Myriam Bélanger,1,
Joan Whitlock,1
Emil Kozarov,2 and
Ann Progulske-Fox1*
Department of Oral Biology, College of Dentistry, and Center for Molecular Microbiology, University of Florida, Gainesville,1 College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida2
Received 26 April 2005/ Returned for modification 10 June 2005/ Accepted 7 August 2005
| ABSTRACT |
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| INTRODUCTION |
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P. gingivalis can invade many cell types, including human oral epithelial cells (29, 46, 58), human gingival fibroblasts (2), human coronary artery smooth muscle cells, and human coronary artery endothelial (HCAE) cells (14, 38). Adherence to target cells is a required initial event for invasion of host cells (4). In order to avoid nonspecific host defenses, such as mechanical clearance, bacteria bind to host cells through adhesin molecules. Subsequent bacterial entry into host cells confers protection from the host immune system and may contribute to host tissue damage (4, 13, 15). Hemagglutinins can function as adhesins and are required for virulence of several bacterial pathogens (1, 9, 24, 35). Hemagglutinins are also considered important virulence factors, as they can be a mechanism to acquire hemin, necessary for bacterial growth, from erythrocytes (39). Several hag genes, encoding hemagglutinins of P. gingivalis, have been previously described and cloned (20, 40, 48, 49). However, the importance of the hemagglutinins in the colonization process of P. gingivalis remains to be determined. In this study, we investigated the role of hemagglutinin B of P. gingivalis in adhesion to and invasion of HCAE cells. Our results indicate that HagB promotes attachment of P. gingivalis to host cells but, alone, is not sufficient for internalization into host cells.
| MATERIALS AND METHODS |
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HCAE cells (Cambrex, Walkersville, MD) were cultured in endothelial cell basal medium-2 (EBM-2; Cambrex) supplemented with EGM-2-MV single-use aliquots (Single Quots; Cambrex) as described by the manufacturer. HCAE cells were maintained at 37°C with 5% CO2 in a humidified atmosphere.
P. gingivalis HagB mutant construction.
The BamHI/PstI fragment containing hagB from clone ST7 and was cloned into the BamHI/PstI site of pUC18 (Amersham Biosciences Corp., Piscataway, NJ) in E. coli JM109 (49). The ermF-ermAm cassette was cut out from plasmid pVA2198 (graciously provided by F. Macrina) using SacI and BamHI, and the ends were blunt ended using the Klenow enzyme. The
2.3-kb cassette was then ligated into the StuI site of the hagB fragment within the hagB-pUC18 construct. This plasmid was maintained in E. coli JM109 and designated pJW1. The purified plasmid was electroporated into P. gingivalis 381, the HagB mutant was obtained, and the mutation was confirmed by Southern hybridization (data not shown) as previously described (48). Sequencing was also performed to confirm the mutation. All restriction and modification enzymes were purchased from Promega Corporation (Madison, WI).
rHagB purification and analysis. The hagB gene of P. gingivalis (1.4 kb) was cloned into the vector pQE-31 (QIAGEN), and the construct was designated pQE-31-TX1 (32). The histidine-tagged HagB was purified on a nickel-nitrilotriacetic acid affinity column by fast protein liquid chromatography (FPLC) (Bio-Rad Laboratories, Hercules, CA) from E. coli M15[pREP4]pQE-31-TX1, as described previously (32). The eluted protein was dialyzed against 500 mM sodium chloride (NaCl) and 10 mM Tris, pH 7.4, and was concentrated using polyethylene glycol (PEG) 8000 (Fisher Scientific, Fair Lawn, NJ).
The purified recombinant HagB (rHagB) was run on a sodium dodecyl sulfate (SDS)-polyacrylamide gel, as described below. The 49-kDa band was excised from the gel and digested with trypsin, as previously described (22). Identification was confirmed by liquid chromatography-mass spectroscopy analysis performed at the Interdisciplinary Center for Biotechnology Research (ICBR) in the Protein Chemistry Core Laboratory of the University of Florida and by a SEQUEST database search.
