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Enterococcus faecalis sustained infection induces macrophage pro-resolution polarization.

David Polak1, Alin Yaya1,2, Dan Henry Levy3

  • 1Department of Periodontology, Jerusalem, Israel.

International Endodontic Journal
|May 20, 2021
PubMed
Summary

Enterococcus faecalis infection causes macrophage death, but survivors harbor bacteria and shift to a pro-resolution M2 phenotype, indicating unresolved infection in apical periodontitis.

Keywords:
bacteriabone losscell differentiationendodonticsinfectious diseases

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Area of Science:

  • Oral microbiology
  • Immunology
  • Endodontics

Background:

  • Enterococcus faecalis is a common bacterium in persistent root canal infections.
  • Asymptomatic apical periodontitis often involves chronic inflammation and bacterial presence.

Purpose of the Study:

  • To examine macrophage responses during sustained Enterococcus faecalis infection.
  • To understand macrophage polarization and function in the context of apical periodontitis.

Main Methods:

  • THP-1 macrophages were infected with E. faecalis.
  • Assessed phagocytosis, bacterial survival, ROS production, mitochondrial activity, and M1/M2 marker expression.
  • Analyzed periapical tissue samples from human biopsies.

Main Results:

  • E. faecalis induced macrophage apoptosis and necrosis.
  • Surviving macrophages harbored bacteria, maintained mitochondrial activity, and showed increased internal ROS.
  • A polarization towards M2 macrophages occurred, mirroring findings in human periapical tissues.

Conclusions:

  • Sustained E. faecalis infection leads to macrophage death and a shift to an M2 pro-resolution phenotype.
  • This suggests a non-resolved infectious process in apical periodontitis.