Article(id=1226554096598040706, tenantId=1146029695717560320, journalId=1192105938417971205, issueId=1226554095926952065, articleNumber=null, orderNo=null, doi=10.13343/j.cnki.wsxb.20240806, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1733932800000, receivedDateStr=2024-12-12, revisedDate=null, revisedDateStr=null, acceptedDate=1741104000000, acceptedDateStr=2025-03-05, onlineDate=1770362884901, onlineDateStr=2026-02-06, pubDate=1751558400000, pubDateStr=2025-07-04, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1770362884901, onlineIssueDateStr=2026-02-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1770362884901, creator=13701087609, updateTime=1770362884901, updator=13701087609, issue=Issue{id=1226554095926952065, tenantId=1146029695717560320, journalId=1192105938417971205, year='2025', volume='65', issue='7', pageStart='2771', pageEnd='3233', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1770362884741, creator=13701087609, updateTime=1770363575040, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1226556991309529548, tenantId=1146029695717560320, journalId=1192105938417971205, issueId=1226554095926952065, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1226556991309529549, tenantId=1146029695717560320, journalId=1192105938417971205, issueId=1226554095926952065, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2799, endPage=2810, ext={EN=ArticleExt(id=1226554096845504645, articleId=1226554096598040706, tenantId=1146029695717560320, journalId=1192105938417971205, language=EN, title=Research progress on the mechanism of biofilm formation of Streptococcus mutans mediated by fluid shear stress, columnId=1192149543727808575, journalTitle=Acta Microbiologica Sinica, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