MAb and PAb production. Mouse monoclonal antibodies (MAbs) against the purified rHagB were produced by standard protocols utilized by the ICBR Hybridoma Core Laboratory at the University of Florida (28, 29). Briefly, three 6- to 8-week-old female BALB/cByj mice were immunized subcutaneously with either 25 µg or 50 µg of the antigen, using the MPL + TDM adjuvant system (Sigma-Aldrich Company, Ltd., St. Louis, MO), or with 10 µg of the antigen mixed with the ImmunEasy adjuvant system (QIAGEN). Spleen cells from the immunized mice were fused with myeloma cells (sp2/0) at a ratio of 7:1 by using 50% PEG (Hoffmann-LaRoche Inc., Nutley, NJ). Fused cells were grown in hypoxanthine, aminopterine, and thymidine selective medium. Hybridoma cells were evaluated by enzyme-linked immunosorbent assay (ELISA) for the presence of antibodies that bound to the immunogen. Hybridomas from the ELISA-positive wells were transferred to 24-well plates and screened by ELISA a second time using anti-mouse whole-molecule- or heavy-chain (gamma or mu)-specific secondary antibodies (Sigma-Aldrich). Screening was also performed by Western blotting, as described below. Two positive hybridomas were selected and cloned using a single-cell-per-well procedure. The MAb HL1858 (immunoglobulin G1 [IgG1]) developed against HagB and an unrelated MAb, HL1830, were used in this study.
Specific rabbit polyclonal antibody (PAb) A7985 was raised against the purified rHagB protein (Strategic Biosolutions, Newark, DE). Preimmune rabbit serum was obtained prior to the first immunization and used as a negative control.
Antibody purification. The MAb HL1858 and the unrelated MAb HL1830 were purified by FPLC on a protein A cartridge (Bio-Rad), using ImmunoPure IgG binding and elution buffers as described by the manufacturer (Pierce, Rockford, IL). The purified MAbs were dialyzed in 10 mM sodium phosphate and 0.15 M NaCl, pH 7.5, and then concentrated using PEG 8000. Purity was determined by running them on gels, as described below. Concentrations of purified MAbs were determined using a bicinchoninic acid protein determination assay (Pierce).
Gel electrophoresis and Western immunoblot analysis. SDS-polyacrylamide gel electrophoresis was carried out by the method of Laemmli (36), using 4 to 20% Ready Gel Tris-HCl gels (Bio-Rad). Gels were stained with Coomassie brilliant blue R-250 or transferred onto polyvinylidene difluoride membranes (PerkinElmer Life Sciences, Inc., Boston, MA) (28). The specific protein HagB bands were subsequently detected by incubating with MAb HL1858 or PAb A7985 and then immunostaining with an anti-mouse or anti-rabbit IgG conjugated with alkaline phosphatase (ICN Biomedicals, Aurora, OH). The membranes were revealed using 5-bromo-4-chloro-3-indolyl phosphate-nitroblue tetrazolium (Sigma-Aldrich) as the substrate.
Immunoelectron microscopy. Immunoelectron microscopy was used to detect the presence of the HagB antigen on the surfaces of the wild-type and HagB mutant of P. gingivalis 381, E. coli JM109 expressing HagB (E. coli-HagB), and E. coli JM109 containing pUC9 (E. coli-pUC9). Bacteria were grown overnight, harvested, and incubated on 400-nm nickel hexagonal grids. Grids were blocked with 1% percent nonfat dry milk for 10 min, incubated with a 1/200 dilution of MAb HL1858 or unrelated MAb HL1831 for 1 h at room temperature, and then washed three times with phosphate-buffered saline (PBS). Anti-mouse IgG (Jackson ImmunoResearch Laboratories, West Grove, PA) labeled with 18-nm-diameter gold particles was added, incubated for 1 h at room temperature, and then washed with PBS three times. The grids were examined using a Hitachi 7000 transmission electron microscope at the ICBR Electron Microscopy Core Laboratory of the University of Florida.
Adhesion and invasion assays. HCAE cells were seeded in 24-well tissue culture plates at 105 cells per well and incubated for 18 h. Overnight broth cultures of P. gingivalis 381 (wild type and HagB mutant), E. coli-HagB, and E. coli-pUC9 were centrifuged and then resuspended in antibiotic-free EBM-2 medium to a concentration of 107 CFU/ml, as determined with a spectrophotometer (Shimadzu, Kyoto, Japan). The HCAE cells were washed with PBS and infected with 1 ml per well of P. gingivalis 381 (wild type and HagB mutant), E. coli-HagB, or E. coli-pUC9. Three wells per bacterial strain were infected. The plates were incubated aerobically at 37°C for 90 min and then washed three times with PBS. Cells were lysed with sterile H2O for 20 min at 37°C.
For the invasion assay, the wells were treated with 300 µg/ml gentamicin and 200 µg/ml metronidazole for 60 min at 37°C to kill all extracellular bacteria prior to lysing the cells with sterile H2O. Decimal serial dilutions were plated, and CFU were enumerated. Each assay was performed in triplicate. The adhesion or invasion ratios were then calculated.
