INTRODUCTION
Chronic periodontitis is an inflammatory disease that results in the destruction of the supporting tissues of the teeth. It is associated with specific bacteria in subgingival dental plaque. The disease is a major public health problem in all societies and is estimated to affect around 30% of the adult population, with severe forms affecting 5 to 10% (
1,
3,
41). Chronic periodontitis poses a significant public health challenge as it is not only a major cause of tooth loss in adults but also a risk factor for cardiovascular diseases (
12,
47). In addition, chronic periodontitis has recently been associated with an increased risk of pancreatic cancer (
20,
29,
48) and squamous cell carcinoma of the head, neck, and esophagus (
18).
The periodontal pathogen
Porphyromonas gingivalis is a black-pigmented, Gram-negative, anaerobic coccobacillus. This bacterium has been implicated as a major opportunistic pathogen in the progression of chronic periodontitis, and its invasion into the host may be associated with the increased risk of systemic disease (
35). It is usually found only in small numbers or not at all in the subgingival plaque of periodontally healthy individuals, but its numbers substantially increase in subjects with chronic periodontitis, especially at sites where bleeding occurs (
46).
P. gingivalis is normally found as part of a polymicrobial biofilm, called subgingival plaque, accreted to the nonshedding surface of the tooth root below the gum line. Biofilms are communities of bacteria that live associated with a surface and embedded in a polymeric matrix, which complicates treatment of chronic infections such as periodontitis by protecting bacteria from the immune system, decreasing antibiotic/antimicrobial efficacy, and allowing dispersal of planktonic cells to invade the host and colonize at distant sites (
10,
11).
P. gingivalis releases antigens, toxic metabolites, and hydrolytic enzymes such as proteinases that enter host tissues and subvert the host's immune response (
35). The proteinases have been shown to be essential for virulence and tissue invasion by
P. gingivalis (
35,
38). The major proteinases of
P. gingivalis are its cell surface-located complexes of Arg- and Lys-specific cysteine proteinases (RgpA/B and Kgp) (
35).
Lactoferrin (LF), an 80-kDa iron-binding glycoprotein of the transferrin family, is present in the milk of various mammals, other exocrine secretions such as tears, saliva, gingival crevicular fluid, and synovial fluid, and the secondary granules of neutrophils and blood. It is believed to play an important role in innate immunity, exhibiting antibacterial, antiviral, antifungal, antitumor, parasiticidal, immunomodulatory, and anti-inflammatory activities (for reviews, see references 16, 22, 26, and 37). The iron-binding capacity of LF sequesters iron from the microbial environment, contributing to its ability to inhibit the growth of bacteria and yeasts (
39,
40). In addition, LF can directly interact with microbial membranes to alter their permeability through dispersion of membrane components, such as lipopolysaccharide (LPS), thereby causing cell death (
4,
15,
52).
In this study, we show that LF inhibited the P. gingivalis proteinases in a time-dependent manner and that LF was relatively resistant to cleavage by the proteinases. LF inhibited P. gingivalis biofilm formation while having only limited direct antibacterial activity against the bacterium. The initial cleavage site of LF was identified using in-source decay (ISD) mass spectrometry (MS) and was located on an external, hydrophilic loop of the protein. The results suggest that this cleavage did not cause a major disruption of the tertiary structure of the molecule. Even after incubation with P. gingivalis for extended time periods, LF still retained antiproteinase and biofilm inhibitory activity.
DISCUSSION
The major virulence factors of
P. gingivalis are its cysteine proteinases RgpA and Kgp and associated adhesins that form large complexes on the cell surface and cleave C-terminally to arginine or lysine residues (
35). These proteinase-adhesin complexes hydrolyze a range of host regulatory proteins, peptides, and cell receptors, leading to dysregulation of the host immune response and subsequent tissue damage (
19,
25,
35). The proteinases are essential for tissue invasion by
P. gingivalis in an animal model (
35,
38) that has been used extensively to determine the invasive characteristics of pathogenic bacteria (
23,
50).
In this study, we have shown that LF inhibited the proteolytic activity of both RgpA and Kgp (
Table 1). Shi et al. (
42) have previously shown that human LF and bovine lactoferricin, the N-terminal domain of bovine LF, were able to bind to the
P. gingivalis RgpA/Kgp proteinase-adhesin complexes and disrupt their quaternary structure, leading to the release of the hemoglobin-binding domain (Hbr). In our study, LF inhibition of the proteolytic activity of RgpB, which does not contain adhesin domains, indicated that the protein was interacting with the catalytic domain of the proteinases. Kinetic analyses demonstrated that LF inhibited the proteinases of
P. gingivalis in a time-dependent manner, confirming that LF was interacting with the catalytic domain of the proteinases. The
KI of LF for RgpA activity was 5.02 μM. This inhibition is consistent with the work of Ohashi et al. (
36), who reported that LF inhibited the proteinases cathepsin and papain, although they did not examine the time-dependent nature or the mechanism of inhibition. The time dependency of the inhibition suggests that LF is a slow binding inhibitor with a low dissociation rate (
49). The molecular dynamics simulation of the interaction between LF and RgpB (
Fig. 2) provided a mechanism for the observed inhibition. The zinc ion-binding C-lobe of LF (
21,
57) can bind the zinc ion in the active site of the RgpA/B and Kgp proteinases, ultimately forming a stable structure explaining the observed time-dependent inactivation of the proteinases.