This article explores the dynamic regulation of fluid shear stress on the biofilm formation of Streptococcus mutans, aiming to elucidate the pathogenic mechanism of this bacterium and provide references for the prevention of dental caries. S. mutans is a major cariogenic bacterium in the oral cavity, and it destroys the tooth tissue by forming biofilms and producing acids by metabolism. Studies have shown that fluid shear stress can regulate the physical structure, secretion of extracellular polymeric substances, adhesion, and quorum sensing of biofilms, thereby affecting the pathogenicity. This study provides a theoretical basis for deeply understanding the ecological adaptability of pathogens in fluid environments and the development of new intervention measures in clinical practice.

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*E-mail: QIANG Le,
HOU Tiezhou,
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本文系统分析了流体剪切力对变异链球菌生物膜形成的动态调控,阐明了其在致病机制中的核心作用,并为龋病防治提供了新策略。变异链球菌是口腔内主要的致龋菌,它通过形成生物膜并代谢产酸来破坏牙体组织。研究表明,流体剪切力能够调节生物膜的物理结构、胞外聚合物的分泌、黏附能力以及群体感应系统,从而影响其致病性。本研究为深入理解病原菌在流体环境中的生态适应性,以及开发新的临床干预措施提供了理论依据。

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作者贡献声明

孙懿格:论文初稿撰写、文献查阅;亓庆国:论文审阅与修订、综述内容验证与核实;侯铁舟:论文审阅与修订、研究课题监管与指导、综述内容验证与核实;强乐:论文审阅与修订、综述概念生成、研究课题监管与指导、综述内容验证与核实。

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流体剪切力介导的变异链球菌生物膜形成机制研究进展
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孙懿格 1, 2, 3 , 亓庆国 4 , 侯铁舟 1, 2, 3 , 强乐 1, 2, 3
微生物学报 | 综述 2025,65(7): 2799-2810
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微生物学报 | 综述 2025, 65(7): 2799-2810
流体剪切力介导的变异链球菌生物膜形成机制研究进展
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孙懿格1, 2, 3, 亓庆国4, 侯铁舟1, 2, 3 , 强乐1, 2, 3
作者信息
  • 1.西安交通大学 口腔医院,陕西省颅颌面精准医学研究重点实验室,陕西 西安
  • 2.西安交通大学 口腔医院,陕西省牙颌疾病临床研究中心,陕西 西安
  • 3.西安交通大学 口腔医院,牙体牙髓病科,陕西 西安
  • 4.济南可恩口腔医院,山东 济南
Research progress on the mechanism of biofilm formation of Streptococcus mutans mediated by fluid shear stress
Yige SUN1, 2, 3, Qingguo QI4, Tiezhou HOU1, 2, 3 , Le QIANG1, 2, 3