Competitive inhibition assays. (i) Competition using rHagB protein. Purified rHagB protein was used in the assay as a competitive inhibitor. A lysate of E. coli M15[pREP4]pQE-31 was run through a Ni-nitrilotriacetic acid column, and the eluted proteins were used as the negative control preparation. The E. coli M15[pREP4]pQE-31 eluted proteins, the purified rHagB protein, or bovine serum albumin (BSA) (Sigma-Aldrich) was added to HCAE cells in increasing concentrations of 50, 150, and 450 µg/ml. The HCAE cells were preincubated with the rHagB protein, the E. coli control proteins, or BSA (control) for 1 h at 37°C before addition of wild-type P. gingivalis or E. coli-HagB. Assays were then performed as described in the previous section.
(ii) Competition using antibodies. In the antibody inhibition assay, MAb HL1858 against HagB and an unrelated MAb, HL1830 (control), were diluted in threefold-increasing concentrations of 5.6 to 450 µg/ml. Polyclonal antibody A7985 or preimmune rabbit serum (control) was diluted in fivefold-increasing concentrations of 1/1250, 1/250, 1/50, and 1/10 and then mixed with bacteria. Bacteria without preincubation with serum were used as positive controls. After a 1-h preincubation period at 37°C, bacteria were centrifuged at 5,000 rpm for 15 min, washed three times with PBS, vortexed for 40 s, and then used in the adhesion assays, as described above.
Statistical analysis. Differences between groups were determined by analysis of variance. Normality and equal variance of the data were confirmed in preliminary analysis. When indicated, multiple pairwise comparisons were done using the Student-Newman-Keuls test (SigmaStat 3.0; SPSS Inc, Chicago, IL). For all comparisons, P values of <0.05 were considered significant.
| RESULTS |
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Antibody purification and analysis. After FPLC purification, monoclonal antibodies were confirmed to be pure by SDS-polyacrylamide gel electrophoresis (data not shown). Immunoblotting was performed to confirm the reactivity of PAb A7985 or MAb HL1858 against HagB. Both antibodies strongly recognized the rHagB protein. Neither the PAb nor the MAb reacted with bands of similar molecular weight in the FPLC-purified lysate of E. coli M15[pREP4]pQE-31 control proteins (data not shown).
Adhesion and invasion assay. To determine whether HagB is involved in adhesion to and/or invasion of host cells, P. gingivalis 381 (wild type and HagB mutant), E. coli-HagB, and E. coli-pUC9 (negative control) were used to infect HCAE cells. The adhesion value for P. gingivalis 381 was normalized to 100% and was used as the control to derive the other adhesion values. The attachment and invasion of P. gingivalis 381 and of the HagB mutant to the HCAE cells were compared. No statistically significant difference (P = 0.331) was observed between the two groups. However, we observed a statistically significant difference (P < 0.001) between the E. coli control (6.6% ± 1.6%) and E. coli expressing the HagB protein (34.1% ± 8.5%). E. coli expressing the HagB protein attached approximately 5 times more to the HCAE cells than did the control E. coli. A statistically significant difference was also observed between P. gingivalis 381 (100% ± 27.8%) and both E. coli strains (see results above). Because no bacteria were recovered intracellularly from cells exposed to the E. coli strains but bacteria were recovered from strain 381 (control) incubated cells, it was concluded that E. coli-HagB and E. coli-pUC9 did not invade the HCAE cells.
rHagB competitive inhibition assay. Various concentrations of purified rHagB protein were preincubated with the HCAE cells before they were infected with the microorganisms. In the competitive assay with P. gingivalis 381, no inhibition was observed when the cells were preincubated with either 50 or 150 µg/ml of rHagB (Fig. 1A). However, a statistically significant difference in the attachment was observed between P. gingivalis 381 preincubated with 450 µg/ml of rHagB and all the other groups (0, 50, and 150 µg/ml of inhibitor). The addition of BSA (data not shown) or of control proteins from E. coli M15[pREP4]pQE-31 did not inhibit P. gingivalis 381 from attaching to the HCAE cells (P = 0.781) (Fig. 1A). Statistically significant differences were also observed in the attachment of E. coli-HagB to the HCAE cells when preincubations were performed in presence of 150 or 450 µg/ml rHagB (P < 0.001) (Fig. 1B). BSA (data not shown) or control proteins from E. coli M15[pREP4]pQE-31 at concentrations ranging from 50 to 450 µg/ml did not inhibit E. coli-HagB from attaching to HCAE cells (P = 0.666) (Fig. 1B).
