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Investigating the Potential of Biosurfactants in the Control of Tooth Infections

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Investigating the Potential of Biosurfactants in the Control of Tooth Infections A thesis submitted to Cardiff University in fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) 2019 Zahraa Amer Hashim College of Biomedical and Life Sciences School of Dentistry Cardiff University Declaration This work has not been submitted in substance for any other degree or award at this or any other university or place of learning, nor is being submitted concurrently in candidature for any degree or other award. Signed :............................................. (Zahraa Amer Hashim) Date:................ Statement 1 This thesis is being ubmitted in partial fulfillment of the requirements for the degree of PhD. Signed :............................................. (Zahraa Amer Hashim) Date:................ Statement 2 This thesis is the result of my own independent work/investigation, except where otherwise stated. Other sources are acknowledged by explicit references. The views expressed are my own. Signed :............................................. (Zahraa Amer Hashim) Date:................ Statement 3 I hereby give consent for my thesis, if accepted, to be available for photocopying and for inter-library loan, and for the title and summary to be made available to outside organisations. Signed :............................................. (Zahraa Amer Hashim) Date:................ Statement 4: Previously Approved Bar on Access I hereby give consent for my thesis, if accepted, to be available for photocopying and for inter-library loans after expiry of a bar on access previously approved by the Academic Standards & Quality Committee. Signed :............................................. (Zahraa Amer Hashim) Date:................ ii Dedication to IRAQ in general, NINAVA in particular I dedicate this thesis iii Acknowledgements First and foremost, I praise ALLAH, the almighty for granting me the opportunity, capability and providing me with patience to complete this Thesis. Pursuing my PhD has been an incredible challenge especially when I suddenly found myself alone raising three children away from my family whom themselves were in danger. This journey would not have been possible to be completed successfully without the help and support of those around me. I owe a huge deal of gratitude to my main supervisor: Prof. Rachel Waddington, I can see your advice as a reality now while I am putting all together “PhD is a sequential acquisition of knowledge”. Thank you for your patience, understanding and continuous guidance and support. I would like also to thank my secondary supervisor Dr. Melanie Wilson for her tremendous advice, generous support and being friendly along the study time and to Prof. Jean-Yves Maillard, my third supervisor, for his shrewdness, kindness and valuable feedback and advice. I must include thanks to the Higher Committee for Education Development (HCED) in Iraq for the financial support to get this degree. My praise goes to all the technicians, staff and colleagues in the Oral and Biomedical Department, especially Dr. Wayne Ayre, Dr. Amr Alraies, Dr. Ahmed Al-Qarakhli, Dr. Daniel Morse and Dr. Steven Avery for their training and advice; Dr. Sarah Youde and Dr. Maria Stack for assistance in molecular biology and tissue culture; Lucy Marsh and Dr. Sarah Bamford in the microbiology lab; Hayley Pincott and Sue Wozniak in the pathology lab, as has the advice of Dr. Adam Jones; Wendy Rowe for her training and help with imaging; Dr Kate Heesom, facility director of University of Bristol Proteomics Facility and Dr Ian Brewis, Central Biotechnology Services (CBS) operational director for help in running Mass spectrometry. There have been many others who have lent a hand, an ear or a piece of equipment along the way, and I am very lucky to have worked with such a supportive group of people. To Nadia Alaidaroos, Uzma Ghulam, Jabur Khan, Vildan Celiksoy and to all other unnamed friends, I highly appreciated your support and being a part of my life here in Cardiff. A special thank you to my parents for your love, reassurance and continued support. I will always be indebted to what you have done for me throughout my life and for the patience and understanding you have demonstrated throughout my academic endeavours away from home. To my other family and friends who I have not mentioned here, thank you for your additional support and encouragement. My wonderful children: Zakariya, Zainab and little Asma thank you for giving me love, company and happiness, thank you for your patience on those days and weekends when I was conducting experiments, feeding cells or killing bugs returning back home late instead of being with you, I LOVE you. iv