Affiliations
  • 1.Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
  • 2.Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
  • 3.Department of Cariology and Endodontics, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
  • 4.Jinan Keen Dental Hospital, Jinan, Shandong, China
出版时间: 2025-07-04 doi: 10.13343/j.cnki.wsxb.20240806
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本文系统分析了流体剪切力对变异链球菌生物膜形成的动态调控,阐明了其在致病机制中的核心作用,并为龋病防治提供了新策略。变异链球菌是口腔内主要的致龋菌,它通过形成生物膜并代谢产酸来破坏牙体组织。研究表明,流体剪切力能够调节生物膜的物理结构、胞外聚合物的分泌、黏附能力以及群体感应系统,从而影响其致病性。本研究为深入理解病原菌在流体环境中的生态适应性,以及开发新的临床干预措施提供了理论依据。

流体动力学  /  变异链球菌  /  生物膜  /  群体感应系统  /  龋病

This article explores the dynamic regulation of fluid shear stress on the biofilm formation of Streptococcus mutans, aiming to elucidate the pathogenic mechanism of this bacterium and provide references for the prevention of dental caries. S. mutans is a major cariogenic bacterium in the oral cavity, and it destroys the tooth tissue by forming biofilms and producing acids by metabolism. Studies have shown that fluid shear stress can regulate the physical structure, secretion of extracellular polymeric substances, adhesion, and quorum sensing of biofilms, thereby affecting the pathogenicity. This study provides a theoretical basis for deeply understanding the ecological adaptability of pathogens in fluid environments and the development of new intervention measures in clinical practice.

fluid dynamics  /  Streptococcus mutans  /  biofilm  /  quorum sensing system  /  dental caries
孙懿格, 亓庆国, 侯铁舟, 强乐. 流体剪切力介导的变异链球菌生物膜形成机制研究进展. 微生物学报, 2025 , 65 (7) : 2799 -2810 . DOI: 10.13343/j.cnki.wsxb.20240806
Yige SUN, Qingguo QI, Tiezhou HOU, Le QIANG. Research progress on the mechanism of biofilm formation of Streptococcus mutans mediated by fluid shear stress[J]. Acta Microbiologica Sinica, 2025 , 65 (7) : 2799 -2810 . DOI: 10.13343/j.cnki.wsxb.20240806