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| DISCUSSION |
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Since multiple attempts to create a hagB hagC double mutant were unsuccessful, E. coli-HagB was used to test the involvement of HagB in adhesion to and invasion of HCAE cells. E. coli-HagB was found to have significantly increased attachment to HCAE cells compared to the parental E. coli strain. However, E. coli-HagB was not able to invade the host cells. This suggests that HagB is involved in P. gingivalis attachment to human cells but is not sufficient for invasion. Since multiple bacterial cell components and factors are involved in the complex process of entry into host cells (23, 46, 49), these results were expected. The role that HagB may play in host cell entry and trafficking within the cell thus cannot be deduced from this study.
In an attempt to further verify the role of HagB in the adhesion of P. gingivalis to host cells, rHagB protein was also purified and used in competitive assays. The purified rHagB migrated as a 49-kDa protein during electrophoresis, as described previously (49), even though the predicted molecular mass of P. gingivalis HagB is 39.4 kDa. This differential migration could be due to the high pI of the protein and thus aberrant migration during electrophoresis, as has been described for other similar proteins (32), or possibly to posttranslational modifications. Using serum from a rabbit immunized with a whole preparation of P. gingivalis 381, we observed a reaction in Western blotting with the purified His6-rHagB protein, demonstrating that at least some epitopes of rHagB are in the same conformation as when present in whole P. gingivalis cells (M. Bélanger, unpublished data). A competitive assay was performed using the rHagB protein to prevent bacterial adhesion to HCAE cells. Inhibition of the attachment to host cells was dose dependent for E. coli-HagB. Also, the presence of 450 µg/ml of rHagB inhibited the attachment of P. gingivalis to HCAE cells. Both MAb and a specific PAb directed against HagB and used in competitive assays also significantly decreased the adherence of P. gingivalis and E. coli-HagB to host cells. Furthermore, we observed that inhibition of E. coli-HagB was dose dependent, strongly suggesting that HagB is necessary for P. gingivalis binding to HCAE cells.
HagB is expressed on P. gingivalis and E. coli-HagB cell surfaces, as the MAb designed against HagB labeled these bacterial cells as tested by immunoelectron microscopy. However, the HagB mutant was also labeled by MAb HL1858, a MAb directed against HagB. As the hagC gene of P. gingivalis is 98.6% homologous to hagB (47), it is most likely that MAb HL1858 recognizes a common epitope of HagB and HagC. No difference in attachment of the wild type and the HagB mutant of P. gingivalis to HCAE cells was observed. Because of the high homology of hagB and hagC, a mutant deficient in HagB may not have decreased attachment to host cells, as HagC may "complement" the mutation. Furthermore, preliminary data obtained in our laboratory suggest that HagA is also responsible, at least in part, for binding to host cells (H. Song, 83rd Gen. Session Exhibit. Int. Assoc. Dent. Res. 2004, abstr. 3637). Double and, if possible, triple mutants of these different hemagglutinin genes would be desirable for defining the relative roles of each hemagglutinin in adherence. However, as indicated above, such mutant constructions have not been achieved. It is possible that a hagB hagC double mutant is lethal for some unknown reason.
P. gingivalis has been reported to invade HCAE cells and coronary artery smooth muscle cells (16, 19). Invasion of the endothelial and smooth muscle cells of the arterial wall by P. gingivalis might contribute to the pathogenesis of cardiovascular disease (14, 16). Avoidance of nonspecific host defenses, such as mechanical clearance, and adherence to target cells are required initial events for bacterial invasion of host cells. Therefore, HagB might play a role in adhesion to the arterial wall, whereas other P. gingivalis molecules would be responsible for the invasion step. One objective of defining the virulence factors of P. gingivalis is to develop a potential vaccine and/or a new antimicrobial agent. We and others have shown that an induction of protection against P. gingivalis infection occurred after subcutaneous or intranasal immunization with HagB in mice (17, 32, 61, 63). Also, purified rHagB has been found to elicit a protective immune response in the rat bone loss model (30). Our study has demonstrated that HagB is involved in P. gingivalis adhesion to HCAE cells. Taken together, these results provide preliminary evidence for a rationale for investigation of a HagB-based vaccine for the prevention and treatment not only of periodontal disease but also of cardiovascular disease.
| ACKNOWLEDGMENTS |
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This study was supported by National Institutes of Health grant DE 07496.
