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Journal of Clinical Microbiology, August 2004, p. 3873-3876, Vol. 42, No. 8
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.8.3873-3876.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Distribution of Porphyromonas gingivalis Biotypes Defined by Alleles of the kgp (Lys-Gingipain) Gene
Mangala A. Nadkarni,1* Ky-Anh Nguyen,1 Cheryl C. Chapple,1 Arthur A. DeCarlo,2,3 Nicholas A. Jacques,1 and Neil Hunter1
Institute of Dental Research, Westmead Millennium Institute, and Westmead Centre for Oral Health,1
United Dental Hospital, Sydney, Australia,2
NSU Dental, Nova Southeastern University, Ft. Lauderdale, Florida3
Received 12 November 2003/
Returned for modification 3 February 2004/
Accepted 28 April 2004

ABSTRACT
Paired subgingival plaque samples representing the most-diseased
and least-diseased sites were collected from 34 adult patients
with diagnosed chronic periodontitis. The percentage of
Porphyromonas gingivalis relative to the total anaerobic and gram-negative
bacterial load at each site was determined by real-time PCR.
Based on variations in the noncatalytic C terminus of the Lys-gingipain
(Kgp), it was reasoned that DNA sequence variation in the 3'-coding
region of the
kgp gene might determine functional biotypes.
Perusal of the available sequence information in GenBank indicated
three such forms of the
kgp gene corresponding to
P. gingivalis strains HG66, 381, and W83. Analysis of patient samples revealed
the presence of a fourth genotype (W83v) that showed duplication
of a sequence recognized by the W83 reverse primer. The four
biotypes, HG66, 381, W83, and W83v, were present in the study
group in the ratio 8:11:6:5, respectively. Each subject was
colonized by one predominant biotype, and only three patients
were colonized by a trace amount of a second biotype.

