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Retired in 2010, In Memoriam
Anti-inflammatory Activity of a High-molecular-weight Cranberry Fraction on Macrophages Stimulated by Lipopolysaccharides from Periodontopathogens
C. Bodet<SUP></SUP>, <NOBR>F. Chandad<SUP></SUP></NOBR>, and <NOBR>D. Grenier<SUP></SUP><SUP>*</SUP></NOBR>
[SIZE=-1]Groupe de Recherche en ?cologie Buccale, Facult? de M?decine Dentaire, Universit? Laval, Qu?bec City, Qu?bec, Canada G1K 7P4 [/SIZE]
http://jdr.iadrjournals.org/cgi/content/full/85/3/235
ABSTRACT
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TOP
ABSTRACT
INTRODUCTION
MATERIALS & METHODS
RESULTS
DISCUSSION
REFERENCES
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Periodontitis is a chronic inflammatory disease affecting oral<SUP> </SUP>tissues. The continuous, high production of cytokines by host<SUP> </SUP>cells triggered by periodontopathogens is thought to be responsible<SUP> </SUP>for the destruction of tooth-supporting tissues. Macrophages<SUP> </SUP>play a critical role in this host inflammatory response to periodontopathogens.<SUP> </SUP>
The aim of this study was to investigate the effect of non-dialyzable<SUP> </SUP>material prepared from cranberry juice concentrate on the pro-inflammatory<SUP> </SUP>cytokine response of macrophages induced by lipopolysaccharides<SUP> </SUP>(LPS) from Actinobacillus actinomycetemcomitans, Fusobacterium<SUP> </SUP>nucleatum subsp. nucleatum, Porphyromonas gingivalis, Treponema<SUP> </SUP>denticola, Tannerella forsythia, and Escherichia coli.
Interleukin-1<SUP> </SUP>beta (IL-1?), IL-6, IL-8, tumor necrosis factor alpha<SUP> </SUP>(TNF-
), and Regulated on Activation Normal T-cell Expressed<SUP> </SUP>and Secreted (RANTES) production by macrophages treated with<SUP> </SUP>the cranberry fraction prior to stimulation by LPS was evaluated<SUP> </SUP>by ELISA.
Our results clearly indicate that the cranberry fraction<SUP> </SUP>was a potent inhibitor of the pro-inflammatory cytokine and<SUP> </SUP>chemokine responses induced by LPS.
This suggests that cranberry<SUP> </SUP>constituents may offer perspectives for the development of a<SUP> </SUP>new therapeutic approach to the prevention and treatment of<SUP> </SUP>periodontitis.<SUP> </SUP>
<SUP></SUP>
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Periodontitis is a chronic inflammatory disease affecting oral<SUP> </SUP>tissues. The continuous, high production of cytokines by host<SUP> </SUP>cells triggered by periodontopathogens is thought to be responsible<SUP> </SUP>for the destruction of tooth-supporting tissues. Macrophages<SUP> </SUP>play a critical role in this host inflammatory response to periodontopathogens.<SUP> </SUP>
The aim of this study was to investigate the effect of non-dialyzable<SUP> </SUP>material prepared from cranberry juice concentrate on the pro-inflammatory<SUP> </SUP>cytokine response of macrophages induced by lipopolysaccharides<SUP> </SUP>(LPS) from Actinobacillus actinomycetemcomitans, Fusobacterium<SUP> </SUP>nucleatum subsp. nucleatum, Porphyromonas gingivalis, Treponema<SUP> </SUP>denticola, Tannerella forsythia, and Escherichia coli.
Interleukin-1<SUP> </SUP>beta (IL-1?), IL-6, IL-8, tumor necrosis factor alpha<SUP> </SUP>(TNF-
Our results clearly indicate that the cranberry fraction<SUP> </SUP>was a potent inhibitor of the pro-inflammatory cytokine and<SUP> </SUP>chemokine responses induced by LPS.