变异链球菌(Streptococcus mutans)是口腔内最为重要的致龋微生物之一,通过在牙面构建生物膜并代谢产酸引起牙体硬组织脱矿和损伤,进一步还可导致牙体组织缺损、咀嚼功能受损,是龋病的主要致病菌[1]。近年来,越来越多的研究发现,变异链球菌不仅与龋病密切相关,还可能参与亚急性心内膜炎、脑出血和动脉粥样硬化等系统性疾病的发生,这使其致病机制的研究成为学术界的热点之一[2]。生物膜(biofilm),也称为生物被膜,是附着在有生命或无生命物体表面、由胞外聚合物(extracellular polymeric substances, EPS)包裹的高度组织化的细菌群落[3]。生物膜的存在使致病菌能够更好地适应环境并抵抗抗菌药物的作用,显著增加了治疗难度[4]。变异链球菌通过其群体感应(quorum sensing, QS)系统调节生物膜的形成与维持[5]。此外,生物膜作为细菌的保护屏障,增强了细菌的耐药性,使其成为口腔内抗感染治疗的难点[6]
生物膜的形成始于微生物的黏附,微生物通过物理运动到达接触表面,这一过程主要涉及扩散、重力、动量和流体剪切力等方面。生物膜的结构和动力学受多种因素的影响,包括细菌物种、环境、水动力和营养等[7]。在生物膜形成的过程中,流体剪切力(fluid shear stress, FSS)有助于平衡生物膜的厚度与密度,并促使生物膜形成紧凑而稳定的结构,在生物膜稳态结构的形成与维持中起着决定性作用[8]。同时,流体剪切力还可激活微生物的QS系统,经由特定信号通路对生物膜的形成实施调控[9]。可观察到,生物膜的形成是一个复杂、动态且不断调整的过程。然而,传统的生物膜研究主要聚焦于静态模型,无法模拟细胞在流动、剪切应力以及营养传递等条件下的生长情况[10]。尽管微流体系统能够在一定程度上模仿体内流体剪切力的作用,但仍与体内真实的液体环境存在差异。当前,关于流体剪切力对生物膜的影响作用主要局限于物理性质和现象的研究,缺乏对具体机制的探讨。因此,最大程度地模拟体内液体环境,探究动态模型下流体剪切力对生物膜生长机制的影响,对于理解病原感染至关重要。变异链球菌是口腔中常见的定殖菌,由于唾液的流动与冲洗使得变异链球菌生物膜的形成更加复杂,因此深入探究变异链球菌生物膜在流体剪切力作用下的形成机制具有重要意义。
流体剪切力是影响生物膜形成的重要因素之一。研究发现,在动态环境中流体剪切力可以通过调节变异链球菌、白假丝酵母菌(Candida albicans)和铜绿假单胞菌(Pseudomonas aeruginosa)等的群体感应系统和胞外基质分泌,显著改变生物膜的结构[11-13]。与静态研究相比,动态条件下的生物膜形成机制更贴近真实的生理环境,特别是在口腔环境中唾液的流动会对变异链球菌生物膜的形成产生显著影响。然而,目前关于流体剪切力对变异链球菌生物膜动态影响的研究仍较为有限,且缺乏对其分子机制的深入探讨[10,14-15]
鉴于此,本文将重点探讨流体剪切力对变异链球菌生物膜形成的动态影响,阐明其在生物膜形成过程中的调控作用,并为龋病的预防与治疗提供新的理论依据和实践策略。
变异链球菌是牙菌斑生物膜中的主要致龋微生物,其生物膜形成过程一般分为早期黏附、微菌落聚集、成熟稳固和扩散阶段[16]。在唾液蛋白或牙釉质表面,变异链球菌借助表面黏附蛋白先行定殖;随后,在蔗糖存在时,大量葡萄糖基转移酶(glucosyltransferases, Gtfs)催化合成不溶性葡聚糖,进一步加强细菌的聚集与黏附[17]。随着胞外多糖基质(extracellular matrix, ECM)的增多,变异链球菌在生物膜中逐步构建起高度有序且动态变化的“三维”微生态系统,可抵御外界冲击与宿主免疫清除。生物膜EPS的组成如图1所示。
值得注意的是,变异链球菌具有快速产酸和耐酸的能力,可在pH值低于5.0的环境下继续生长,持续脱矿牙体硬组织,显著加剧龋病的发生和发展。最新研究发现,在高蔗糖条件下,乙酰转移酶GNAT13可调控RNA聚合酶亚基RpoA的乳酸化修饰水平,从而影响Gtfs的分泌量,最终加速生物膜的形成与稳定[18]。此外,机械因素对生物膜的发育也有重要影响:在口腔或其他流体环境中,适度的剪切力会改变细菌表面黏附蛋白的分布或活性,影响EPS的产生与空间排布,形成的生物膜密度更高;相反,过低的剪切力则易于形成松软的生物膜[19-20]
