Similarly,
supplementation of BHIS medium containing 5 µg/ml emodin
with 0.025% cysteine did not result in increased biofilm formation,
i.e., cysteine had no protective effect against the action of
emodin. This strongly suggested that ROS generation is not the
mechanism by which emodin affects
S. mutans cells. This was
confirmed by using the oxidative-stress-specific fluorescent
probe DCF-DA (data not shown). No effect of AQs on competence-stimulating
peptide- or autoinducer-2-based QS was observed (data not shown).
Incubation of
S. mutans LMG 14558
T with emodin or hypericin
resulted in a decreased membrane lateral and rotational diffusion
(Table
2; Fig.
2), indicating reduced membrane fluidity. Although
the average difference in anisotropy between DPH-labeled emodin-treated
cells (0.1528) and untreated cells (0.1327) was low (15.13%)
and not significant (
P = 0.512), these differences were observed
consistently. In addition, small changes (approximately 10%)
in fluorescence anisotropy may reflect marked changes (of about
25%) in membrane microviscosity (
2,
11). Together with the significant
decrease in membrane lateral diffusion, the observed differences
in fluorescence anisotropy strongly suggest an effect of emodin
on membrane microviscosity.
View this table:
[in this window]
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TABLE 2. Relative fluidity of membranes of S. mutans grown under different conditions, as measured using pyrene and DPH
|
It has been reported previously that membrane fluidity has an
influence on many cellular processes, including permeability,
cold adaptation, and growth and survival at suboptimal temperatures
(
3,
4,
10,
19). Bacterial membrane fluidity is most often modulated
by altering the fatty acid composition, but there were no significant
differences in membrane fatty acid composition between
S. mutans cells grown in the presence or absence of emodin (data not shown).
It has been reported that emodin becomes inserted into the phospholipid
bilayer, strongly affects van der Waals interactions between
hydrocarbon chains of phospholipids, and destabilizes membrane
bilayers by promoting nonbilayer phases (
1). Based on this,
we suggest that the antibiofilm effect of emodin is caused by
insertion of the planar molecule into the cell membrane and/or
by binding of the same molecule to membrane-embedded molecules,
including proteins. To our knowledge, there are at present no
data on the effect of changes in bacterial membrane fluidity
on biofilm formation, although an effect on adhesion potential
appears plausible. The observation that the formation of an
S. mutans biofilm can be significantly reduced by AQs at subinhibitory
concentrations is unusual and may lead to novel strategies to
prevent dental plaque and caries.

ACKNOWLEDGMENTS
We thank D. P. Labeda, M. Uyttendaele, and T. Defoirdt for providing
strains, L. Vanhee for excellent technical assistance, I. Vandecandelaere
for the fatty acid analysis, and E. Lorent, Y. Engelborghs,
and S. Desmedt for assistance with and helpful discussions regarding
fluorescence polarization.
This work was supported by an IWT KMO Innovation Project and by Oystershell NV (Belgium).

FOOTNOTES
* Corresponding author. Mailing address: Laboratorium voor Farmaceutische Microbiologie, Universiteit Gent, Harelbekestraat 72, B-9000 Gent, Belgium. Phone: 32 9 2648093. Fax: 32 9 2648195. E-mail:
Tom.Coenye{at}UGent.be 
Published ahead of print on 12 January 2007. 

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Antimicrobial Agents and Chemotherapy, April 2007, p. 1541-1544, Vol. 51, No. 4
0066-4804/07/$08.00+0 doi:10.1128/AAC.00999-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.