This suggests that cranberry<SUP> </SUP>constituents may offer perspectives for the development of a<SUP> </SUP>new therapeutic approach to the prevention and treatment of<SUP> </SUP>periodontitis.<SUP> </SUP>
<SUP></SUP>
[FONT=helvetica, arial][SIZE=-2]KEY WORDS:[/SIZE] cranberry ? periodontopathogen ? macrophage ? anti-inflammatory ? cytokine
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Periodontal diseases are a group of inflammatory disorders that<SUP> </SUP>lead to the destruction of tooth-supporting tissues and are<SUP> </SUP>caused by a specific group of Gram-negative anaerobic bacteria,<SUP> </SUP>including Porphyromonas gingivalis, Treponema denticola, and<SUP> </SUP>Tannerella forsythia (Haffajee and Socransky, 1994).
The host<SUP> </SUP>response to these bacteria and their products is a critical<SUP> </SUP>determinant in the initiation and progression of periodontitis.<SUP> </SUP>
More specifically, lipopolysaccharides (LPS) of Gram-negative<SUP> </SUP>bacteria are potent inducers of pro-inflammatory mediators and<SUP> </SUP>can initiate numerous host-mediated destructive processes (Henderson et al., 1996).<SUP> </SUP>Monocytes and macrophages, which are found in<SUP> </SUP>higher numbers in active periodontal lesions than in inactive<SUP> </SUP>sites (Zappa et al., 1991), play an important role in the host<SUP> </SUP>inflammatory response to periodontopathogens (Kornman et al.,<SUP> </SUP>1997).
The continuous, high secretion of various cytokines?including<SUP> </SUP>interleukin-1? (IL-1?), IL-6, IL-8, and<SUP> </SUP>tumor necrosis factor alpha (TNF-
Active compounds endowed with a<SUP> </SUP>capacity to modulate the host inflammatory response are now<SUP> </SUP>receiving considerable attention, since they may be potential<SUP> </SUP>new therapeutic agents for the treatment of periodontal diseases<SUP> </SUP>(Paquette and Williams, 2000).<SUP> </SUP>
The cranberry is a native North American fruit with various<SUP> </SUP>beneficial properties for human health, such as the inhibition<SUP> </SUP>of human cancer cell line proliferation (Ferguson et al., 2004;<SUP> </SUP>Seeram et al., 2004) and the prevention of adherence of urinary<SUP> </SUP>tract infectious agents (Raz et al., 2004).
In the area of dental<SUP> </SUP>research, it has been reported that a high-molecular-weight<SUP> </SUP>fraction prepared from cranberry juice inhibits the co-aggregation<SUP> </SUP>of many oral bacteria (Weiss et al., 1998) and affects dental<SUP> </SUP>biofilm formation (Steinberg et al., 2004; Yamanaka et al.,<SUP> </SUP>2004).
In addition, this cranberry fraction reduces mutans streptococci<SUP> </SUP>levels in saliva, inhibits in vitro adhesion of Streptococcus<SUP> </SUP>sobrinus to hydroxyapatite (Weiss et al., 2004), and promotes<SUP> </SUP>S. sobrinus desorption from artificial biofilms (Steinberg et<SUP> </SUP>al., 2005).<SUP> </SUP>
<SUP></SUP>
In this study, we hypothesized that the cranberry may have a<SUP> </SUP>beneficial effect in periodontitis by exerting an anti-inflammatory<SUP> </SUP>effect.
Therefore, we investigated the effect of a high-molecular-weight<SUP> </SUP>cranberry fraction prepared from juice concentrate on the production<SUP> </SUP>by macrophages of pro-inflammatory cytokines and chemokines<SUP> </SUP>associated with periodontitis.
More specifically, the cytokine<SUP> </SUP>and chemokine responses of macrophages were induced by LPS prepared<SUP> </SUP>from Escherichia coli and from the major periodontopathogens:<SUP> </SUP>Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum<SUP> </SUP>subsp. nucleatum, P. gingivalis, T. denticola, and T. forsythia.<SUP> </SUP>
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[FONT=helvetica, arial]Cranberry Fraction[/FONT]
Concentrated juice from the American cranberry Vaccinium macrocarpon<SUP> </SUP>was kindly provided by Ocean Spray Cranberries, Inc. (Lakeville-Middleboro,<SUP> </SUP>MA, USA).
