Previous Article | Next Article 
Journal of Clinical Microbiology, February 2003, p. 863-866, Vol. 41, No. 2
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.2.863-866.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Development of a 5' Fluorogenic Nuclease-Based Real-Time PCR Assay for Quantitative Detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis
Akihiro Yoshida, Nao Suzuki, Yoshio Nakano,* Takahiko Oho, Miki Kawada, and Toshihiko Koga
Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Fukuoka 812-8582, Japan
Received 22 August 2002/
Returned for modification 10 October 2002/
Accepted 30 October 2002

ABSTRACT
A 5' nuclease TaqMan PCR was developed for the quantitative
detection of the periodontopathic bacteria
Actinobacillus actinomycetemcomitans and
Porphyromonas gingivalis. The relative numbers of bacteria
were measured by the comparative threshold cycle method. This
simplified method is a way of obtaining the relative quantities
of these organisms from specimens and of monitoring the effect
of therapy.

TEXT
Periodontitis is an inflammation of the supporting tissues of
the teeth (
4). It is generally accepted that periodontal diseases
are infectious diseases caused by oral bacteria (
5).
Actinobacillus actinomycetemcomitans is a nonmotile, gram-negative, capnophilic,
fermentative coccobacillus that has been implicated in the etiology
of localized juvenile periodontitis (
12,
16,
18), while
Porphyromonas gingivalis is a gram-negative, black-pigmented anaerobe that
is strongly implicated as a major pathogen in adult periodontitis
(
14,
19). Several PCR-based systems that use oral specimens
for the detection of oral bacterial infections, especially periodontitis,
have been reported (
1,
2,
13,
15). Most previous diagnostic
systems are qualitative and are therefore unsuitable for the
evaluation of treatment, as quantitative analysis is essential
for monitoring the effect of therapy in treatment trials.
The TaqMan assay based on the 5'-3' exonuclease activity of Taq polymerase has been developed for quantitative detection of DNA (9). Briefly, an oligonucleotide probe that has a reporter fluorescent dye attached to its 5' end and a quencher dye attached to its 3' end is used for the assay. When the probe hybridizes to its target template, the reporter dye is cleaved by the 5' nuclease activity of Taq polymerase and becomes capable of emitting a fluorescent signal, since it is no longer suppressed by the quencher dye (8).
This report describes a simple, rapid method for the relative quantification of major periodontopathic bacteria, including A. actinomycetemcomitans and P. gingivalis, in saliva and subgingival plaque. The method uses a TaqMan PCR assay and the comparative threshold cycle (
Ct) method. This is the first reported TaqMan method developed for the detection of A. actinomycetemcomitans.
The bacterial strains used in this study are listed in Table 1. The strains of A. actinomycetemcomitans and P. gingivalis were cultured as described previously (15, 17). Subgingival plaque and saliva samples from patients with periodontitis were prepared as described previously (15).
The oligonucleotide primers and probes, designed by using Primer
Express (version 1.5) software (Applied Biosystems, Foster City,
Calif.), are listed in Table
2. The sequences of the universal
primers and a probe for a broad range of bacteria are complementary
to highly conserved regions within the 16S rRNA gene (
7). The
A. actinomycetemcomitans- and
P. gingivalis-specific primers
and probes were designed from the
lktA (
6) and 16S rRNA genes,
respectively. The specificities of the primers and probes were
confirmed by conventional PCR (Table
1) and dot blot analysis
with digoxigenin-labeled probes (data not shown), respectively.
Conventional PCR with universal primers amplified a DNA fragment
of a similar size (68 bp) from all the strains listed in Table
1. The fluorescent probes were dually labeled with a reporter
dye (6-carboxyfluorescein [FAM]) covalently attached at the
5' end and a quencher dye (6-carboxytetramethylrhodamine [TAMRA])
covalently attached at the 3' end. The primers used for real-time
PCR were also used for conventional PCR (Table
2). The conventional
PCR assays used to confirm the specificities and universalities
of the primers were performed as follows: 94°C for 5 min,
followed by 25 cycles of 94°C for 15 s, 55°C for 30
s, and 72°C for 1 min. For each real-time PCR, 20 µl
of a mixture containing 1 µl of lysed cells, 1
x TaqMan
Universal PCR master mixture (Applied Biosystems), each sense
and antisense primer at a concentration of 200 nM, and 250 nM
TaqMan probe was placed in each well of a 96-well plate. Amplification
and detection were performed with the ABI PRISM 7700 sequence
detection system (Applied Biosystems) with the following cycle
profile: 50°C for 2 min, 95°C for 10 min, and 60 cycles
at 95°C for 15 s and 58°C for 1 min. Optimal AmpErase
uracil-
N-glycosylase enzyme activity requires a 2-min step at
50°C (
10).
Ct is defined as the cycle at which the fluorescence
becomes detectable above the background fluorescence and is
inversely proportional to the logarithm of the initial number
of template molecules. A standard curve was plotted for each
primer-probe set by using the
Ct values obtained from amplification
of known quantities of DNA. To check the linearity of the detection
system, solutions of lysed
A. actinomycetemcomitans or
P. gingivalis were amplified in successive 10-fold dilutions in a series of
real-time PCRs so that a correlation coefficient could be calculated
from the standard curve of
Ct values. Detection and quantification
were linear over the range of DNA concentrations examined. The
quantity of DNA was linear over the range from 30 pg to 3 µg
per reaction mixture for both species (Fig.
1A and 1B). The
number of
A. actinomycetemcomitans or
P. gingivalis DNA copies
was normalized to the number of 16S rRNA gene DNA copies by
the method of Biéche et al. (
3), with modifications.
Briefly, we measured both the species-specific (
A. actinomycetemcomitans and
P. gingivalis) and the control-specific (16S rRNA gene)
fluorescence for each specimen. In addition, we measured both
types of fluorescence in four serial 10-fold dilutions of sample
lysate. Then, we constructed standard curves for both the targets
and the control for each sample. The results, expressed as the
fold difference (
N) in the number of target gene copies relative
to the number of 16S rRNA gene copies, were determined as follows:
N = 2