至于微生物间的交互作用,尽管白假丝酵母菌等种群也参与口腔生物膜的协同或拮抗过程,但在典型龋病病程中,变异链球菌的黏附与产酸特征仍是致病主因[21-22]。现有研究表明,多菌共生可能在局部微环境中引发更复杂的代谢和耐受机制(图2)。然而,相对于变异链球菌自身通过糖代谢与EPS合成所带来的黏附增强效应而言,其作用仍较为次要。
群体感应(QS)系统是微生物通过特定信号分子进行通信的机制,用于调节细菌的行为和生理过程,以适应环境变化。作为微生物之间的沟通方式,QS系统能够使微生物评估群体中个体的数量和密度。当达到临界阈值时,QS系统可诱导特定基因的表达,启动微生物的特异性群体行为,并促进微生物个体之间的相互沟通[23]。QS系统可以调节微生物群体的生物膜形成、毒力因子的表达和新陈代谢,从而帮助微生物更好地应对环境变化[24]。由于QS系统的通信感应依赖于细胞密度,而生物膜中含有大量细胞,因此QS系统通过细胞密度依赖的基因表达调控,成为生物膜生理形成的重要组成部分[25]。近年来的研究发现,变异链球菌可以通过QS系统分泌和感知信号分子,进而控制生物膜的形成和扩散,并影响其毒力特性[26-27]。变异链球菌的QS系统主要由CSP-ComD/E系统和XIP-ComR/S系统组成,QS系统通过释放感受态刺激肽(competence-stimulating peptide, CSP)和ComX诱导肽(ComX-inducing peptide, XIP),结合相应膜蛋白,影响相关基因的表达,从而调控变异链球菌的行为[28-29]。变异链球菌通过QS系统调控生物膜形成的过程如图3所示。在QS系统释放的细胞间化学信号刺激下,变异链球菌进入感受态,并通过核心感受态调控蛋白替代性Sigma因子(alternative sigma factor, ComX)调节与生物膜形成相关的基因表达,从而控制生物膜的形成和扩散[29-30]。由此可见,变异链球菌生物膜的形成与群体感应系统密切相关。
变异链球菌生物膜的形成与发展涉及黏附蛋白、Gtfs介导的多糖合成、剪切力和群体感应系统调控等多重因素的共同作用。深入理解变异链球菌生物膜形成过程中的这些调控机制,可为龋病的防治提供更具针对性的策略。在接下来的章节中,本文将详细探讨流体剪切力如何影响变异链球菌生物膜的形成。
流体力学(hydrodynamics)是研究流体运动和力学性质的学科,在生物学领域具有重要作用。流体动力学(fluid dynamics)是流体力学的一个分支,专注于流体在力作用下的运动规律及其与边界的相互作用,包括液体动力学与气体动力学。其中,流体的剪切行为是流体动力学的核心研究内容之一,指流体中不同层之间发生相对滑动的现象,而流体剪切力则是这些层间相对运动所产生的力。流体分子间的相互作用导致剪切力的产生,当流体自然流动时,各层间的相对滑动即引发剪切现象。
在医学研究中,流体动力学因素在人体内环境(如血浆、脑脊液和呼吸系统)中具有重要影响,流体动力学具有广泛的研究和应用价值[31-33]。同时,近年来也有大量关于流体剪切力在生物医学研究中的作用探讨[34-35]。由于生理环境下,许多人体细胞(如血管内皮细胞、淋巴管内皮细胞等)都被液体环境包围,因此在生物医学研究中探讨流体动力学的影响十分必要[36]
流变学因素在生物膜形成、生物膜动力学和细胞间分子信号传输中的作用,已成为近年来生物膜研究领域中持续探索的前沿问题。有研究详细探讨了流体动力学在生物膜形成中的作用,实验人员构建了7种不同的流动模型,结果表明,在不同流动条件下,生物膜的面积、厚度、密度和EPS的含量有所不同,说明流变学因素在生物膜形成方面具有显著影响[8]。Zhang等[37]使用微流控装置模拟液体环境,首次发现了能抵抗强流体剪切力的铜绿假单胞菌滞留菌(Pseudomonas aeruginosa persister, SSP),SSP生物膜不仅对各种聚合材料具有强黏附性,而且较常见的铜绿假单胞菌滞留菌具有更强的氨基糖苷类抗生素耐药性。
如前所述,流体剪切力在生物膜的形成和维持中起着重要作用。随着对变异链球菌及其他菌种生物膜的深入研究,越来越多的研究证据表明,流体剪切力对生物膜的物理结构、胞外聚合物(EPS)的分泌、黏附能力、代谢以及群体感应(QS)系统均能产生一定的影响。