The juice was exhaustively dialyzed (5 days) in 14,000<SUP> </SUP>MW cut-off dialysis bags at 4?C against distilled water<SUP> </SUP>and then lyophilized. The non-dialyzable material was considered<SUP> </SUP>as fraction 1. Undialyzed concentrated juice was also lyophilized<SUP> </SUP>and represented fraction 2. The cranberry powders were dissolved<SUP> </SUP>in distilled water prior to use. Chemical analyses of fraction<SUP> </SUP>1 were realized by Robin Roderick (Ocean Spray Cranberries,<SUP> </SUP>Inc.) and revealed that this fraction is devoid of sugars and<SUP> </SUP>acids and contains 0.35% of anthocyanins (0.055% of cyanidin-3-galactoside,<SUP> </SUP>0.003% of cyanidin-3-glucoside, 0.069% of cyanidin-3-arabinoside,<SUP> </SUP>0.116% of peonidin-3-galactoside, 0.016% of peonidin-3-glucoside,<SUP> </SUP>and 0.086% of peonidin-3-arabinoside) and 65.1% of proanthocyanidins.<SUP> </SUP>In addition, commercial epigallocatechin gallate (EGCG; Sigma<SUP> </SUP>Chemical Co., St. Louis, MO, USA), a polyphenol isolated from<SUP> </SUP>green tea, was used as a positive control (Yang et al., 1998).<SUP> </SUP>
<SUP></SUP>
[FONT=helvetica, arial]LPS Preparation[/FONT]
A. actinomycetemcomitans ATCC 29522, F. nucleatum subsp. nucleatum<SUP> </SUP>ATCC 25586, P. gingivalis ATCC 33277, T. denticola ATCC 35405,<SUP> </SUP>and T. forsythia ATCC 43037 were grown in their appropriate<SUP> </SUP>culture media (Grenier, 1996). LPS were isolated from these<SUP> </SUP>bacterial strains, as previously reported (Darveau and Hancock, 1983).<SUP> </SUP>This method is based on protein digestion of a whole-cell<SUP> </SUP>extract by proteinase K and successive solubilization and precipitation<SUP> </SUP>steps.
The LPS preparations were freeze-dried and kept at ?20?C.<SUP> </SUP>The amount of contaminating protein was evaluated with the use<SUP> </SUP>of a protein assay kit (Bio-Rad Laboratories, Mississauga, ON,<SUP> </SUP>Canada), with bovine serum albumin as a control, and was less<SUP> </SUP>than 0.001% in all LPS preparations. T. denticola possesses<SUP> </SUP>a lipooligosaccharide (although it will be called LPS in the<SUP> </SUP>present paper) that has properties rather distinct from those<SUP> </SUP>of the classic LPS of the Bacteroides group (Schultz et al.,<SUP> </SUP>1998). A standard LPS preparation from E. coli O55:B5 (Sigma<SUP> </SUP>Chemical Co.) was also used.<SUP> </SUP>
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[FONT=helvetica, arial]Monocyte and Macrophage Cultures[/FONT]
U937 cells (ATCC CRL-1593.2), a monoblastic leukemia cell line,<SUP> </SUP>were cultivated at 37?C in a 5% CO<SUB>2</SUB> atmosphere in RPMI-1640<SUP> </SUP>medium (HyClone Laboratories, Logan, UT, USA) supplemented with<SUP> </SUP>10% heat-inactivated fetal bovine serum (FBS) (RPMI-FBS) and<SUP> </SUP>100 ?g/mL of penicillin-streptomycin. Monocytes (2 x 10<SUP>5</SUP><SUP> </SUP>cells/mL) were incubated in RPMI-FBS containing 10 ng/mL of<SUP> </SUP>phorbol myristic acid (PMA; Sigma) for 48 hrs to induce differentiation<SUP> </SUP>into adherent macrophage-like cells, as previously reported<SUP> </SUP>(Rovera et al., 1979).