| FOOTNOTES |
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Hong Song and Myriam Bélanger contributed equally to the present study. ![]()
| REFERENCES |
|---|
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| 1. | Alonso, S., N. Reveneau, K. Pethe, and C. Locht. 2002. Eighty-kilodalton N-terminal moiety of Bordetella pertussis filamentous hemagglutinin: adherence, immunogenicity, and protective role. Infect Immun. 70:4142-4147. |
| 2. | Amornchat, C., S. Rassameemasmaung, W. Sripairojthikoon, and S. Swasdison. 2003. Invasion of Porphyromonas gingivalis into human gingival fibroblasts in vitro. J. Int. Acad. Periodontol 5:98-105.[Medline] |
| 3. | Arbes, S. J., Jr., G. D. Slade, and J. D. Beck. 1999. Association between extent of periodontal attachment loss and self-reported history of heart attack: an analysis of NHANES III data. J. Dent. Res. 78:1777-1782. |
| 4. | Beachy, E. H. 1981. Bacterial adherence, p. 1-4. In L. Switalski, M. Hook, and E. H. Beachy (ed.), Molecular mechanisms of microbial adhesion. Springer-Verlag, Inc., New York, N.Y. |
| 5. | Beck, J., R. Garcia, G. Heiss, P. S. Vokonas, and S. Offenbacher. 1996. Periodontal disease and cardiovascular disease. J. Periodontol. 67:1123-1137.[Medline] |
| 6. | Beck, J. D., J. R. Elter, G. Heiss, D. Couper, S. M. Mauriello, and S. Offenbacher. 2001. Relationship of periodontal disease to carotid artery intima-media wall thickness: the atherosclerosis risk in communities (ARIC) study. Arterioscler. Thromb. Vasc. Biol. 21:1816-1822. |
| 7. | Brodala, N., E. P. Merricks, D. A. Bellinger, D. Damrongsri, S. Offenbacher, J. Beck, P. Madianos, D. Sotres, Y. L. Chang, G. Koch, and T. C. Nichols. 2005. Porphyromonas gingivalis bacteremia induces coronary and aortic atherosclerosis in normocholesterolemic and hypercholesterolemic pigs. Arterioscler. Thromb. Vasc. Biol. 25:1446-1451. |
| 8. | Cavrini, F., V. Sambri, A. Moter, D. Servidio, A. Marangoni, L. Montebugnoli, F. Foschi, C. Prati, R. Di Bartolomeo, and R. Cevenini. 2005. Molecular detection of Treponema denticola and Porphyromonas gingivalis in carotid and aortic atheromatous plaques by FISH: report of two cases. J. Med. Microbiol. 54:93-96. |
| 9. | Chen, T., and M. J. Duncan. 2004. Gingipain adhesin domains mediate Porphyromonas gingivalis adherence to epithelial cells. Microb. Pathog. 36:205-209.[CrossRef][Medline] |
| 10. | Chiu, B. 1999. Multiple infections in carotid atherosclerotic plaques. Am. Heart J. 138:S534-S536.[CrossRef][Medline] |
| 11. | Desvarieux, M., R. T. Demmer, T. Rundek, B. Boden-Albala, D. R. Jacobs, Jr., R. L. Sacco, and P. N. Papapanou. 2005. Periodontal microbiota and carotid intima-media thickness: the oral infections and vascular disease epidemiology study (INVEST). Circulation 111:576-582. |
| 12. | Dierickx, K., M. Pauwels, M. L. Laine, J. Van Eldere, J. J. Cassiman, A. J. van Winkelhoff, D. van Steenberghe, and M. Quirynen. 2003. Adhesion of Porphyromonas gingivalis serotypes to pocket epithelium. J. Periodontol. 74:844-848.[CrossRef][Medline] |
| 13. | Dorn, B. R., J. N. Burks, K. N. Seifert, and A. Progulske-Fox. 2000. Invasion of endothelial and epithelial cells by strains of Porphyromonas gingivalis. FEMS Microbiol. Let. 187:139-144.[CrossRef][Medline] |
| 14. | Dorn, B. R., W. A. Dunn, Jr., and A. Progulske-Fox. 1999. Invasion of human coronary artery cells by periodontal pathogens. Infect. Immun. 67:5792-5798. |
| 15. | Dorn, B. R., W. A. Dunn, Jr., and A. Progulske-Fox. 2001. Porphyromonas gingivalis traffics to autophagosomes in human coronary artery endothelial cells. Infect. Immun. 69:5698-5708. |
