The bacteria within the dental biofilms showed resilience in maintaining the overall community diversity but reduced biofilm accumulation following PI/FV therapy. Repeated uses of PI/FV may augment plaque control during dental rehabilitation in children.

Future therapies for the treatment of dental decay have to consider the importance of preserving bacterial ecology while reducing biofilm adherence to teeth. A multi-species plaque derived (MSPD) biofilm model was used to assess how concentrations of N-acetyl-L-cysteine (0, 0.1%, 1%, 10%) affected the growth of complex oral biofilms. Biofilms were grown (n=96) for 24 hours on hydroxyapatite disks in BMM media with 0.5% sucrose. Bacterial viability and biomass formation was examined on each disk using a microtiter plate reader. In addition, fluorescence microscopy and Scanning Electron Microscopy was used to qualitatively examine the effect of NAC on bacterial biofilm aggregation, extracellular components, and bacterial morphology. The total biomass was significantly decreased after exposure of both 1% (from 0.48, with a 95% confidence interval of (0.44, 0.57) to 0.35, with confidence interval (0.31, 0.38)) and 10% NAC (0.14 with confidence interval (0.11, 0.17)). 16S rRNA amplicon sequencing analysis indicated that 1% NAC reduced biofilm adherence while preserving biofilm ecology.

Bacteria that accumulate polyphosphates have previously been shown to dynamically influence the solubility of phosphatic minerals in marine settings and wastewater. Here, we show that dental plaque, saliva, and carious lesions all contain abundant polyphosphate-accumulating bacteria. Saturation state modeling results, informed by phosphate uptake experiments using the model organism Lactobacillus rhamnosus, which is known to inhabit advanced carious lesions, suggest that polyphosphate accumulation can lead to undersaturated conditions with respect to hydroxyapatite under some oral cavity conditions. The cell densities of polyphosphate-accumulating bacteria we observed in some regions of oral biofilms are comparable to those that produce undersaturated conditions (i.e., those that thermodynamically favor mineral dissolution) in our phosphate uptake experiments with L. rhamnosus. These results suggest that the localized generation of undersaturated conditions by polyphosphate-accumulating bacteria constitutes a new potential mechanism of tooth dissolution that may augment the effects of metabolic acid production.IMPORTANCE Dental caries is a serious public health issue that can have negative impacts on overall quality of life and oral health. The role of oral bacteria in the dissolution of dental enamel and dentin that can result in carious lesions has long been solely ascribed to metabolic acid production. Here, we show that certain oral bacteria may act as a dynamic shunt for phosphate in dental biofilms via the accumulation of a polymer known as polyphosphate—potentially mediating phosphate-dependent conditions such as caries (dental decay).

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Central nervous system tumors account for the most childhood cancer mortality. Immunotherapies have made major contributions to treat adult cancers, but application of immunotherapy for childhood brain tumors has been limited, in part due to the unique CNS microenvironment and mechanisms of immune escape in this context. To investigate the immunologic context, we query the transcriptomic profile of ~700 primary brain tumors released by the Children’s Brain Tumor Network. An immune subtype classification from The Cancer Genome Atlas project reveals that 81% of high-grade tumors across molecular subtypes are characterized by an immunosuppressive phenotype (C4) while an inflammatory phenotype (C3) is more common in low-grade lesions (p<0.001). Adjusting for histologic grade and extent of resection, C4 associates with worse overall (OS) and progression-free survival (PFS) in this cohort (HR 3.1, p=0.008 and 1.6, p=0.03 respectively). Deconvolution of the transcriptome reveals that relative to C3, C4 tumors have decreased T-cell signature, OR 0.4 (0.2–0.8), and increased macrophage and tumor-proliferation signature (OR 2.0, 1.3–3.3, and 3.1, 2.3–4.2, respectively). In contrast to C3 tumors, T-cell signature in C4 tumors adversely impacts survival and correlates with multiple immunosuppressive genes and cytokines. Among them, the immune checkpoint CD276 has the highest associated impact on survival in C4 tumors (HR of log increase is 1.9, p<0.001). Additionally, high-grade lesions have suppressed expression of antigen-presenting genes. EZH2 is implicated in downregulating antigen presentation and is found to be significantly upregulated in all high-grade lesions in this cohort. Treatment with the EZH1/2 inhibitor valemetostat resulted in upregulation of antigen-presenting genes and tissue differentiation pathways across three murine syngeneic models, one modeling diffuse midline glioma and two embryonal models. Future in-vivo studies with genetic and chemical modification of immunomodulatory genes of interest aim to identify immunotherapeutic targets with potential for broad applicability in pediatric neuro-oncology.