Selection for Streptococcus mutans with an Altered Xylitol Transport Capacity in Chronic Xylitol Consumers

Trahan, L.; Mouton, Christian

doi:10.1177/00220345870660052301

Cited by 57 publications

(81 citation statements)

References 26 publications

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“…Notably, the now-extensive literature on xylitol inhibition of caries (Mäkinen et al, 1995;Isokangas et al, 2000), usually monitored by measure of frank cavitation of lesions into the dentin, is associated with what might seem to be paradoxical emergence among frequent users of xylitol of X r S. mutans in the mouth (Trahan and Mouton, 1987). The present observations suggest that, in fact, X r strains of S. mutans are of diminished virulence by virtue of compromised colonization of the teeth and compromised ability to induce lesions that penetrate dentin, i.e., to the point that they would have been scored in those clinical studies.…”

Section: Discussionmentioning

confidence: 99%

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Streptococcus mutans: Fructose Transport, Xylitol Resistance, and Virulence

et al. 2006

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Streptococcus mutans, the primary etiological agent of human dental caries, possesses at least two fructose phosphotransferase systems (PTSs), encoded by fruI and fruCD. fruI is also responsible for xylitol transport. We hypothesized that fructose and xylitol transport systems do not affect virulence. Thus, colonization and cariogenicity of fruI − and fruCD − single and double mutants, their WT (UA159), and xylitol resistance (X r ) of S. mutans were studied in rats fed a high-sucrose diet. A sucrose phosphorylase (gtfA − ) mutant and a reference strain (NCTC-10449S) were additional controls. Recoveries of fruI mutant from the teeth were decreased, unlike those for the other strains. The fruCD mutation was associated with a slight loss of cariogenicity on enamel, whereas mutation of fruI was associated with a loss of cariogenicity in dentin. These results also suggest why xylitol inhibition of caries is paradoxically associated with spontaneous emergence of so-called X r S. mutans in habitual human xylitol users.

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Section: Discussionmentioning

confidence: 99%

“…Xylitol inhibition of caries has attracted considerable interest (Scheinin and Mäkinen, 1975;Mäkinen et al, 1995;Isokangas et al, 2000;Söderling et al, 2000), as has the puzzling emergence, in the mouths of habitual xylitol users, of S. mutans that are resistant to metabolic inhibition by xylitol (X r ) (Trahan and Mouton, 1987).…”

Section: Introductionmentioning

confidence: 99%

Streptococcus mutans: Fructose Transport, Xylitol Resistance, and Virulence

et al. 2006

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“…Based on available bacteriologic information [Trahan and Mouton, 1987;Trahan et al, 1992;Trahan, 1995] and field experience from clinical caries trials involving xylitol, it appears that xylitol does exert specific biochemical effects on certain strains of mutans streptococci. Such effects include the mere reduced growth rate of those bacteria in the presence of xylitol, as well as more specific chemical effects, such as weakened adhesivity of the bacteria onto surfaces, increased rate of proteolytic activity of the bacteria, dampening of the acidogenic potential of sucrose, incorporation of xylitol into the bacterial cells with concomitant intracellular accumulation of a toxic xylitol phosphate [Trahan, 1995] and related effects [Mäkinen, 1993].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Erythritol and Xylitol Saliva Stimulants in the Control of Dental Plaque and Mutans Streptococci

Mäkinen

Isotupa²,

Kivilompolo³

et al. 2001

Caries Res

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The effect of 2–month usage of saliva–stimulating pastils containing either erythritol or xylitol was studied in a cohort of 30 subjects assigned to the respective polyol groups (n = 15). The daily consumption level of both polyols was 5.2 g, used in 5 daily chewing episodes. The mean weight of total plaque mass (collectable during a standard period of 3 min from all available tooth surfaces) was reduced significantly in the xylitol–group, while no such effect was observed in the erythritol–group. This reduction in plaque mass was accompanied by a significant reduction in the turbidity readings (A₆₆₀) of aqueous plaque suspensions; no such effect was observed in the erythritol–group. However, plaque protein levels did not differ between baseline and endpoint in either polyol group. The plaque and salivary levels of Streptococcus mutans and plaque levels of total streptococci were reduced significantly in the xylitol–group, while no such effect was detected in the erythritol–group. However, either polyol regimen had no effect on plaque levels of S. sobrinus. The results suggest that systematic use of xylitol–containing saliva stimulants may be more effective in controlling some oral–hygiene–related and caries–associated parameters than similar use of erythritol–containing products. The results also speak for a special relationship between xylitol and S. mutans. However, owing to the great potential of erythritol as a caries–reducing agent – based on the tetritol nature of erythritol – the present laboratory results should be considered preliminary and subject to verifying clinical studies.

