Journal of oral microbiology · 2026
Buprenorphine enhances Streptococcus mutans virulence and biofilm formation.
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Pedrosa Marlus S, Iannaccone Luca L, Schuls Charles S, Ribeiro Apoena A
Аннотация
BACKGROUND: Buprenorphine is widely prescribed for opioid use disorder (OUD). In 2022, the U.S. FDA issued a safety warning on dental diseases associated with buprenorphine. While reports implicate increased caries risk, the microbial mechanisms remain unclear.
OBJECTIVE: To evaluate whether buprenorphine directly modulates Streptococcus mutans (S. mutans) virulence traits relevant to cariogenesis.
DESIGN: S. mutans UA159 were exposed to buprenorphine. Planktonic growth, acidogenicity, acid tolerance, aggregation, and carbohydrate utilization were assessed. Biofilm biomass and extracellular polymeric substance (EPS) production were quantified in hydroxyapatite disc-based monospecies and saliva-derived microcosm models. Biofilm architecture was evaluated using fluorescence in situ hybridization (FISH). The expression of competence- and biofilm-associated genes (comC, comX, gcrR, gtfB, and gtfC) was measured by RT-qPCR.
RESULTS: Buprenorphine did not affect planktonic growth, acid production, or carbohydrate metabolism. However, it increased biofilm biomass and EPS production. FISH imaging revealed denser matrix-rich biofilms with closer spatial integration of S. mutans. Gene expression showed upregulation of comC, comX, gcrR, gtfB, and gtfC, indicating enhanced quorum sensing, stress adaptation, and matrix synthesis.
CONCLUSIONS: Buprenorphine promoted a biofilm-specific virulence program in S. mutans, fostering thicker, EPS-rich biofilms without altering planktonic physiology. These findings provide a mechanistic rationale for buprenorphine's association with caries risk.
OBJECTIVE: To evaluate whether buprenorphine directly modulates Streptococcus mutans (S. mutans) virulence traits relevant to cariogenesis.
DESIGN: S. mutans UA159 were exposed to buprenorphine. Planktonic growth, acidogenicity, acid tolerance, aggregation, and carbohydrate utilization were assessed. Biofilm biomass and extracellular polymeric substance (EPS) production were quantified in hydroxyapatite disc-based monospecies and saliva-derived microcosm models. Biofilm architecture was evaluated using fluorescence in situ hybridization (FISH). The expression of competence- and biofilm-associated genes (comC, comX, gcrR, gtfB, and gtfC) was measured by RT-qPCR.
RESULTS: Buprenorphine did not affect planktonic growth, acid production, or carbohydrate metabolism. However, it increased biofilm biomass and EPS production. FISH imaging revealed denser matrix-rich biofilms with closer spatial integration of S. mutans. Gene expression showed upregulation of comC, comX, gcrR, gtfB, and gtfC, indicating enhanced quorum sensing, stress adaptation, and matrix synthesis.
CONCLUSIONS: Buprenorphine promoted a biofilm-specific virulence program in S. mutans, fostering thicker, EPS-rich biofilms without altering planktonic physiology. These findings provide a mechanistic rationale for buprenorphine's association with caries risk.