Ct = 2
(
Ct target -
Ct 16S rRNA), where

Ct is
Ct target
minus
Ct 16S rRNA and
Ct is the difference in threshold cycles
for target and reference. The
Ct values for the sample and 16S
rRNA were determined by subtracting the average
Ct value for
the target gene from the average
Ct value for the 16S rRNA gene.
This study determined the numbers of
A. actinomycetemcomitans and
P. gingivalis bacteria in saliva and subgingival plaque
samples from 10 patients with periodontitis (Table
3). Furthermore,
conventional PCR was performed for comparison of the sensitivities
of both the conventional and the real-time PCR analyses. The
conventional PCR analysis was performed under the same conditions
used for the real-time PCR, and the sensitivities were compared
(Table
3). The real-time PCR analysis was more sensitive than
the conventional PCR analysis in this assay.
One way to quantify bacteria is to use absolute quantification,
which requires very precise sample collection. Another way is
to use relative quantification by the

Ct method. From a clinical
perspective, analysis of the percentage of specific bacteria
in a region is often required to evaluate treatment. Lyons et
al. (
11) pointed out the importance of relative quantification
rather than determination of the absolute number of a single
species in a mixed sample.
The percentages of A. actinomycetemcomitans and P. gingivalis bacteria in each subgingival plaque sample varied by a few orders of magnitude (Table 3). Our results for P. gingivalis are consistent with those from a previous report (11). The proportion of A. actinomycetemcomitans bacteria ranged from 0 to 0.11%. Similar results were obtained with the saliva samples, in which the proportion of P. gingivalis bacteria ranged from 0 to 1.56% and that of A. actinomycetemcomitans bacteria ranged from 0 to 0.22%.
The simplified 
Ct method is accurate and useful for the relative quantification of periodontopathic bacteria. Further studies of this real-time PCR-based quantitative detection system might be useful both for the evaluation of treatment and for elucidation of the etiologic role of unculturable oral bacteria in periodontitis.

ACKNOWLEDGMENTS
This investigation was supported by Grant-in-Aid for the Encouragement
of Young Scientists 13771265 (to Y.N.) from the Ministry of
Education, Culture, Sports, Science, and Technology of Japan;
a research grant from the Takeda Science Foundation (to Y.N.);
and research fellowships from the Japan Society for the Promotion
of Science for Young Scientists (to N.S.).