Following the PMA treatment, the medium<SUP> </SUP>was replaced with fresh medium, and the differentiated cells<SUP> </SUP>were incubated for an additional 24 hrs prior to use. Adherent<SUP> </SUP>macrophages were suspended in RPMI-FBS and centrifuged at 200<SUP> </SUP>x g for 8 min. They were washed and suspended in RPMI with 1%<SUP> </SUP>heat-inactivated FBS at a density of 1 x 10<SUP>6</SUP> cells/mL and seeded<SUP> </SUP>in a six-well plate (2 x 10<SUP>6</SUP> cells/well in 2 mL) at 37?C<SUP> </SUP>in a 5% CO<SUB>2</SUB> atmosphere.<SUP> </SUP>
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[FONT=helvetica, arial]Treatment of Macrophages[/FONT]
The macrophages were treated with increasing concentrations<SUP> </SUP>of fraction 1, fraction 2, and EGCG, ranging from 10 to 50 ?g/mL,<SUP> </SUP>and incubated at 37?C in 5% CO<SUB>2</SUB> for 2 hrs before stimulation<SUP> </SUP>with LPS at a final concentration of 1 ?g/mL. After a<SUP> </SUP>24-hour incubation (37?C in 5% CO<SUB>2</SUB>), the culture medium<SUP> </SUP>supernatants were collected and stored at ?20?C until<SUP> </SUP>used. Cells incubated in culture medium with or without cranberry<SUP> </SUP>fraction or EGCG, but not stimulated with LPS, were used as<SUP> </SUP>controls.<SUP> </SUP>
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[FONT=helvetica, arial]Cell Viability[/FONT]
Macrophage viability was evaluated by 0.2% Trypan Blue staining.<SUP> </SUP>Cell viability of macrophages was also evaluated by a MTT (3-[4,5-diethylthiazol-2-yl]-2,5-diphenyltetrazolium<SUP> </SUP>bromide) test, according to the manufacturer?s protocol<SUP> </SUP>(Roche Diagnostics, Mannheim, Germany).<SUP> </SUP>
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[FONT=helvetica, arial]Determination of Cytokine Production[/FONT]
We used commercial enzyme-linked immunosorbent assay (ELISA)<SUP> </SUP>kits (R&D Systems, Minneapolis, MN, USA) to quantify IL-1?,<SUP> </SUP>IL-6, IL-8, TNF-
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[FONT=helvetica, arial]Statistical Analyses[/FONT]
We performed two-way analyses of variance to compare the means<SUP> </SUP>of the different conditions. Differences were deemed significant<SUP> </SUP>at the 0.05 level (P value). Protected Fisher least-significant<SUP> </SUP>differences were used for pairwise comparisons.<SUP> </SUP>
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[FONT=helvetica, arial]Effects of Cranberry Fractions on LPS-induced Pro-inflammatory Cytokine Production[/FONT]
To investigate the effects of cranberry fractions on pro-inflammatory<SUP> </SUP>cytokine production, we treated macrophages with lyophilized<SUP> </SUP>non-dialyzable material of cranberry juice concentrate (fraction<SUP> </SUP>1) or lyophilized cranberry juice concentrate (fraction 2) prior<SUP> </SUP>to stimulation with the LPS of major periodontopathogens.
To<SUP> </SUP>exclude the possibility that cell toxicity due to the cranberry<SUP> </SUP>fractions might have been responsible for a decrease in cytokine<SUP> </SUP>levels, we evaluated the viability of the macrophages by an<SUP> </SUP>MTT test and Trypan blue exclusion.
