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Table of Contents   
SYSTEMATIC REVIEW AND META-ANALYSIS  
Year : 2021  |  Volume : 32  |  Issue : 4  |  Page : 524-527
Efficacy of marine algal extracts against oral pathogens - A systematic review


1 Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondicherry, India
2 Department of Periodontics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondicherry, India
3 CIDRF, Sri Balaji Vidyapeeth, India
4 Department of Public Health Dentistry, Saveetha Dental College, SIMATS, Chennai, India
5 Department of Pharmacology, Saveetha Dental College, SIMATS, Chennai, India

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Date of Submission17-Mar-2020
Date of Decision09-Apr-2021
Date of Acceptance01-May-2021
Date of Web Publication18-May-2022
 

   Abstract 


Introduction: Marine algae possess a plethora of secondary active metabolites which has many biomedical applications. Anti-bacterial activity against oral cariogenic bacteria is reported in literature, however there is no comprehensive review available. Hence, this review is attempted to collate all the evidence available regarding the marine algal extracts and its constituents against oral cariogenic bacteria. Methods: Electronic search was conducted in the Google scholar, the Pubmed database and various clinical trial registries. Included studies were clinical, in-vitro studies assessing DMFT, DMFS, minimum inhibitory concentration or colony forming unit counts. Result: A total of 19 trials were obtained out of which only 7 were eligible for this review. Quality assessment was done by Higgins and Greens (2011) method. Results showed all the studies where they used crude algal extracts or its active constituents were showing anti-bacterial activity. Conclusion: Thus, this review showed that marine algal extracts and other constituents are having anti-microbial properties, making them potential anti-microbial agents for oral hygiene maintenance without adverse effects of currently available chemical based oral care products.

Keywords: Biofilm, dental decay, macroalgae, seaweed.

How to cite this article:
Murugaboopathy V, Saravankumar R, Mangaiyarkarasi R, Kengadaran S, Samuel S R, Rajeshkumar S. Efficacy of marine algal extracts against oral pathogens - A systematic review. Indian J Dent Res 2021;32:524-7

How to cite this URL:
Murugaboopathy V, Saravankumar R, Mangaiyarkarasi R, Kengadaran S, Samuel S R, Rajeshkumar S. Efficacy of marine algal extracts against oral pathogens - A systematic review. Indian J Dent Res [serial online] 2021 [cited 2022 Jun 29];32:524-7. Available from: https://www.ijdr.in/text.asp?2021/32/4/524/345418



   Introduction Top


Dental caries is a complex, multifactorial, biofilm-mediated, dynamic disease with phasic demineralization and remineralization of dental hard tissues.[1] Strepotococcus mutans is believed to play a major role in the formation of dental caries and the presence of S. mutans is 70 times higher in caries-affected individuals than caries-free individuals.[2]

S. mutans survival depends strictly on a biofilm lifestyle in its natural ecosystem i.e., dental plaque, which is also the major factor responsible for formation and development of dental caries.[3]

Dental biofilms do not allow easy penetration of chemotherapeutic agents. The ability of this bacterium to produce (acidogenic) and tolerate (aciduric) acids coupled with its property of synthesizing extracellular glucans allows its effective colonization in the oral cavity leading to the establishment of highly cariogenic dental biofilms.[4] Extracellular glucans synthesized from sucrose by glucosyltransferases (GTFs) play a critical role in the adhesive interactions of S. mutans which contributes to the structural integrity of dental plaque.[5] These virulence properties thus provide a unique microenvironment for survival of S. mutans in the oral cavity and intervention targeting the virulence properties of S. mutans, could be an alternative to prevent dental caries.

Numerous anti-plaque agents are documented to reduce dental biofilm formation amongst which fluoride is a well-known cariostatic agent. However, it's excessive use results in side effects like fluorosis and hence its use is limited.[6]

Moreover, Chlorhexidine is considered as a gold standard for anti-plaque agent have also been reported to cause DNA damage.[7] Despite availability of a variety of anti-plaque agents, the search for an effective and safer agent still continues.