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“…It has been shown that the anticariogenic effect of xylitol lasts for several years after the practice of consuming xylitol daily has been discontinued and is associated partly with the reduction in the total levels of S. mutans and partly with the decrease in the amount and adhesiveness of dental plaque (8). Some studies have failed to document any long-term decrease in the amount of S. mutans bacteria, however (13,19), and this has been explained by the selection of bacterial strains: habitual use of xylitol may select S. mutans strains which are up to 87% nonexpressive of the fructose phosphotransferase enzyme (17) and are thought to have lower adhesiveness to enamel and, therefore, lower virulence (7,12).…”

Section: Fig 2 In Vitro Growth Of S Mitismentioning

confidence: 99%

Effect of xylitol on growth of nasopharyngeal bacteria in vitro

Kontiokari

Uhari

Koskela

1995

Antimicrob Agents Chemother

100

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Xylitol is known to reduce caries by inhibiting the growth of Streptococcus mutans. We hypothesized that xylitol could also affect the growth of other nasopharyngeal bacterial flora, which could be important when considering respiratory infections caused by these bacteria. We studied this in vitro by adding xylitol to the medium and observed that 1 and 5% xylitol reduced markedly the growth of alpha-hemolytic streptococci, including S. pneumoniae. It reduced slightly the growth of beta-hemolytic streptococci but not that of Haemophilus influenzae or Moraxella catarrhalis. The inhibitory growth pattern was similar to that previously seen with S. mutans, which may indicate a similarity in the enzymatic processing of five-carbon sugars such as xylitol. This sugar alcohol is a widely used sweetener, and the concentrations used in our experiments are easily achieved in the oral cavity. If xylitol reduces the growth of S. pneumoniae in the nasopharynx, it could also reduce the carriage of this pathogen and thus have clinical significance in the prevention of pneumococcal diseases.Being a five-carbon sugar alcohol, xylitol is not fermented by most oral microorganisms, such as Streptococcus mutans (3), although most S. mutans strains are able to transport xylitol into the cell via the fructose phosphotransferase system (1a). Once in the cell, it is phosphorylated to xylitol-5-phosphate, which then has to be expelled from the cell (16). This futile energy-consuming xylitol cycle is thought to be responsible for the inhibition of S. mutans growth observed both in vitro and in vivo when the bacteria are exposed to xylitol (16).It has been shown on several occasions that regular consumption of xylitol reduces the incidence of caries, although the mechanisms are not clearly understood (2,6,9,14,15). The most significant effect so far demonstrated is its ability to reduce the growth and acid production of S. mutans. Research into caries has not shown any other major changes in the oral flora, except occasionally a reduction in other oral streptococci (1a, 10, 13, 18).We hypothesized that xylitol could also affect the growth of other bacteria in the nasopharyngeal flora, which could be important when considering respiratory infections caused by these bacteria. S. pneumoniae, in particular, could make use of xylitol in a manner similar to that of S. mutans. To test our hypothesis, we evaluated the growth of some strains of nasopharyngeal bacteria when xylitol was added to the medium. MATERIALS AND METHODSBacterial strains. Ten strains of S. pneumoniae and Haemophilus influenzae and five strains of Moraxella (Branhamella) catarrhalis were isolated from consecutive routine patient middle ear effusion samples or maxillary sinus aspirates. Five strains of S. pyogenes and S. mitis and four strains of group G streptococci were isolated from throat samples of asymptomatic children. Pneumococci, H. influenzae, M. catarrhalis, and beta-hemolytic streptococci were selected because of their ability to cause upper respiratory tract infecti...

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Selection for Streptococcus mutans with an Altered Xylitol Transport Capacity in Chronic Xylitol Consumers

Cited by 57 publications

References 26 publications

Streptococcus mutans: Fructose Transport, Xylitol Resistance, and Virulence

Streptococcus mutans: Fructose Transport, Xylitol Resistance, and Virulence

Comparison of Erythritol and Xylitol Saliva Stimulants in the Control of Dental Plaque and Mutans Streptococci

Effect of xylitol on growth of nasopharyngeal bacteria in vitro

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