生物膜在受到流体剪切力的作用后,其形态和结构会发生明显变化。在较大的流体剪切力作用下形成的生物膜更薄,具有更致密的三维结构。随着负载流体剪切力的逐渐增大,生物膜内先形成随剪切应力增高而逐渐变大的细胞簇,这些细胞簇可能会从生物膜表面脱落;当流体剪切力继续升高,生物膜内部结构将变得紧凑,表面积也逐渐增大,从而形成致密的薄层生物膜,并与接触表面黏附得更紧密。有研究使用3种不同流速模型(0.21、0.13和0.05 mL/min)探究不同流体剪切力下,变异链球菌生物膜的形成和脱落情况,结果表明流体剪切力能促进生物膜形成,表现为生物膜最大干重的升高;但随着剪切力的不断加载,生物膜干重随之降低,逐渐趋于稳定[38]。综上所述,流体剪切力会导致生物膜物理结构变得更加紧凑和稳定,从而增强其对外部环境的抵抗力。
流体剪切力对生物膜EPS的产生也具有影响。如前所述,生物膜是微生物细胞的高度结构化群落,病原菌嵌入EPS中并紧密黏附于接触表面,而生物膜EPS的分泌可以受到流体剪切应力、压力、含盐量、温度等外界环境的影响[39]。Ramasamy等[40]研究表明,随着表面流体剪切力的增加,生物膜中EPS的量也随之增加。当流体剪切力作用于生物膜表层EPS后,生物膜能感受到这种刺激,因此分泌更多EPS以抵抗流体剪切力的作用[20]。针对变异链球菌生物膜,实验人员使用原子力显微镜分析了生物膜形成不同阶段的各种纳米机械性能,在此过程中也发现了这一现象,即流体剪切力能刺激生物膜产生更多EPS,促进生物膜紧密结构的形成[41]
流体剪切力对生物膜的黏附也具有一定影响。在流体动力学环境下,若病原菌从生物膜上脱落并随血液流动,有可能引起人体血行感染,从而进一步加大临床医疗诊治的难度。因此,探究流体剪切力与生物膜黏附能力之间的关系具有重要意义。研究表明,生物膜的黏附强度与病原菌与接触表面之间的接触时间、加载的流体剪切力有关[42-43]。此外,EPS的黏弹性也能帮助病原菌生物膜牢固附着于接触表面,增强其黏附能力。
近年来,针对流体剪切力对变异链球菌生物膜黏附的研究日益增多。实验人员在探究变异链球菌生物膜中EPS的作用时发现,当剪切应力从0增加到0.184 N/m2时,流体剪切力引起的生物膜剥脱大幅增加;而当外部剪切力增加到约10倍(1.785 N/m2)时,生物膜剥脱的变化幅度反而不明显。这说明更接近接触表面的生物膜具有更强的黏附能力,对流体剪切力具有更高的抵抗性;同时,该研究分析了EPS协助生物膜抵抗流体剪切力的能力,结果表明,更高的EPS含量以及更密集的EPS结构能够帮助生物膜抵抗外界流体剪切力带来的机械清除作用[14]
以往关于变异链球菌生物膜的研究大多使用平板装置探讨其黏附能力,但在口腔环境中,生物膜在牙齿邻间隙更为多见。因此,有实验人员使用微流体漏斗装置模拟牙齿邻间隙形态,探究流体剪切力作用下变异链球菌生物膜的黏附能力。该研究分别对能够产EPS的蔗糖依赖性变异链球菌和不能产EPS的非蔗糖依赖性变异链球菌进行测试,结果显示蔗糖依赖性变异链球菌更能抵抗流体剪切力的破坏作用,即EPS的存在增加了变异链球菌生物膜的黏附能力[44]。综上所述,流体剪切力对生物膜的黏附强度有显著影响,增加的剪切力能够强化生物膜的黏附性能,使其更难以被移除。
流体剪切力在生物膜代谢方面具有重要作用,其影响主要表现在促进生物膜内部物质交换以及增强细胞活性(图4)。
研究表明,流体剪切力通过在生物膜表面形成湍流,促进生物膜内部与外界环境的物质交换。在琥珀酸放线杆菌生物膜中,高流体剪切力条件下生长的细胞活力达到79%,显著高于低流体剪切力下的57%[15]。此外,高剪切力还能提高生物膜的代谢效率,使其在动态环境下表现出更强的代谢潜力。
为了更好地研究流体剪切力对营养输送的动态影响,研究人员通过3D打印技术设计了动静可切换的变异链球菌体外生物膜模型。在动态模拟条件下,由于持续地营养输送,生物膜的干重明显高于静态条件[10]。这一结果进一步证明,流体剪切力可以通过增强物质流动性,促进生物膜的代谢和生长。
微生物通过感知环境的各种刺激信号(如pH值、生物膜结构、压力等的变化)激活QS系统,并通过QS系统调控自身生物膜内部的生化反应,以适应环境的变化,进而调控生物膜的形成。在变异链球菌生物膜中,已发现2条与QS系统ComX相关的信号通路,分别为CSP介导的调节种内密度的ComD/E信号通路和XIP介导的与变异链球菌吸收外源DNA和细菌素产生能力相关的ComR/S信号通路。相关研究表明,液体相关环境可以诱导变异链球菌QS系统中CSP与XIP的合成,且过量的CSP与XIP可以抑制变异链球菌生物膜的生长,妨碍生物膜的形成[9,45]。有研究证明,在高流体剪切力作用下,肺炎链球菌(Streptococcus pneumoniae)首先形成较薄的生物膜,QS系统被激活,加速了肺炎链球菌生物膜的形成[46]。另一项研究发现,在较低流体剪切力作用下形成的生物膜为疏松多孔结构,增大了生物膜的空间异质性,生物膜内物质分布不均匀,在营养丰富的区域QS系统ComD/E信号通路被活化,而ComR/S信号通路受到抑制[47]。综上所述,流体剪切力通过激活群体感应系统,调控变异链球菌的基因表达,从而影响生物膜的形成和扩散。