Antimicrobial peptides and proteins in host secretions may have reduced efficacy against bacteria due to their susceptibilities to hydrolysis by cell-surface or secreted bacterial proteinases.
P. gingivalis proteinases have been shown to degrade a range of host proteins, including human transferrin and hemoglobin (
13,
17). The high level of
P. gingivalis cell surface and extracellular proteolytic activity has been shown to hydrolyze antibacterial proteins and peptides, such as histatin, thereby reducing their efficacy (
32). In this study, we showed that despite an abundance of arginine and lysine residues (
Fig. 4), LF was relatively resistant to hydrolysis by
P. gingivalis proteinases (
Fig. 3). After 3 h of incubation of LF with
P. gingivalis whole cells in a physiological buffer, only two major polypeptides (33 and 53 kDa) were detected, and these fragments resulted from cleavage at a single site. LF has been reported to be relatively resistant to degradation by both trypsin and chymotrypsin, and the N-linked glycosylation of LF has been shown to help protect the protein from trypsin hydrolysis (
7,
53). In our study, LF was more extensively hydrolyzed by trypsin than the
P. gingivalis proteinases (
Fig. 3), which is most likely related to the ability of LF to inhibit the
P. gingivalis proteinases.
Bovine LF contains five N-linked glycosylation sites (Asn-233, -281, -368, -476, and -545) (
55), and the majority of glycans are located in the N-terminal region of LF (33-kDa fragment); consequently, the variation in glycosylation could explain why this fragment eluted in two distinct peaks from RP-HPLC (
Fig. 5). The glycosylation of both fragments made it impossible to use the measured masses of the peptide fragments to identify the cleavage site. ISD MS was therefore used to analyze the primary cleavage site of LF when exposed to
P. gingivalis (
Fig. 4 and
6). The R
284-to-S
285 cleavage site identified occurs on an exposed external hydrophilic loop of the LF molecule (
2). Cleavage at this site is unlikely to cause dissociation of the two polypeptides such that the molecule would retain its tertiary structure. This was confirmed by SEC analysis of LF-Pg (6 h of incubation) that demonstrated that the two fragments (33 kDa and 53 kDa) eluted as a single peak with native LF (
Fig. 7).
In this study, we also showed that LF inhibited
P. gingivalis biofilm formation by >84% at concentrations above 0.01 mg/ml. At concentrations as low as 0.001 mg/ml, LF still significantly inhibited
P. gingivalis biofilm formation by 50% (
Fig. 10). The
P. gingivalis biofilm inhibitory activity of LF was not a general protein effect, as BSA and β-Lg did not inhibit
P. gingivalis biofilm formation and in fact enhanced it. This is consistent with the recent data of Wakabayashi et al. (
54), who showed that LF inhibited
P. gingivalis biofilm formation by ∼60% at a concentration of 0.008 mg/ml.
The biofilm inhibitory activity of LF against
P. gingivalis was not attributed to its planktonic growth inhibitory activity, as LF displayed little growth inhibitory activity against planktonic cells (
Fig. 9). LF reduced
P. gingivalis planktonic growth at high concentrations while significantly increasing the mean generation time, indicating that LF was slowing growth rather than having a bactericidal action (
Fig. 9). This is consistent with the findings of Wakabayashi et al. (
54), who showed that native bovine LF had no significant effect on
P. gingivalis viability when incubated in saline over a 4-h period. They also showed that apo-LF (iron free) had little effect on the planktonic growth of
P. gingivalis, while high concentrations (8 mg/ml) of holo-LF (iron saturated) reduced growth by 60%, as determined using an ATP luminescence assay. These data are consistent with the findings of Singh et al. (
45) and Singh (
44), who showed that LF at 0.02 mg/ml effectively inhibited
Pseudomonas aeruginosa biofilm formation but had no effect below 0.1 mg/ml on the growth rate of free-swimming bacterial cells (
45). From the current study, the results suggest that the
P. gingivalis biofilm inhibitory activity of LF may be attributable, at least in part, to its proteinase inhibitory activity, as the known proteinase inhibitor TLCK also inhibited
P. gingivalis biofilm formation. Kontani et al. (
24) have demonstrated that the Arg-specific proteinase of
P. gingivalis can expose cryptic receptors to enhance binding, and this may explain why proteinase inhibition reduced biofilm formation.
Importantly, even after incubation with P. gingivalis proteinases, LF still retained its inhibitory activity. This further supports LF retaining its tertiary structure after cleavage at the R284-to-S285 site, as when it was purified using RP-HPLC the two major fragments of LF-Pg preparations individually had no inhibitory activity.
The proteolytic activity of
P. gingivalis is central to its pathogenicity (
33,
35,
38), and this study is the first to demonstrate that LF inhibits the proteinase activity of
P. gingivalis in a time-dependent manner. It also shows that LF is relatively resistant to hydrolysis by these proteinases and that it displays sustained antibiofilm activity even when incubated with the bacterium. Therefore, LF may have an important role in gingival crevicular fluid and saliva in helping to prevent
P. gingivalis-associated disease.