Natural products with a wide range of biological activities could be useful for the development of alternative or adjunctive anti-plaque agents.[8]

Marine organisms are potential sources of new therapeutic agents as they produce a variety of compounds with pharmacological activities, including anticancer, antimicrobial, antifungal, antiviral, anti-inflammatory and others. They produce complex secondary metabolites as a response to ecological pressure, such as competition for space, predation and tide variations. Some of these compounds are antimicrobials that inhibit or limit the development and growth of other competitive microorganisms.[9]

Very few studies have explored the effectiveness of other marine algal extracts on oral micro-organisms.[10],[11],[12],[13] There is lack of comprehensive review of literature about the antibacterial effect of seaweeds against cariogenic micro-organisms.


   Materials and Methods Top


Structured question

  • Do seaweeds and their isolated constituents exhibit antibacterial activity against cariogenic bacteria?


PICO analysis

Problem: Dental caries/cariogenic micro-organism

Intervention: Seaweeds/marine algal species

Outcome: Antibacterial Activity

The databases of PubMed and Google scholar were searched up to July 2019 for the related topics using the PICO terms. Free-text terms were used to search the following on-going trial registers US National Institutes of Health Trials Register (http://clinicaltrials.gov), The WHO Clinical Trials Registry Platform (http://apps.who.int/trialsearch/default.aspx), Clinical Trial Registry of India (http://ctri.nic.in/Clinicaltrials/advsearch.php).

Only articles in English language, randomized controlled trials, clinical trials and in-vitro studies were included during the electronic search. Reference list of the identified randomized trials were also checked for possible additional studies. Studies evaluating the antibacterial activity of seaweeds and their isolated constituents against cariogenic bacteria were included; animal study and reviews were excluded.

Data collection and analysis

Screening and selection

Electronic search was carried out using the keywords in the search engines - PubMed and Google Scholar which yielded a total of 19 articles [Flowchart 1]. Hand search was done in caries research, which yielded zero articles. Based on present inclusion and exclusion criteria, the titles of the studies identified from the search were assessed independently by authors. Conflicts concerning inclusion of the studies were resolved by discussion. 19 titles were identified from the search after excluding duplications. 10 articles were excluded after reading titles. Abstracts of selected articles were reviewed independently. The variables of interest is listed in [Table 1]. One article was excluded after reading the abstract. Full text articles were retrieved for 8 relevant studies. After reviewing the articles independently, one article was excluded after full text reading. Finally, 7 articles were selected based on eligibility criteria.[10],[11],[14],[15],[16],[17],[18]

Table 1: Variables of Interest

Click here to view


The reference list of the full text articles was reviewed for identifying additional studies. Titles of articles relevant to the review were selected by discussion. Abstracts of the two selected articles were reviewed. Difference of opinion concerning inclusion of a study was resolved by discussion and one article was eliminated after reviewing abstracts. Quality assessment criteria to evaluate the studies were decided by five review authors in accordance with CHRIS guidelines. The risk of bias for each study was independently assessed by the review authors and conflicts concerning risk of bias were sorted by discussion.


   Results Top


A total of 19 published trials was obtained from the database searched, out of which only 7 trials fit into the scope of this review. The following process was done for data extraction for general characteristics of studies and variables of outcome was done.

For each trial the following data were recorded:

  • Author and Journal
  • Algae/Seaweed
  • Active component
  • Methodology
  • Results


Quality assessment

The Higgins and Green criteria were followed. The quality assessment of included trials was undertaken independently as a part of data extraction process. Four main quality criteria (method of randomization, allocation concealment, outcome assessors blinded to intervention, completeness of follow up) and 4 minor criteria (presence or absence of sample size calculation, comparability of groups at the start, clear inclusion or exclusion criteria, Presence or absence of estimate of measurement error) were examined.