No obvious cytotoxic effects<SUP> </SUP>were detected following treatments of macrophages with both<SUP> </SUP>fractions, and cell viability was
<SUP></SUP>
For IL-1?, TNF-
This effect was not observed when the macrophages<SUP> </SUP>were treated with fraction 2. Among the other LPS tested, the<SUP> </SUP>LPS from F. nucleatum subsp. nucleatum and E. coli induced a<SUP> </SUP>TNF-
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</NOBR> </TD><TD vAlign=top align=left>Figure 1. Effect of treating macrophages with fraction 1 (non-dialyzable material of cranberry juice), fraction 2 (cranberry juice), and epigallocatechin gallate (EGCG) on the secretion of IL-6 (A), TNF-
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</NOBR> </TD><TD vAlign=top align=left>Table. Effect of the Cranberry Non-dialyzable Material (fraction 1) on the Secretion by Macrophages<SUP>a</SUP> of IL-1?, TNF-
Antagonist effects of fraction 1 on A. actinomycetemcomitans<SUP> </SUP>LPS-induced IL-1? release were observed (Fig. 1C
However, at a concentration of<SUP> </SUP>50 ?g/mL, fraction 1 caused a significant reduction in<SUP> </SUP>LPS-induced IL-1? secretion by macrophages that was<SUP> </SUP>comparable with that obtained with EGCG. This concentration-dependent<SUP> </SUP>effect on IL-1? production was also observed when<SUP> </SUP>macrophages were stimulated with the LPS of F. nucleatum subsp.<SUP> </SUP>nucleatum (Table
Only a weak IL-1? secretion was observed following<SUP> </SUP>stimulations of macrophages with the LPS of P. gingivalis, T.<SUP> </SUP>denticola, or T. forsythia, and fraction 1 showed no significant<SUP> </SUP>effect (Table
<SUP></SUP>
For IL-8, the interaction between LPS and the cranberry fractions<SUP> </SUP>was not significant, and the effects of cranberry fraction 1<SUP> </SUP>were analyzed without discrimination of LPS source. LPS of A.<SUP> </SUP>actinomycetemcomitans induced a higher IL-8 response than did<SUP> </SUP>the other LPS tested (P < 0.05). Fraction 1 (50 ?g/mL)<SUP> </SUP>significantly reduced the IL-8 response of macrophages stimulated<SUP> </SUP>with LPS (Fig. 2A
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</NOBR> </TD><TD vAlign=top align=left>Figure 2. Effect of treating macrophages with fraction 1 (non-dialyzable material of cranberry juice), fraction 2 (cranberry juice), and epigallocatechin gallate (EGCG) on the secretion of IL-8 (A) and RANTES (B) induced by LPS (1 ?g/mL) of A. actinomycetemcomitans ATCC 29522 for 24 hrs. Macrophages were treated with cranberry fractions, or EGCG, for 2 hrs before lipopolysaccharides (LPS) stimulation. Cytokine secretion was assessed by ELISA. The data are the means ? standard deviations of triplicate assays for three independent experiments. *P value of < 0.05 compared with untreated control.
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For RANTES, the interaction between LPS and the cranberry fractions<SUP> </SUP>was significant, and the results of pairwise comparisons were<SUP> </SUP>used. Fraction 1 and EGCG significantly reduced the RANTES response<SUP> </SUP>induced by the LPS of A. actinomycetemcomitans at all the concentrations<SUP> </SUP>tested (Fig. 2B
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The host inflammatory response to periodontopathogens is considered<SUP> </SUP>a major factor causing the local tissue destruction observed<SUP> </SUP>in periodontitis.
Macrophages participate in the host response<SUP> </SUP>induced by periodontopathogens and are the principal target<SUP> </SUP>for LPS.
To determine whether cranberry extracts can interfere<SUP> </SUP>with LPS signaling and reduce the production of pro-inflammatory<SUP> </SUP>molecules, we stimulated cranberry-fraction-treated macrophages<SUP> </SUP>with the LPS from major periodontopathogens and from E. coli.<SUP> </SUP>
The cranberry non-dialyzable material significantly reduced<SUP> </SUP>LPS-induced pro-inflammatory cytokine and chemokine production.<SUP> </SUP>
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Cytokines, more particularly IL-1?, are potential<SUP> </SUP>markers of the progression and severity of periodontitis as<SUP> </SUP>well as indicators of an appropriate response to treatment (Hou et al., 1995).<SUP> </SUP>
It has been reported that cytokine synthesis<SUP> </SUP>inhibitors can reduce bone resorption in experimental periodontitis<SUP> </SUP>in rats (Lima et al., 2004).
Moreover, local inhibition of both<SUP> </SUP>IL-1 and TNF production in periodontal tissues significantly<SUP> </SUP>inhibits the inflammatory response and bone loss in ligature-induced<SUP> </SUP>periodontitis in monkeys (Assuma et al., 1998).
This suggests<SUP> </SUP>that local inhibition of cytokines may be a successful approach<SUP> </SUP>for inhibiting bone resorption in periodontitis.
In this study,<SUP> </SUP>we showed that treating macrophages with the non-dialyzable<SUP> </SUP>material of cranberry juice can inhibit LPS-induced IL-1?,<SUP> </SUP>TNF-
<SUP></SUP>
IL-8 and RANTES are potent chemokines that direct the migration<SUP> </SUP>of neutrophils, eosinophils, monocytes, and T<SUB>H</SUB>1 cells to sites<SUP> </SUP>of infection (Luster, 1998).
