The present investigation explored the hypothesis that elevated levels of certain enzymes in the gingival crevicular environment of individuals with poor oral hygiene and/or gingival inflammation may modify the surfaces of epithelial cells and thereby modulate the types of bacteria which attach and colonize. Buccal epithelial cells treated with neuraminidase and certain proteases were used as a model for study. Bacteria studied included Streptococcus sanguis and Streptococcus mitis which have been associated with gingival health, Actinomyces species which are increased in plaque associated with developing gingivitis, and Bacteroides gingivalis, Bacteroides intermedius, and Actinobacillus actinomycetemcomitans which are associated with destructive periodontal diseases. Treatment of epithelial cells with the enzymes studied produced selective effects on their receptivity for bacteria. Neuraminidase treatment of epithelial cells greatly reduced the attachment of all strains of S. sanguis and S. mitis studied. In contrast, the number of Actinomyces viscosus, A. naeslundii and A. israelii cells which attached was significantly increased. Neuraminidase treatment also appeared to enhance attachment of B. intermedius and B. gingivalis. Treatment of buccal cells with trypsin, chymotrypsin or papain also selectively affected bacterial attachment. Such protease treatment greatly reduced the numbers of streptococci and A. viscosus cells which attached, while the numbers of B. gingivalis and B. intermedius were significantly increased. Treatment of epithelial cells with preparations of lysosomal enzymes derived from human PMNs produced similar selective effects. The changes in bacterial adhesion observed by the enzyme treatments studied are consistent with the shifts in the composition of the gingival crevice flora which occur when oral hygiene is terminated and gingivitis develops.
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