Abstract
Candida albicans has been detected in root carious lesions. The current study aimed to explore the action of this fungal species on the microbial ecology and the pathogenesis of root caries. Here, by analyzing C. albicans in supragingival dental plaque collected from root carious lesions and sound root surfaces of root-caries subjects as well as caries-free individuals, we observed significantly increased colonization of C. albicans in root carious lesions. Further in vitro and animal studies showed that C. albicans colonization increased the cariogenicity of oral biofilm by altering its microbial ecology, leading to a polymicrobial biofilm with enhanced acidogenicity, and consequently exacerbated tooth demineralization and carious lesion severity. More importantly, we demonstrated that the cariogenicity-promoting activity of C. albicans was dependent on PHR2. Deletion of PHR2 restored microbial equilibrium and led to a less cariogenic biofilm as demonstrated by in vitro artificial caries model or in vivo root-caries rat model. Our data indicate the critical role of C. albicans infection in the occurrence of root caries. PHR2 is the major factor that determines the ecological impact and caries-promoting activity of C. albicans in a mixed microbial consortium.
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Data availability
Microbiome sequencing data have been deposited in public database Sequence Read Archive (http://www.ncbi.nlm.nih.gov/Traces/sra) with accession no. PRJNA613946. All data sets generated and/or analyzed in the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We greatly thank Professors Williama A. Fonzi, Dominique Sanglard, Aaron P. Mitchell, David Kadosh, Joachim F. Ernst, Gerald R. Fink, Haoping Liu and Lo Hsiu-Jung for kindly providing fungal strains. Vivian Chen is a recipient of a 2017–2018 Fulbright Research grant to China. This work was supported by the National Natural Science Foundation of China (81771099 to XX, 81870754 to XZ, 81600858 to BR, 31720103901 to Lixin Zhang), the “111” Project of China (B18022 to Lixin Zhang), a research grant from the Department of Science & Technology Sichuan Province (2018SZ0121 to XX), and the Fundamental Research Funds for the Central Universities (22221818014S to Lixin Zhang).
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Conceptualization: QD, BR, L. Zhang, XZ, and XX; methodology: QD, BR, L. Zhang, XZ, and XX; formal analysis: QD, JH, QG, and L. Zheng; investigation: QD, JH, XP, QG; resources: XP, QG, L. Zheng; data curation: JL, HD; writing original draft: QD, BR, XZ, XX; writing, review, and editing: VC, L. Zhang, XZ, XX; visualization: QD, BR, XX; supervision: L. Zhang, XZ; funding acquisition: BR, XZ, XX.
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Du, Q., Ren, B., He, J. et al. Candida albicans promotes tooth decay by inducing oral microbial dysbiosis. ISME J 15, 894–908 (2021). https://doi.org/10.1038/s41396-020-00823-8
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DOI: https://doi.org/10.1038/s41396-020-00823-8
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