Association of CBP+ Streptococcus mutans with root caries in older adults

由于预期寿命的延长和牙齿的保留，再加上社会经济的限制，物理上的 在认知能力方面，老年患者极易患根面龋病。在美国，%的成年人年龄超过 60岁有根面龋病经历。口腔病原菌变形链球菌是我国口腔疾病的重要病原菌 龋病与龋病的发生发展有直接的关系。近20%的变形链球菌 菌株表达胶原结合蛋白(CBPS)，特别是CNM和CBM，它们介导与胶原结合。 丰富的表面。我们的研究小组发现，CNM还介导口腔上皮细胞的侵袭和亲和性结合 牙本质和牙根表面(两者都富含胶原蛋白)。使用大鼠龋齿模型，我们证明了CNM对 与口腔定植、牙科生物膜成熟和严重的冠状龋齿有关。此外，在最近的一次 对儿童的横断面研究，我们观察到变形链球菌CBP+感染与 菌株和儿童早期龋齿(ECC)复发。在牙龈萎缩的情况下，牙本质通常会暴露出来。 由于物理磨损和脱矿作用。由于胶原蛋白是牙本质的主要有机物质， 考虑到我们最近观察到的CBP+变形链球菌菌株与ECC复发密切相关， 我们假设，经历牙龈衰退的老年人也感染了CBP+变形链球菌 与感染CBP-S变形杆菌菌株的人相比，患根面龋病的风险更大。然而，临床上 CBP+变形链球菌菌株的存在与根面龋病相关的证据支持这一假说 缺乏。本补充剂应用程序的目标是识别与根面龋齿相关的微生物特征 并确定感染CBP+变形链球菌菌株是否与 增加根面龋齿的风险。因此，这种补充剂应用的结果可能会导致范式从 临床干预仅侧重于病变出现根面龋齿预防和治疗后的治疗 通过将这些信息整合到龋病风险评估中进行治疗。加西亚博士的职业目标是 成为一名独立的临床医生兼科学家，在一所研究密集型牙科学校进行临床- 翻译研究，并作为下一代临床医生科学家的导师。这份副刊将 让她获得额外的培训(课程)和经验(新的实验室技能)，以实现平稳过渡 成为一名独立的牙医兼科学家。此外，一批优秀的大学导师 由微生物学家和一名牙医科学家组成，将与候选人密切合作，为 专业发展和这项建议的科学方面。

Due to the prolonged life expectancy and retention of teeth combined with socioeconomic limitations, physical and cognitive abilities, older patients are highly vulnerable to root caries. In the U.S, 64% of adults older than 60 years of age experience root caries. The oral pathogen Streptococcus mutans is a keystone pathogen in dental caries due to its direct association with caries initiation and development. Nearly 20% of S. mutans strains express collagen-binding proteins (CBPs), specifically Cnm and Cbm, that mediate binding to collagen- rich surfaces. Our group showed that Cnm also mediates invasion of oral epithelial cells and avid binding to dentin and root surfaces (both are rich in collagen). Using a rat caries model, we showed that Cnm contributes to oral colonization, maturation of the dental biofilm, and severity of coronal caries. Moreover, in a recent cross-sectional study with children, we observed a strong association between infection with S. mutans CBP+ strains and early childhood caries (ECC) recurrence. In cases of gingival recession, the dentin is often exposed due to physical abrasion and demineralization. As collagen is the main organic material of dentin and, considering our recent observation that CBP+ S. mutans strains are strongly associated with ECC recurrence, we hypothesize that older adults experiencing gingival recession who are also infected with CBP+ S. mutans are at greater risk of developing root caries than those infected with CBP– S. mutans strains. However, clinical evidence correlating the presence of CBP+ S. mutans strains with root caries to support this hypothesis is lacking. The goal of this supplement application is to identify microbial signatures associated with root caries in older adult populations and determine whether infection with CBP+ S. mutans strains is associated with increased risk of root caries. Thus, findings from this supplement application can lead to a paradigm shift from clinical interventions focused solely on treatment after the lesion appears to root caries prevention and treatment by integration of this information into the assessment of caries risk. Dr. Garcia's career goal is to become an independent clinician-scientist at a research-intensive dental school conducting clinical- translational research, and serving as a mentor to the next generation clinician scientists. This supplement will allow her to obtain the additional training (courses) and experience (new lab skills) to make a smooth transition into an independent career as a dentist-scientist. Additionally, an outstanding group of collegial mentors comprised of microbiologists and a dentist-scientist will work closely with the candidate to provide guidance in professional development and with the scientific aspect of this proposal.