TEXT
Although a variety of technologies have been employed to demonstrate
the genetic diversity of
Porphyromonas gingivalis, it remains
unclear if there are virulent biotypes of this bacterium. While
analysis by restriction fragment length polymorphism (
1) indicated
that the same ribotypes of
P. gingivalis are found in subgingival
plaque samples of periodontitis patients in different countries,
data obtained by random amplified primer detection and multilocus
enzyme electrophoresis methods (
19,
21) suggested that multiple
strains are associated with disease, leading to the conclusion
that infection by this bacterium is largely opportunistic. There
is no consensus from studies employing
fimA genotyping, heteroduplex
formation, and capsular antigen serotyping (
2,
3,
8,
16).
Diversity in P. gingivalis appears to have arisen by genetic recombination rather than mutation (7, 15, 24). Accordingly, the structure and function of major virulence factors, such as the gingipain cysteine proteinases, provide key insights into the pathogenicity of different strains (17). The use of inactivation mutants (18, 26) and specific inhibitors (5) has demonstrated the important role of the Lys-gingipain, Kgp, in the acquisition of essential heme for growth in vitro and the virulence of P. gingivalis in animal models. The form and partitioning of Kgp between the cell and the extracellular milieu have been reported to show variations (28) that correlate with distinct changes in the functional properties of P. gingivalis strains (12, 22). Differences have also been observed in the pathogenic potential of laboratory strains, depending on the animal model (4, 13) or the in vitro assay employed (10, 11). The latter differences in virulence may be a function of the heterogeneity within virulence genes such as kgp.
The kgp gene codes for a protein composed of five domains: a propeptide, a catalytic domain, and three adhesin domains, Kgp39, HA2, and Kgp44. A variable region exists in the Kgp44 domain of different strains of P. gingivalis (Fig. 1). The DNA sequence of the 3'-hemagglutinin region of the kgp gene is also found in multiple copies in the hemagglutinin gene, hagA (9). On the basis of evidence currently available, the distribution of biotypes based on variation of Kgp structure in patients with periodontal disease appears to be important. The present study was therefore undertaken to explore the feasibility of detecting different biotypes of P. gingivalis based on sequence variation of the kgp gene as a basis for defining the distribution of these forms in clinical samples.
Adult patients attending the periodontal clinics of the United
Dental Hospital and Westmead Centre for Oral Health were selected
on the basis of no history of systemic disease known to affect
the periodontium, no periodontal therapy for the preceding 3
years and a diagnosis of generalized or localized periodontitis.
After removal of supragingival plaque, subgingival plaque was
obtained by curette sampling from the most diseased and least
diseased sites of 34 patients (mean age, 51 ± 10 years;
18 males and 16 females). DNA was extracted from reference strains
and from subgingival plaque samples by using the ATL buffer
reagent (Qiagen, Victoria, Australia), which efficiently releases
DNA from gram-negative bacteria as well as those cultured under
anaerobic conditions (
20,
23). Total bacterial and
P. gingivalis loads were quantified in the subgingival plaque by real-time
PCR on an ABI-PRISM 7700 sequence detection system (Applied
Biosystems, Foster City, Calif.) using a universal primer and
probe set and a
P. gingivalis-specific primer and probe set,
respectively, to detect 16S rRNA genes (
20,
23). The amount
of DNA in each sample was measured on a standard graph of
P. gingivalis DNA (DNA range of 3.6 fg to 3.6 ng) and was converted
to theoretical cell numbers based on the assumption that each
cell contained 2.37 fg of DNA (
20). The relative abundance of
P. gingivalis was therefore expressed as a percentage of the
total anaerobic plus gram-negative load determined by using
a universal bacterial amplicon (
20,
23). Thirty-one patients
were positive for
P. gingivalis, with the relative abundance
of this organism varying from 0.003 to 38% of the total anaerobic
and gram-negative load (see Fig.
3). The samples that were positive
for
P. gingivalis were further tested for different biotypes
based on variations in the
kgp gene.
In order to determine the feasibility of discriminating biotypes
of
P. gingivalis based on the
kgp gene, DNA was first extracted
from individual batch cultures (
20) of the
P. gingivalis strains
HG66, 381, and W83, which express three different alleles of
the
kgp gene (
27). To discriminate strains 381 and W83, a biotype-specific
region of the
kgp gene was amplified by PCR using the
kgp-forward
primer,
kgpF, complementary to a region of identity in all strains,
and either the strain-specific reverse primer 381R or W83R,
which were complementary to unique DNA sequences within the
3'-variable region of the gene (Table
1 and Fig.
1). To further
discriminate these two alleles from a third expressed by strain
HG66, the HG66F primer, complementary to a DNA sequence within
the region coding for the Kgp39 domain, and the HG66R primer,
complementary to a DNA sequence coding for a region within the
Kgp44 domain, were used (Table
1 and Fig.
1).
PCR was carried out with HotStarTaq Master Mix (Qiagen, Australia)
with an initial enzyme activation at 95°C for 15 min followed
by 40 cycles of 15 s of denaturation at 95°C and 5 min of
annealing and extension at 60°C. The capacity of the primer
sets to differentiate the three structural homologs of
kgp was
established (Fig.
2). The primer set HG66F and HG66R amplified
an HG66-biotype-specific amplicon of 1.9 kb, the primer set
kgpF and 381R amplified a 381-biotype-specific amplicon of 3.4
kb, and the primer set
kgpF and W83R amplified a W83-biotype-specific
amplicon of 3.6 kb. All three primer sets were strain specific
(Fig.
2). Analysis of patient samples, however, revealed a further
kgp allele, identified as a variant of the W83 type (designated
W83v; GenBank accession no.
AY559244). This allele possessed
a duplication of a sequence complementary to that of the W83R
primer in the Kgp39 domain (Fig.
1) that resulted in the amplification
of a 2.2-kb amplicon by PCR (Fig.
2I, gel C, samples 6D and
10D; Fig.
2II, gel C, samples 25D, 26D, and 27D).
Biotypes of
P. gingivalis based on
kgp heterogeneity were identified
in the most-diseased sites of 27 patients (Fig.
2 and
3), in
which the relative abundance of
P. gingivalis exceeded 0.01%
of total gram-negative and anaerobic bacterial load. This result
indicated either that the detection of a specific biotype was
less sensitive than bacterial detection based on the 16S rRNA
gene or that samples with low levels of
P. gingivalis contained
an unknown biotype(s).
P. gingivalis was detected in the least-diseased
sites in 12 patients. In all patients in which
P. gingivalis could be quantified at both sites, the same biotype(s) was detected
(Fig.
2). Only three individuals carried more than one biotype:
two harbored both the HG66 and W83v biotypes (Fig.
2I, 6D, and
2II, 25D), while one possessed a combination of
P. gingivalis HG66 and 381 biotypes (Fig.
2I, 8D). The frequency of occurrence
of biotype HG66 versus biotype 381 versus biotype W83 versus
biotype W83v was 8:11:6:5.
Different alleles of kgp may be relevant to the virulence of P. gingivalis strains. First, the importance of Kgp in heme acquisition is evident from studies of kgp deletion mutants in P. gingivalis ATCC 33277 (kgp biotype 381) where the mutants are poorly pigmented in comparison with the wild type (29). This change in heme acquisition is reflected in the different biotypes that formed the basis of the current study, since colonies of P. gingivalis HG66 grown on blood agar are poorly pigmented. This phenomenon may be related to the observed release of gingipain moieties by strain HG66 compared with the primary retention of these complexes at the cell surface by strain 381 (28). Second, all biotypes (including W83v) possess a putative C-terminal membrane-anchoring peptide in the Kgp44 domain (30). A region of identity extends from this anchoring peptide for a further 30 residues towards the N terminus of the protein to a site where processing of the protein is considered to occur based on the analysis of the X-ray crystallographic structure of the processed protein, RgpB, which belongs to a related family of gingipains (6). The region N terminal to this processing site is identical in the Kgp of P. gingivalis strains HG66 and 381 but differs in strains W83 and W83v. Accordingly, Kgp in W83 and W83v may be processed differently. Third, a segment within the variable region of W83 and W83v shows 65% identity to a synthetic 20-amino-acid peptide that can inhibit hemagglutination (14). The same segment is not observed in other strains. Fourth, variations in immunological reactivity have been noted. The Kgp from P. gingivalis HG66 has two copies of an epitope: one in the Kgp39 adhesin domain and one in the variable region of the Kgp44 domain (25), while only one copy is to be found in the Kgp39 adhesin domain of other P. gingivalis strains. It is presently unknown if clinical isolates corresponding to the reference P. gingivalis Kgp-based biotypes described here have similar properties with respect to Kgp partitioning and functionality. Future expanded analysis of the relationship of the biotypes to the structure and stage of the periodontal lesion will provide a basis for evaluating the association of kgp alleles with the virulence of this bacterium.

ACKNOWLEDGMENTS
We wish to thank Ann Progulske-Fox, University of Florida, for
providing
P. gingivalis strains 381 and W83 and Neil O'Brien-Simpson,
University of Melbourne, Melbourne, Australia, for providing
P. gingivalis strain HG66.

FOOTNOTES
* Corresponding author. Mailing address: Institute of Dental Research, Westmead Centre for Oral Health, P.O. Box 533, Wentworthville, NSW 2145, Australia. Phone: 61 2 9845 7826. Fax: 61 2 9845 7599. E-mail:
mnadkarni{at}dental.wsahs.nsw.gov.au.


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Journal of Clinical Microbiology, August 2004, p. 3873-3876, Vol. 42, No. 8
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.8.3873-3876.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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