Prevention of colonization of Streptococcus mutans by topical application of monoclonal antibodies in human subjects.

Topical application of Streptococcus mutans-specific MAbs was examined as a means of preventing colonization in the mouth. The MAbs recognize the cell surface antigen (SA I/II) of Strep. mutans and also bind to the intact bacterial cell. In experiments with implantation of an exogenous Strep. mutans strain, specific MAb significantly reduced the levels of implantation when compared with that in controls given a non-specific MAb. In a second investigation, the effect of MAb on recolonization by indigenous Strep. mutans was studied in subjects after treatment with a topical antibacterial mouthwash (chlorhexidine), which had decreased Strep. mutans to undetectable levels. In control subjects, the indigenous Strep. mutans started to recolonize within days, but those receiving MAb remained free of Strep. mutans for up to 2 yr. By using different Strep. mutans-specific MAbs, it was found that the serotype and epitope specificities of the IgG MAb were essential, but that the IgG sub-class may not be important. No clinical side-effects were detected in any of the subjects receiving MAb and there was no evidence of serum, salivary or gingival fluid antibody responses against the antibody. Local passive immunization with MAbs is a safe method for preventing colonization of Strep. mutans in the mouth.