   Discussion Top


This review assessed studies conducted to find the anti-bacterial activity of the marine algae and its constituents against oral cariogenic bacteria. Anti-microbial activity is minimal inhibitory concentration (MIC), which is a technique used to determine the lowest concentration of a particular antibiotic needed to kill bacteria. The microbial biofilm formation assay is used to study the early stages of biofilm formation, this method is useful in assessing the efficacy of the component in disrupting the biofilm.[19] The presence of chemical functional groups like fatty acids, alkaloids, alcohols, polysaccharides are reported to be responsible for anti-bacterial activity. The mechanism of action is purported due to presence of glycoprotein-receptors on the surface of the polysaccharides, this binds with the compounds present in the bacterial cell wall, DNA and cytoplasmic membrane.

As seen in [Table 2], out of the 7 studies, 6 studies assessed the anti-microbial activity using MIC method and 1 study assessed the disruption of biofilm formation.
Table 2: General Characteristics of the Studies

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The study conducted by Bong-Kyu Choi et al.,[14] showed that 0.1% chitooligosaccharide derived from crustaceans had anti-bacterial activity against S. mutans, similarly MubarakAli Davoodbasha et al.,[15] study showed that fatty acid methyl esters (FAME) derived from cyanobacteria had antibacterial activity against S. mutans, E. coli and Candida albicans.

Four of the selected studies have used methanolic or ethanolic extracts of the marine algae and other three studies have used the constituents of marine like oligosaccharides, methyl esters or analogues. All these studies have showed positive antibacterial effect against common oral pathogens like S. mutans, E. coli P. intermedia, and P. gingivalis. Thus, showing the potential of these marine algae and its constituents' antimicrobial activity.

The study by Ziga Hodnik et al.,[16] showed that indole-based analogues disrupted the biofilm formation and also showed excellent antibacterial activity against S. mutans. Similarly, Isao Kubo et al.,[18] study showed crinitol derived from Sargassum tortile showed excellent antibacterial activity against S. mutans.

The chitooligosaccharide from crustaceans showed excellent activity by inactivating both Actinobacillus actinomycetemcomitans and S. mutans after 120 mins of exposure, which are the two most common organism responsible for the initiation and progression of the dental caries. Fatty acids methyl esters from microalgae and cyanobacteria had anti-bacterial activity against S. mutans, and E. coli. Indole based analogues from oroidin showed inhibitory effect against S. mutans.

Extracts of brown algal species viz. Laminaria japonica, Padina sanctaecrucis and Sargassum tortile were possessing excellent anti-microbial activity against S. mutans, E. coli and oral streptococci at varying concentration.

This review included studies which has tested anti-microbial activity of marine algae and its constituents. Possible limitation of this study could not include other databases. Also, the dearth in the number of studies shows that there is limited interest among researchers to explore marine algae as an anti-bacterial agent. Many studies are available for marine algae and its application as anti-bacterial agent in general. But studies to dental caries and oral pathogens are very few in number.


   Conclusion Top


This review showed that there are very limited studies assessing the anti-microbial activity of marine algae and its constituents against oral pathogens. All the included studies showed that marine algal extracts and its active components have the potential to be an excellent anti-microbial agent against oral pathogens.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Pitts NB, Zero DT, Marsh PD, Ekstrand K, Weintraub JA, Ramos-Gomez F, et al. Dental caries. Nat Rev Dis Primers 2017;3:17030.  Back to cited text no. 1
    
2.
Peterson SN, Snesrud E, Liu J, Ong AC, Kilian M, Schork NJ, et al. The dental plaque microbiome in health and disease. PLoS One 2013;8:e58487.  Back to cited text no. 2
    
3.
Svensater G, Borgstrom M, Bowden GH, Edwardsson S. The acid-tolerant microbiota associated with plaque from initial caries and healthy tooth surfaces. Caries Res 2003;37:395-403.  Back to cited text no. 3
    