| 16. | Dorn, B. R., L. J. Harris, C. T. Wujick, F. J. Vertucci, and A. Progulske-Fox. 2002. Invasion of vascular cells in vitro by Porphyromonas endodontalis. Int. Endod. J. 35:366-371.[CrossRef][Medline] |
| 17. | Dusek, D. M., A. Progulske-Fox, and T. A. Brown. 1994. Systemic and mucosal immune responses in mice orally immunized with avirulent Salmonella typhimurium expressing a cloned Porphyromonas gingivalis hemagglutinin. Infect. Immun. 62:1652-1657. |
| 18. | Dusek, D. M., A. Progulske-Fox, J. Whitlock, and T. A. Brown. 1993. Isolation and characterization of a cloned Porphyromonas gingivalis hemagglutinin from an avirulent strain of Salmonella typhimurium. Infect. Immun. 61:940-946. |
| 19. | Gibson, F. C., III, C. Hong, H. H. Chou, H. Yumoto, J. Chen, E. Lien, J. Wong, and C. A. Genco. 2004. Innate immune recognition of invasive bacteria accelerates atherosclerosis in apolipoprotein E-deficient mice. Circulation 109:2801-2806.[CrossRef][Medline] |
| 20. | Han, N., J. Whitlock, and A. Progulske-Fox. 1996. The hemagglutinin gene A (hagA) of Porphyromonas gingivalis 381 contains four large, contiguous, direct repeats. Infect. Immun. 64:4000-4007.[Abstract] |
| 21. | Haraszthy, V. I., G. Hariharan, E. M. Tinoco, J. R. Cortelli, E. T. Lally, E. Davis, and J. J. Zambon. 2000. Evidence for the role of highly leukotoxic Actinobacillus actinomycetemcomitans in the pathogenesis of localized juvenile and other forms of early-onset periodontitis. J. Periodontol. 71:912-922.[CrossRef][Medline] |
| 22. | He, X. Y., Y. H. Zhuang, X. G. Zhang, and G. L. Li. 2003. Comparative proteome analysis of culture supernatant proteins of Mycobacterium tuberculosis H37Rv and H37Ra. Microbes Infect. 5:851-856.[CrossRef][Medline] |
| 23. | Ishibashi, Y., and A. Nishikawa. 2002. Bordetella pertussis infection of human respiratory epithelial cells up-regulates intercellular adhesion molecule-1 expression: role of filamentous hemagglutinin and pertussis toxin. Microb. Pathog. 33:115-125.[CrossRef][Medline] |
| 24. | Ishibashi, Y., D. A. Relman, and A. Nishikawa. 2001. Invasion of human respiratory epithelial cells by Bordetella pertussis: possible role for a filamentous hemagglutinin Arg-Gly-Asp sequence and 5ß1 integrin. Microb. Pathog. 30:279-288.[CrossRef][Medline] |
| 25. | Ishihara, K., A. Nabuchi, R. Ito, K. Miyachi, H. K. Kuramitsu, and K. Okuda. 2004. Correlation between detection rates of periodontopathic bacterial DNA in coronary stenotic artery plaque and in dental plaque samples. J. Clin. Microbiol. 42:1313-1315. Erratum, 42:5437. |
| 26. | Jain, A., E. L. Batista, Jr., C. Serhan, G. L. Stahl, and T. E. Van Dyke. 2003. Role for periodontitis in the progression of lipid deposition in an animal model. Infect. Immun. 71:6012-6018. |
| 27. | Janket, S. J., A. E. Baird, S. K. Chuang, and J. A. Jones. 2003. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 95:559-569.[Medline] |
| 28. | Kain, S. R., and H. L. Henry. 1990. Quantitation of proteins bound to polyvinylidene difluoride membranes by elution of Coomassie brilliant blue R-250. Anal. Biochem. 189:169-172.[CrossRef][Medline] |
| 29. | Kao, K. J., and P. A. Klein. 1986. A monoclonal antibody-based enzyme-linked immunosorbent assay for quantitation of plasma thrombospondin. Am. J. Clin. Pathol. 86:317-323.[Medline] |
| 30. | Katz, J., K. P. Black, and S. M. Michalek. 1999. Host responses to recombinant hemagglutinin B of Porphyromonas gingivalis in an experimental rat model. Infect. Immun. 67:4352-4359. |
| 31. | Khader, Y. S., Z. S. Albashaireh, and M. A. Alomari. 2004. Periodontal diseases and the risk of coronary heart and cerebrovascular diseases: a meta-analysis. J. Periodontol. 75:1046-1053.[CrossRef][Medline] |