FOOTNOTES
* Corresponding author. Mailing address: Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Phone: 81 92 642 6423. Fax: 81 92 642 6354. E-mail:
yosh{at}dent.kyushu-u.ac.jp.

This article is respectfully dedicated to the memory of Toshihiko Koga, who died on 14 October 2001. 

REFERENCES
1 - Amano, A., M. Kuboniwa, I. Nakagawa, S. Akiyama, I. Morisaki, and S. Hamada. 2000. Prevalence of specific genotypes of Porphyromonas gingivalis fimA and periodontal health status. J. Dent. Res. 79:1664-1668.[Abstract/Free Full Text]
2 - Ashimoto, A., C. Chen, I. Bakker, and J. Slots. 1996. Polymerase chain reaction detection of 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions. Oral Microbiol. Immunol. 11:266-273.[Medline]
3 - Biéche, I., B. Parfait, V. Le Doussal, M. Olivi, M. C. Rio, R. Lidereau, and M. Vidaud. 2001. Identification of CGA as a novel estrogen receptor-responsive gene in breast cancer: an outstanding candidate marker to predict the response to endocrine therapy. Cancer Res. 61:1652-1658.[Abstract/Free Full Text]
4 - Christersson, L. A., C. L. Fransson, R. G. Dunford, and J. J. Zambon. 1992. Subgingival distribution of periodontal pathogenic microorganisms in adult periodontitis. J. Periodontol. 63:418-425.[Medline]
5 - Genco, R. J., J. J. Zambon, and L. A. Christersson. 1988. The origin of periodontal infections. Adv. Dent. Res. 2:245-259.[Abstract/Free Full Text]
6 - Goncharoff, P., D. H. Figurski, R. H. Stevens, and D. H. Fine. 1993. Identification of Actinobacillus actinomycetemcomitans: polymerase chain reaction amplification of lktA-specific sequences. Oral Microbiol. Immunol. 8:105-110.[Medline]
7 - Greisen, K., M. Loeffelholz, A. Purohit, and D. Leong. 1994. PCR primers and probes for the 16S rRNA gene of most species of pathogenic bacteria, including bacteria found in cerebrospinal fluid. J. Clin. Microbiol. 32:335-351.[Abstract/Free Full Text]
8 - Heid, C. A., J. Stevens, K. J. Livak, and P. M. Williams. 1996. Real time quantitative PCR. Genome Res. 6:986-994.[Abstract/Free Full Text]
9 - Holland, P. M., R. D. Abramson, R. Watson, and D. H. Gelfand. 1991. Detection of specific polymerase chain reaction product by utilizing the 5'
3' exonuclease activity of Thermus aquaticus DNA polymerase. Proc. Natl. Acad. Sci. USA 88:7276-7280.[Abstract/Free Full Text]
10 - Longo, M. C., M. S. Berninger, and J. L. Hartley. 1990. Use of uracil DNA glycosylase to control carry-over contamination in polymerase chain reactions. Gene 93:125-128.[CrossRef][Medline]
11 - Lyons, S. R., A. L. Griffen, and E. J. Leys. 2000. Quantitative real-time PCR for Porphyromonas gingivalis and total bacteria. J. Clin. Microbiol. 38:2362-2365.[Abstract/Free Full Text]
12 - Meyer, D. H., and P. M. Fives-Taylor. 1997. The role of Actinobacillus actinomycetemcomitans in the pathogenesis of periodontal disease. Trends Microbiol. 5:224-228.[CrossRef][Medline]
13 - Oho, T., Y. Yamashita, Y. Shimazaki, M. Kushiyama, and T. Koga. 2000. Simple and rapid detection of Streptococcus mutans and Streptococcus sobrinus in human saliva by polymerase chain reaction. Oral Microbiol. Immunol. 15:258-262.[CrossRef][Medline]
14 - Slots, J., and R. J. Genco. 1984. Black-pigmented Bacteroides species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans in human periodontal disease: virulence factors in colonization, survival, and tissue destruction. J. Dent. Res. 63:412-421.[Free Full Text]