4.
Hasan S, Danishuddin M, Khan AU. Inhibitory effect of zingiber officinale towards Streptococcus mutans virulence and caries development: In vitro and in vivo studies. BMC Microbiol 2015;15:1.  Back to cited text no. 4
    
5.
Donlan RM, Costerton JW. Biofilms: Survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev 2002;15:167-93.  Back to cited text no. 5
    
6.
Featherstone JD. Remineralization, the natural caries repair process--The need for new approaches. Adv Dent Res 2009;21:4-7.  Back to cited text no. 6
    
7.
Ribeiro DA, Bazo AP, da Silva Franchi CA, Marques ME, Salvadori DM. Chlorhexidine induces DNA damage in rat peripheral leukocytes and oral mucosal cells. J Periodontal Res 2004;39:358-61.  Back to cited text no. 7
    
8.
Jeon JG, Rosalen PL, Falsetta ML, Koo H. Natural products in caries research: Current (limited) knowledge, challenges and future perspective. Caries Res 2011;45:243-63.  Back to cited text no. 8
    
9.
Pérez MJ, Falqué E, Domínguez H. Antimicrobial action of compounds from marine seaweed. Mar Drugs 2016;14:52.  Back to cited text no. 9
    
10.
Choi JS, Ha YM, Joo CU, Cho KK, Kim SJ, Choi IS. Inhibition of oral pathogens and collagenase activity by seaweed extracts. J. Environ. Biol 2012;33:115-21.  Back to cited text no. 10
    
11.
Kim YH, Kim JH, Jin HJ, Lee SY. Antimicrobial activity of ethanol extracts of Laminaria japonica against oral microorganisms. Anaerobe 2013;21:34-8.  Back to cited text no. 11
    
12.
Naqvi AZ, Buettner C, Phillips RS, Davis RB, Mukamal KJ. n-3 fatty acids and periodontitis in US adults. J Am Diet Assoc 2010;110:1669-75.  Back to cited text no. 12
    
13.
Lee KY, Jeong MR, Choi SM, Na SS, Cha JD. Synergistic effect of fucoidan with antibiotics against oral pathogenic bacteria. Arch Oral Biol 2013;58:482-92.  Back to cited text no. 13
    
14.
Choi BK, Kim KY, Yoo YJ, Oh SJ, Choi JH, Kim CY. In vitro antimicrobial activity of a chitooligosaccharide mixture against Actinobacillus actinomycetemcomitans and Streptococcus mutans. Int J Antimicrob Agents 2001;18:553-7.  Back to cited text no. 14
    
15.
Davoodbasha M, Edachery B, Nooruddin T, Lee SY, Kim JW. An evidence of C16 fatty acid methyl esters extracted from microalga for effective antimicrobial and antioxidant property. Microb Pathog 2018;115:233-8.  Back to cited text no. 15
    
16.
Hodnik Ž, Łoś JM, Žula A, Zidar N, Jakopin Ž, Łoś M, et al. Inhibition of biofilm formation by conformationally constrained indole-based analogues of the marine alkaloid oroidin. Bioorg Med Chem Lett 2014;24:2530-4.  Back to cited text no. 16
    
17.
Nogueira LF, Morais EC, Brito MA, Santos BS, Vale DL, Lucena BF, et al. Evaluation of antibacterial, antifungal and modulatory activity of methanol and ethanol extracts of Padina sanctae-crucis. Afr Health Sci 2014;14:372-6.  Back to cited text no. 17
    
18.
Kubo I, Himejima M, Tsujimoto K, Muroi H, Ichikawa N. Antibacterial activity of crinitol and its potentiation. J Nat Prod 1992;55:780-5.  Back to cited text no. 18
    
19.
O'Toole GA. Microtiter dish biofilm formation assay. J Vis Exp 2011:2437. doi: 10.3791/2437.  Back to cited text no. 19
    

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Correspondence Address:
Dr. Vikneshan Murugaboopathy
Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Pondicherry - 607402
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdr.IJDR_243_20

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