近年来,人体各部位和医疗器械上形成的顽固生物膜已经成为临床医学面临的主要难题之一。生物膜的复杂结构使其对抗生素具有抵抗作用,因此,生物膜是造成病原菌顽固性感染和器械相关感染的主要原因[48]。由于生物膜的形态和功能强烈依赖于流体动力学条件[49-50],研究流体动力学因素对生物膜的影响具有十分重要的意义。因抗菌药物渗透的限制、菌群群体感应系统的激活、特异性耐受机制的诱导、滞留菌的形成以及相关基因表达的抑制,生物膜内的病原菌较浮游菌具有更高的耐药性[51-53]。研究表明,生物膜微生物对抗生素的耐药性可达浮游微生物的1 000倍[54]。生物膜与接触表面结合的天然紧密性以及不断升高的耐药性,使得病原菌感染的治疗和预防更加困难。
抗生素对生物膜的抗菌活性取决于其是否能以足够浓度接触生物膜内部细菌。EPS的包裹作用和黏弹性使得抗菌药物的渗透和生物膜的机械清除受到阻碍,导致病原菌耐药性的增加和滞留菌的形成,从而增大了生物膜清除的难度[55-56]。EPS的过量分泌使生物膜的结构更加复杂,由于EPS的包裹,细胞间的孔隙减少,比表面积升高,抗菌药物的渗透效率降低。然而由于抗菌药物渗透的减慢,病原菌有更多时间启动适应性应激反应,进而增加耐药性。此外,一些阳离子抗生素如妥布霉素、万古霉素等能与EPS中带负电荷的多糖、胞外DNA (extracellular DNA, eDNA)结合,从而阻碍抗菌药物对生物膜的有效渗透[57]。如前所述,由于流体剪切力能够增加生物膜中EPS的含量,因此在流体环境中生长的生物膜可能具有更强的耐药性,使得生物膜的清除更加困难。由于EPS能够搭建病原菌生物膜的骨架,协助病原菌生物膜牢固附着在接触表面,如果能有效抑制生物膜中EPS的形成,就能够进一步清除生物膜,削弱致病菌的毒力。在此假设下,研究人员构建了一种新型抗菌复合物ABR-MC,经过验证发现这种复合物可以降低变异链球菌生物膜中EPS的产能,使生物膜无法形成紧凑结构,在很低的剪切应力作用下就能脱落[58]
有学者研究发现,乳酸杆菌对变异链球菌生物膜的形成具有抑制作用,并且探究了在乳酸杆菌影响下,变异链球菌葡聚糖产生、果聚糖产生、群体感应和耐酸性等10个相关靶基因(gtfBgtfCgtfDsacBcomCcomDvicKvicRaguDatpD)表达水平的影响,结果显示,这10种变异链球菌相关毒力基因表达水平均有下降,变异链球菌生物膜的形成受到抑制,提示乳酸杆菌具有潜在的防龋作用[59]
近年来,口腔牙菌斑生物膜清除相关的流体动力学疗法研究受到了广泛关注,并在近年来取得了一定进展。使用高速水微滴去除口腔中变异链球菌生物膜的研究逐步应用于临床实践。在相关研究中,实验人员发现在0.3-1.7 Pa的流体剪切力范围内,分离的细胞多为较大的细胞簇,而单个细菌或小的细胞簇则很少分离。也就是说,流体剪切力优先去除大的细胞团簇,而小细胞簇仍然能牢固地附着于生物膜表面[60]。相关实验人员在另一项研究中发现,仅靠空气流动无法使牙面上的生物膜脱离牙面,当有液体加载后,生物膜才会随着强流体剪切力而脱落[61]。同时,该组实验人员还探究了使用高速微喷雾输送抗菌药物的生物膜渗透能力,结果显示相较于含漱渗透,高速微喷雾使抗菌药物的渗透能力有显著的增强,生物膜表面的高流体剪切力能够增加基质的平流和生物膜结构的重塑,进而破坏生物膜结构,并且30°的喷射角度较90°更能将抗菌药物传送到生物膜内部[62]。这些研究强调了流体动力学在有效清除生物膜方面的作用。
流体剪切力的加载能促使生物膜细胞密度增加,促进EPS的分泌,进一步促进生物膜耐药性的形成。然而,研究人员也可以利用流体动力疗法破坏或清除生物膜,同时增加抗菌药物的渗透。因此,生物膜的清除将很大程度上依赖于生理条件下流体剪切力的控制,这将成为临床生物膜感染控制的有效方向。
变异链球菌是人体内常见的定殖菌。在流体环境下,变异链球菌通过群体感应(QS)系统调控生物膜的形成以适应环境变化,从而导致严重感染。流体剪切力是影响生物膜形成的重要因素,对生物膜的物理结构、胞外聚合物(EPS)分泌、黏附性、代谢及群体感应系统等方面产生显著影响,因此被视为临床治疗难治性和反复性生物膜感染的关键靶点。同时,流体剪切力能够激活变异链球菌的QS系统,通过群体感应实现生物膜的动态调控。近年来,针对流体剪切力对变异链球菌生物膜形成的研究取得了重要进展。本综述旨在通过分析流体剪切力对变异链球菌生物膜形成的影响,进一步理解其致病机制,为生物膜的精准清除及感染控制提供新的思路和治疗方向。