15 - Suzuki, N., Y. Nakano, Y. Yoshida, D. Ikeda, and T. Koga. 2001. Identification of Actinobacillus actinomycetemcomitans serotypes by multiplex PCR. J. Clin. Microbiol. 39:2002-2005.[Abstract/Free Full Text]
16 - Wilson, M., and B. Henderson. 1995. Virulence factors of Actinobacillus actinomycetemcomitans relevant to the pathogenesis of inflammatory periodontal diseases. FEMS Microbiol. Rev. 17:365-379.[CrossRef][Medline]
17 - Yoshimura, M., Y. Nakano, Y. Yamashita, T. Oho, T. Saito, and T. Koga. 2000. Formation of methyl mercaptan from L-methionine by Porphyromonas gingivalis. Infect. Immun. 68:6912-6916.[Abstract/Free Full Text]
18 - Zambon, J. J. 1985. Actinobacillus actinomycetemcomitans in human periodontal disease. J. Clin. Periodontol. 12:1-20.[CrossRef][Medline]
19 - Zambon, J. J., H. S. Reynolds, and J. Slots. 1981. Black-pigmented Bacteroides spp. in the human oral cavity. Infect. Immun. 32:198-203.[Abstract/Free Full Text]
Journal of Clinical Microbiology, February 2003, p. 863-866, Vol. 41, No. 2
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.2.863-866.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
This article has been cited by other articles:
-
Zhao, H., Wang, Y., Wu, Y., Li, X., Yang, G., Ma, X., Zhao, R., Liu, H.
(2009). Hyperlipidemia does not prevent the cardioprotection by postconditioning against myocardial ischemia/reperfusion injury and the involvement of hypoxia inducible factor-1{alpha} upregulation. Acta Biochim Biophys Sin
41: 745-753
[Abstract]
[Full Text]
-
Hyvarinen, K., Laitinen, S., Paju, S., Hakala, A., Suominen-Taipale, L., Skurnik, M., Kononen, E., Pussinen, P. J.
(2009). Detection and quantification of five major periodontal pathogens by single copy gene-based real-time PCR. Innate Immunity
15: 195-204
[Abstract]
-
Suzuki, N., Yoshida, A., Nakano, Y.
(2005). Quantitative Analysis of Multi-Species Oral Biofilms by TaqMan Real-Time PCR. Clin Med Res
3: 176-185
[Abstract]
[Full Text]
-
Nagashima, S., Yoshida, A., Suzuki, N., Ansai, T., Takehara, T.
(2005). Use of the Genomic Subtractive Hybridization Technique To Develop a Real-Time PCR Assay for Quantitative Detection of Prevotella spp. in Oral Biofilm Samples. J. Clin. Microbiol.
43: 2948-2951
[Abstract]
[Full Text]
-
Yoshida, A., Nagashima, S., Ansai, T., Tachibana, M., Kato, H., Watari, H., Notomi, T., Takehara, T.
(2005). Loop-Mediated Isothermal Amplification Method for Rapid Detection of the Periodontopathic Bacteria Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. J. Clin. Microbiol.
43: 2418-2424
[Abstract]
[Full Text]
-
Boutaga, K., van Winkelhoff, A. J., Vandenbroucke-Grauls, C. M. J. E., Savelkoul, P. H. M., Yoshida, A., Suzuki, N., Nakano, Y., Kawada, M., Oho, T.
(2004). Considerations in Evaluating the Applicability of Universal Detection of Oral Pathogens. J. Clin. Microbiol.
42: 4414-4415
[Full Text]
-
Suzuki, N., Yoshida, A., Saito, T., Kawada, M., Nakano, Y.
(2004). Quantitative Microbiological Study of Subgingival Plaque by Real-Time PCR Shows Correlation between Levels of Tannerella forsythensis and Fusobacterium spp.. J. Clin. Microbiol.
42: 2255-2257
[Abstract]
[Full Text]
-
Yoshida, A., Suzuki, N., Nakano, Y., Kawada, M., Oho, T., Koga, T.
(2003). Development of a 5' Nuclease-Based Real-Time PCR Assay for Quantitative Detection of Cariogenic Dental Pathogens Streptococcus mutans and Streptococcus sobrinus. J. Clin. Microbiol.
41: 4438-4441
[Abstract]
[Full Text]