Department of Stomatology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China.
Department of Clinical Medicine, First Affiliated Hospital of Dali University, Dali, Yunnan, China.
Crit Rev Immunol. 2024;44(1):41-53. doi: 10.1615/CritRevImmunol.2023050313.
Enterococcus faecalis was the main causative bacteria of refractory periapical periodontitis (PP), there is a pressing need to explore effective methods for eradicating E. faecalis in patients with refractory PP. This study aimed to assess the anti-infective effectiveness of phage PEf771 in treating periapical inflammation in rats. We developed a rat model of PP through E. faecalis YN771 induction. Micro-computed tomography and hematoxylin-eosin staining were utilized to evaluate bone destruction and inflammation in experimental teeth for seven consecutive weeks. Subsequently, rats with PP caused by E. faecalis YN771 were treated with phage PEf771, calcium hydroxide preparation, and 2% chlorhexidine gel. The healing progress of bone defects and inflammation in the apical region was monitored over three consecutive weeks using imaging and histopathology assessments. The PP rat model was successfully developed, and bone destruction and inflammatory cell infiltration in the apical region of the experimental tooth peaked at 4 weeks. The area of bone destruction in rats treated with phage PEf771, calcium hydroxide preparation, and 2% chlorhexidine gel was significantly smaller than that in the untreated group. Phage PEf771, calcium hydroxide preparation, and 2% chlorhexi-dine gel all have the effect of promoting the healing of apical lesions. Therapeutic effects of phage PEf771 on periapical inflammation infected by E. faecalis YN771 enhanced with time. Phage PEf771 promoted the healing of apical lesions, presenting a promising new approach for the treatment of refractory PP using bacteriophages.
粪肠球菌是难治性根尖周炎（PP）的主要致病菌，因此迫切需要探索有效方法来清除难治性 PP 患者中的粪肠球菌。本研究旨在评估噬菌体 PEf771 治疗大鼠根尖周炎的抗感染效果。我们通过粪肠球菌 YN771 诱导建立了大鼠 PP 模型。利用微计算机断层扫描和苏木精-伊红染色连续 7 周评估实验牙的骨破坏和炎症情况。随后，对由粪肠球菌 YN771 引起的 PP 大鼠用噬菌体 PEf771、氢氧化钙制剂和 2%洗必泰凝胶进行治疗。使用影像学和组织病理学评估连续 3 周监测根尖区骨缺损和炎症的愈合进展。成功建立了 PP 大鼠模型，实验牙根尖区的骨破坏和炎症细胞浸润在第 4 周达到高峰。噬菌体 PEf771、氢氧化钙制剂和 2%洗必泰凝胶处理的大鼠的骨破坏面积明显小于未处理组。噬菌体 PEf771、氢氧化钙制剂和 2%洗必泰凝胶均具有促进根尖病变愈合的作用。噬菌体 PEf771 对感染粪肠球菌 YN771 的根尖炎症的治疗效果随时间增强。噬菌体 PEf771 促进根尖病变的愈合，为使用噬菌体治疗难治性 PP 提供了一种有前景的新方法。