Presentations Work from this thesis has been presented at the following meetings: Speaking of Science, Cardiff, 5th May 2016 “Investigate the potential of probiotics and their products in endodontic infections” Zahraa Hashim, Melanie J Wilson, Jean-Yves Maillard, Rachel Waddington Oral Microbiology and Immunology Group (OMIG) meeting, Wales, 9th- 11th March 2016 “Investigating the potential for probiotic micro-organisms and biosurfactants in preventing pathogenic infection” Zahraa Hashim, Daniel J Morse, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington School of Medicine and Dentistry Postgraduate Research Day, Cardiff, November 2016 “Assessment of Biosurfactants from Lactobacillus plantarum to Fight Endodontic Infection” Zahraa Hashim, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington CITER annual scientific meeting, Cardiff, September 2017 “Assessment of Biosurfactants from Lactobacillus plantarum to Fight Endodontic Infection” Zahraa Hashim, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington BSODR annual general meeting, Plymouth, September 2017 “Biosurfactants from Lactobacillus plantarum to Fight Endodontic Infection” Zahraa Hashim, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington IADR/PER General Session-London, England “Assessing the Potential of Novel Biosurfactants in Treating Pulpal Infection” Zahraa Hashim, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington v 17th Annual Conference of the UK Society for Biomaterials, 28th -29th Jun 2018 Bath “Assessment of Biosurfactants from Lactobacillus plantarum to Fight Endodontic Infection” Zahraa Hashim, Jean-Yves Maillard, Melanie J Wilson, Rachel J Waddington vi Abstract A shift from the “doomed” organ concept of an exposed pulp to the concept of hope and retrieval has been recently adopted with the introduction of vital pulp therapy. Microbial contamination of the capped pulp is the main cause of therapy failure and is a fundamental challenge of contemporary endodontics. Biosurfactants are tensioactive microbe-derived molecules with a potential antimicrobial/antiadhesive activity. This project aimed to investigate the role of biosurfactants, specifically probiotic-derived ones and a commercial- sourced rhamnolipid (Sigma Aldrich), as novel endodontic antimicrobial therapies that can aid in reducing the incidence of infection and endodontic failure. Of five probiotic strains studied, Lactobacillus plantarum demonstrated significant antimicrobial activity against three Streptococcus anginosus group members; S. anginosus, S. constellatus and S. intermedius and against Enterococcus faecalis. A cell-bound biosurfactant (Lp-BS) was successfully extracted from the potential probiotic L. plantarum. Biochemical characterisation identified Lp-BS as a glycoprotein molecule that was capable of reducing surface tension and emulsifying hydrocarbons. For the endodontic pathogens studied, Lp-BS demonstrated no antibacterial activity up to concentrations of 50 mg/ml, but displayed significant antiadhesive potential at 20 mg/mL. Proteomic analysis revealed a rich heterogeneous proteinaceous nature of Lp-BS mixture and importantly identified three adhesin-like proteins raising the possibility for applications in pathogenic bacterial adhesion interference. Ten mg/ml Lp-BS induced high levels of apoptosis in pulpal fibroblasts at 24 h, resulting in significant reduction in cell number. No significant differences were reported in cell counts or histology of pulp tissue treated with 0.625-10 mg/mL Lp-BS in comparison to the controls, over a 24 h time period. Subsequent incubation with 10 mg/mL for 48 h revealed obvious pulp tissue toxicity. Partial purification of Lp-BS by means of size-exclusion chromatography resulted in five elution pools with the first fraction determined to retain the biosurfactant activity; this fraction can be further investigated for antimicrobial/antiadhesive effects. Rhamnolipid demonstrated substantial antimicrobial effect with minimum inhibitory concentrations determined to be 0.097 mg/mL against S. anginosus, 0.048 mg/mL against S. constellatus and S. intermedius and 50 mg/mL against E. faecalis. Rhamnolipid also reduced attachment of S. anginosus and S. intermedius to an abiotic surface. Of importance, rhamnolipid was shown to tolerate serum concentrations ≤ 5 % v/v. However, above this concentration inactivation of rhamnolipid effect was demonstrated. Application of rhamnolipid to rodent ex-vivo tooth model infected with S. anginosus and S. constellatus demonstrated significant antimicrobial activity and a mild immune response of pulp tissue in response to treatment was documented. This work provides the foundation for further investigation on Lp-BS adhesin-like proteins as a novel endodontic antiadhesive therapy. Furthermore, the cost-effective rhamnolipid with its
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