| 32. | Kohler, J. J., L. Pathangey, A. Hasona, A. Progulske-Fox, and T. A. Brown. 2000. Long-term immunological memory induced by recombinant oral Salmonella vaccine vectors. Infect. Immun. 68:4370-4373. |
| 33. | Kohler, R., A. Bubert, W. Goebel, M. Steinert, J. Hacker, and B. Bubert. 2000. Expression and use of the green fluorescent protein as a reporter system in Legionella pneumophila. Mol. Gen. Genet. 262:1060-1069.[CrossRef][Medline] |
| 34. | Kozarov, E. V., B. R. Dorn, C. E. Shelburne, W. A. Dunn, Jr., and A. Progulske-Fox. 2005. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Arterioscler. Thromb. Vasc. Biol 25:e17-e18. |
| 35. | Kuramitsu, H. K., I. C. Kang, and M. Qi. 2003. Interactions of Porphyromonas gingivalis with host cells: implications for cardiovascular diseases. J. Periodontol. 74:85-89.[CrossRef][Medline] |
| 36. | Laemmli, U. K. 1970. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 227:680-685.[CrossRef][Medline] |
| 37. | Lalla, E., I. B. Lamster, M. A. Hofmann, L. Bucciarelli, A. P. Jerud, S. Tucker, Y. Lu, P. N. Papapanou, and A. M. Schmidt. 2003. Oral infection with a periodontal pathogen accelerates early atherosclerosis in apolipoprotein E-null mice. Arterioscler. Thromb. Vasc. Biol. 23:1405-1411. |
| 38. | Lamont, R. J., A. Chan, C. M. Belton, K. T. Izutsu, D. Vasel, and A. Weinberg. 1995. Porphyromonas gingivalis invasion of gingival epithelial cells. Infect. Immun. 63:3878-3885.[Abstract] |
| 39. | Lepine, G., R. P. Ellen, and A. Progulske-Fox. 1996. Construction and preliminary characterization of three hemagglutinin mutants of Porphyromonas gingivalis. Infect. Immun. 64:1467-1472.[Abstract] |
| 40. | Lepine, G., and A. Progulske-Fox. 1996. Duplication and differential expression of hemagglutinin genes in Porphyromonas gingivalis. Oral Microbiol. Immunol. 11:65-78.[Medline] |
| 41. | Li, L., E. Messas, E. L. Batista, Jr., R. A. Levine, and S. Amar. 2002. Porphyromonas gingivalis infection accelerates the progression of atherosclerosis in a heterozygous apolipoprotein E-deficient murine model. Circulation 105:861-867. |
| 42. | Loesche, W. J., S. A. Syed, E. Smitdt, and E. C. Morrison. 1985. Bacterial profiles of subgingival plaques in periodontitis. J. Periodontol. 56:447-456.[Medline] |
| 43. | Mastragelopulos, N., V. I. Haraszthy, J. J. Zambon, and G. G. Zafiropoulos. 2002. Detection of periodontal pathogenic microorganisms in atheromatous plaque. Preliminary results. Chirurg 73:585-591.[CrossRef][Medline] |
| 44. | Mattila, K. J., V. V. Valtonen, M. Nieminen, and J. K. Huttunen. 1995. Dental infection and the risk of new coronary events: prospective study of patients with documented coronary artery disease. Clin. Infect. Dis. 20:588-592.[Medline] |
| 45. | Morrison, H. I., L. F. Ellison, and G. W. Taylor. 1999. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J. Cardiovasc. Risk 6:7-11.[Medline] |
| 46. | Njoroge, T., R. J. Genco, H. T. Sojar, N. Hamada, and C. A. Genco. 1997. A role for fimbriae in Porphyromonas gingivalis invasion of oral epithelial cells. Infect. Immun. 65:1980-1984.[Abstract] |
| 47. | Progulske-Fox, A., E. Kozarov, B. Dorn, W. Dunn, Jr., J. Burks, and Y. Wu. 1999. Porphyromonas gingivalis virulence factors and invasion of cells of the cardiovascular system. J. Periodontal Res. 34:393-399.[CrossRef][Medline] |
| 48. | Progulske-Fox, A., S. Tumwasorn, and S. C. Holt. 1989. The expression and function of a Bacteroides gingivalis hemagglutinin gene in Escherichia coli. Oral Microbiol. Immunol. 4:121-131.[Medline] |