Stimulation of chemokine production<SUP> </SUP>by periodontopathogens favors the accumulation of leukocytes<SUP> </SUP>during active inflammation, which contributes to periodontal<SUP> </SUP>tissue destruction.
Interestingly, periodontal therapy reduces<SUP> </SUP>cell numbers in the infiltrate and the levels of IL-8 and RANTES,<SUP> </SUP>suggesting a relationship between these chemokines and periodontal<SUP> </SUP>status (Gamonal et al., 2001).
The non-dialyzable material of<SUP> </SUP>cranberry juice reduced LPS-induced IL-8 and RANTES production<SUP> </SUP>by macrophages.
In the context of the development of novel therapeutic<SUP> </SUP>strategies targeting the control of periodontal inflammatory<SUP> </SUP>reactions, these results suggest that this cranberry fraction<SUP> </SUP>may help reduce the influx of inflammatory cells at disease<SUP> </SUP>sites.<SUP> </SUP>
<SUP></SUP> The lyophilized cranberry juice did not show any capacity to<SUP> </SUP>inhibit LPS-induced cytokine production by macrophages.
This<SUP> </SUP>is likely related to the fact that active compounds were concentrated<SUP> </SUP>in the non-dialyzable material of cranberry juice.
One such<SUP> </SUP>group of compounds that showed a 125-fold enrichment was the<SUP> </SUP>proanthocyanidins (data not shown). EGCG, the green tea polyphenol<SUP> </SUP>used as a positive control, also showed anti-inflammatory activity.<SUP> </SUP>This is in agreement with the previously reported capacity of<SUP> </SUP>EGCG to inhibit LPS-induced TNF-
Previous studies have revealed that some<SUP> </SUP>plant flavonoids may inhibit the expression of inflammation-related<SUP> </SUP>proteins/enzymes by suppressing activation of transcription<SUP> </SUP>factors such as nuclear transcription factor-
Future studies will investigate<SUP> </SUP>the cellular mechanisms by which cranberry constituents modulate<SUP> </SUP>cytokine expression.<SUP> </SUP>
<SUP></SUP>
Therapeutic agents that modulate host inflammatory mediators<SUP> </SUP>have shown promise for managing adult periodontitis and may<SUP> </SUP>be highly useful for individuals with a substantially increased<SUP> </SUP>risk for periodontitis (Kornman, 1999).
In addition to the previously<SUP> </SUP>recognized inhibitory effect of the cranberry non-dialyzable<SUP> </SUP>material fraction on the aggregation of oral bacteria and dental<SUP> </SUP>biofilm formation (Weiss et al., 1998; Steinberg et al., 2004),<SUP> </SUP>we showed that this fraction was a potent inhibitor of the pro-inflammatory<SUP> </SUP>cytokine and chemokine responses induced by periodontopathogens<SUP> </SUP>and E. coli.
This provides promising perspectives for the development<SUP> </SUP>of novel host-modulating therapies for adjunctive treatments<SUP> </SUP>of periodontitis or other inflammatory diseases by use of the<SUP> </SUP>high-molecular-weight constituents from cranberries.<SUP> </SUP><SUP></SUP>
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This work was supported by the Cranberry Institute (East Wareham,<SUP> </SUP>MA, USA). We thank Robin Roderick and Marge Leahy (Ocean Spray<SUP> </SUP>Cranberries, Inc.) for chemical analyses and for providing cranberry<SUP> </SUP>juice concentrate.<SUP> </SUP>
<SUP></SUP>
Received April 25, 2005; Last revision October 14, 2005; Accepted October 26, 2005
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<!-- null -->Assuma R, Oates T, Cochran D, Amar S, Graves DT (1998). IL-1 and TNF antagonists inhibit the inflammatory response and bone loss in experimental periodontitis. J Immunol 160:403?409.<!-- HIGHWIRE ID="85:3:235:1" --><NOBR>[Abstract/Free Full Text]</NOBR><!-- /HIGHWIRE -->
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<!-- null -->Grenier D (1996).
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