随着对生物膜研究的深入,当前研究方向逐渐从静态转向动态模拟,进一步揭示了生理液体环境下生物膜的物理特性。然而,由于生物膜的形成涉及多种基因、蛋白及环境因素的交互作用,对流体剪切力作用下的生物膜形成机制的研究仍显不足。现有研究在探讨流体剪切力对变异链球菌生物膜中基因表达和信号传导的调控作用时,仍主要集中于单菌种分析,尚难以涵盖多菌种间的交互作用及复杂的多组分生物膜的动态特性。
本文总结了流体剪切力对变异链球菌生物膜形成的动态调控机制。未来研究应着重开发更精准的动态模拟模型,以模拟复杂的口腔环境和生物膜微生态系统的动态特性。本课题组近年来基于自研微流控芯片/微纳生化传感平台,力求仿生模拟变异链球菌附着在牙釉质上的真实过程,针对致龋生物膜动力学和生物膜信号转导开展了一系列研究。基于流体剪切力可以通过激活QS系统中的ComD/E信号通路和ComR/S信号通路影响生物膜的形成,课题组拟构建牙釉质仿生微流控芯片探究流体剪切力通过QS系统影响变异链球菌生物膜的形成,并探讨comS基因调控XIP表达的潜在机制。未来研究重点可以放在探索多菌种协同作用如何在流体环境中影响生物膜的形成及其适应性,进一步研究流体剪切力对关键基因(如rncgtfB等)的具体调控机制,这将有助于全面揭示变异链球菌生物膜的致病机制。此外,新型抗菌材料与流体动力学疗法的结合,例如高速微喷雾与抗菌药物的联合应用,可能为生物膜感染控制开辟全新的治疗方向,推进临床感染控制的进步。传统生物膜流体动力学检测方法(如流变仪)难以保持生物膜结构的完整性,检测结果与自然生长条件下的生物膜流体响应存在差异[63-64]。原位流变技术虽能实现生物膜的原位检测,但难以区分生物膜内部不均质的三维结构和异质配置对流体动力学的具体影响。因此,亟需发展新的生物膜流体动力学表征方法,以更好地探究流体动力学对QS系统及生物膜形成的调控作用。
作者声明不存在任何可能会影响本文所报告工作的已知经济利益或个人关系。
  • 国家自然科学基金(42307568)
  • 西安市科技计划项目医学研究一般研究项目(23YXYJ0150)
  • 西安交通大学口腔医院青年骨干教师项目(080122)
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2025年第65卷第7期
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doi: 10.13343/j.cnki.wsxb.20240806
  • 接收时间:2024-12-12
  • 首发时间:2026-02-06
  • 出版时间:2025-07-04
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  • 收稿日期:2024-12-12
  • 录用日期:2025-03-05
基金
National Natural Science Foundation of China(42307568)
国家自然科学基金(42307568)
General Research Project of Xi’an Science and Technology Plan Medical Research(23YXYJ0150)
西安市科技计划项目医学研究一般研究项目(23YXYJ0150)
Yong Teacher Foundation of College of Stomatology, Xi’an Jiaotong University(080122)
西安交通大学口腔医院青年骨干教师项目(080122)
作者信息
    1.西安交通大学 口腔医院,陕西省颅颌面精准医学研究重点实验室,陕西 西安
    2.西安交通大学 口腔医院,陕西省牙颌疾病临床研究中心,陕西 西安
    3.西安交通大学 口腔医院,牙体牙髓病科,陕西 西安
    4.济南可恩口腔医院,山东 济南
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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