| 49. | Progulske-Fox, A., S. Tumwasorn, G. Lepine, J. Whitlock, D. Savett, J. J. Ferretti, and J. A. Banas. 1995. The cloning, expression and sequence analysis of a second Porphyromonas gingivalis gene that codes for a protein involved in hemagglutination. Oral Microbiol. Immunol. 10:311-318.[Medline] |
| 50. | Pussinen, P. J., G. Alfthan, J. Tuomilehto, S. Asikainen, and P. Jousilahti. 2004. High serum antibody levels to Porphyromonas gingivalis predict myocardial infarction. Eur. J. Cardiovasc. Prev. Rehabil. 11:408-411.[CrossRef][Medline] |
| 51. | Pussinen, P. J., P. Jousilahti, G. Alfthan, T. Palosuo, S. Asikainen, and V. Salomaa. 2003. Antibodies to periodontal pathogens are associated with coronary heart disease. Arterioscler. Thromb. Vasc. Biol. 23:1250-1254. |
| 52. | Qi, M., H. Miyakawa, and H. K. Kuramitsu. 2003. Porphyromonas gingivalis induces murine macrophage foam cell formation. Microb. Pathog. 35:259-267.[CrossRef][Medline] |
| 53. | Relman, D. A., M. Domenighini, E. Tuomanen, R. Rappuoli, and S. Falkow. 1989. Filamentous hemagglutinin of Bordetella pertussis: nucleotide sequence and crucial role in adherence. Proc. Natl. Acad. Sci. USA 86:2637-2641. |
| 54. | Sambri, V., A. Marangoni, F. Cavrini, O. Leone, G. Magnani, L. Montebugnoli, C. Prati, and R. Cevenini. 2004. Need for procedural details in detection of periodontopathic bacterial DNA in the atheromatous plaque by PCR. J. Clin. Microbiol. 42:4914. Author reply, 42:4914-4915. |
| 55. | Simi, S., E. Pelosi-Teixeira, A. T. Yamada, P. P. Joazeiro, C. F. Catani, and T. Yano. 2002. Hemagglutinating factor (HAF) associated with adhesiveness in enteroinvasive Escherichia coli (EIEC). Microbiol. Immunol. 46:359-363.[Medline] |
| 56. | Slots, J., L. Bragd, M. Wikström, and G. Dahlén. 1986. The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bacteroides intermedius in destructive periodontal disease in adults. J. Clin. Periodontol. 13:570-577.[CrossRef][Medline] |
| 57. | van den Berg, E., B. M., H. Beekhuizen, R. J. L. Willems, F. R. Mooi, and R. van Furth. 1999. Role of Bordetella pertussis virulence factors in adherence to epithelial cell lines derived from the human respiratory tract. Infect. Immun. 67:1056-1062. |
| 58. | Weinberg, A., C. M. Belton, Y. Park, and R. J. Lamont. 1997. Role of fimbriae in Porphyromonas gingivalis invasion of gingival epithelial cells. Infect. Immun. 65:313-316.[Abstract] |
| 59. | Wilson, M. E., J. J. Zambon, J. B. Suzuki, and R. J. Genco. 1985. Generalized juvenile periodontitis, defective neutrophil chemotaxis and Bacteroides gingivalis in a 13-year-old female. A case report. J. Periodontol. 56:457-463.[Medline] |
| 60. | Wood, N., and R. B. Johnson. 2005. Recovery of periodontopathogenic bacteria from embalmed human cadavers. Clin. Anat. 18:64-67.[CrossRef][Medline] |
| 61. | Yang, Q. B., M. Martin, S. M. Michalek, and J. Katz. 2002. Mechanisms of monophosphoryl lipid A augmentation of host responses to recombinant HagB from Porphyromonas gingivalis. Infect. Immun. 70:3557-3565. |
| 62. | Yildiz, F. H., N. A. Dolganov, and G. K. Schoolnik. 2001. VpsR, a member of the response regulators of the two-component regulatory systems, is required for expression of vps biosynthesis genes and EPS(ETr)-associated phenotypes in Vibrio cholerae O1 El Tor. J. Bacteriol. 183:1716-1726. |
| 63. | Zhang, P., Q. B. Yang, D. J. Marciani, M. Martin, J. D. Clements, S. M. Michalek, and J. Katz. 2003. Effectiveness of the quillaja saponin semi-synthetic analog GPI-0100 in potentiating mucosal and systemic responses to recombinant HagB from Porphyromonas gingivalis. Vaccine 21:4459-4471.[CrossRef][Medline] |
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