Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/66—Microorganisms or materials therefrom
  • A61K35/74—Bacteria
  • A61K35/741—Probiotics
  • A61K35/744—Lactic acid bacteria, e.g. enterococci, pediococci, lactococci, streptococci or leuconostocs
  • A61K35/747—Lactobacilli, e.g. L. acidophilus or L. brevis
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23G—COCOA; COCOA PRODUCTS, e.g. CHOCOLATE; SUBSTITUTES FOR COCOA OR COCOA PRODUCTS; CONFECTIONERY; CHEWING GUM; ICE-CREAM; PREPARATION THEREOF
  • A23G4/00—Chewing gum
  • A23G4/06—Chewing gum characterised by the composition containing organic or inorganic compounds
  • A23G4/12—Chewing gum characterised by the composition containing organic or inorganic compounds containing microorganisms or enzymes; containing paramedical or dietetical agents, e.g. vitamins
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23G—COCOA; COCOA PRODUCTS, e.g. CHOCOLATE; SUBSTITUTES FOR COCOA OR COCOA PRODUCTS; CONFECTIONERY; CHEWING GUM; ICE-CREAM; PREPARATION THEREOF
  • A23G4/00—Chewing gum
  • A23G4/06—Chewing gum characterised by the composition containing organic or inorganic compounds
  • A23G4/12—Chewing gum characterised by the composition containing organic or inorganic compounds containing microorganisms or enzymes; containing paramedical or dietetical agents, e.g. vitamins
  • A23G4/123—Chewing gum characterised by the composition containing organic or inorganic compounds containing microorganisms or enzymes; containing paramedical or dietetical agents, e.g. vitamins containing microorganisms, enzymes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/66—Microorganisms or materials therefrom
  • A61K35/74—Bacteria
  • A61K35/741—Probiotics
  • A61K35/744—Lactic acid bacteria, e.g. enterococci, pediococci, lactococci, streptococci or leuconostocs
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K8/00—Cosmetics or similar toiletry preparations
  • A61K8/18—Cosmetics or similar toiletry preparations characterised by the composition
  • A61K8/96—Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution
  • A61K8/99—Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution from microorganisms other than algae or fungi, e.g. protozoa or bacteria
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
  • A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
  • A61K9/0056—Mouth soluble or dispersible forms; Suckable, eatable, chewable coherent forms; Forms rapidly disintegrating in the mouth; Lozenges; Lollipops; Bite capsules; Baked products; Baits or other oral forms for animals
  • A61K9/0058—Chewing gums
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
  • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
  • A61K9/1605—Excipients; Inactive ingredients
  • A61K9/1629—Organic macromolecular compounds
  • A61K9/1652—Polysaccharides, e.g. alginate, cellulose derivatives; Cyclodextrin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/02—Stomatological preparations, e.g. drugs for caries, aphtae, periodontitis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61Q—SPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
  • A61Q11/00—Preparations for care of the teeth, of the oral cavity or of dentures; Dentifrices, e.g. toothpastes; Mouth rinses

Definitions

• the present invention relates to certain microorganisms or mixtures thereof for use in the treatment and/or prevention of inflammation in the oral cavity, preferably for the treatment and/or prevention of gingivitis and/or peridontitis.
• the present invention relates to microorganisms or mixtures thereof for use as probiotic agents for forming co-aggregates with microorganisms associated with gingivitis and/or peridontitis, in particular with oral bacterial species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• the present invention provides oral pharmaceutical compositions, oral care products or products for nutrition or pleasure comprising one or more of the probiotic microorganisms as active agents as well as a method of production thereof.
• Inflammatory conditions of the gums are primarily induced by the formation of dental plaque. Colonizing bacteria form a biofilm on the surface of the teeth aided by the presence of food residues as well as components of saliva. If not sufficiently cleared away at an early stage, plaque films on the surface of the teeth result in deposition of dental calculus which is very hard to remove. The presence of raised numbers of bacteria at the gingival margin leads to inflammation of the gingivae, known as gingivitis. In susceptible individuals, gingivitis may progress to peridontitis, which can lead to tooth loss.
• lipopolysaccharides present in Gram-negative bacteria can cause a non-specific immune response by LPS-stimulated macrophages, which release prostaglandin E2 (PEG2) and pro-inflammatory mediators such as interleukins and TNF-a in the affected tissue.
• PEG2 prostaglandin E2
• pro-inflammatory mediators induce the release of further PGE2s and matrix metalloproteinases (MMPs) from the residing fibroblasts, which destroy the extracellular matrix of the surrounding tissue.
• MMPs matrix metalloproteinases
• the normal oral microbiota is highly complex and includes over 700 bacterial species as well as archaea, fungi, protozoa and viruses.
• Probiotic action of bacteria in the oral cavity has been subject to some research but it has been found to vary strongly with the species used and suitable parame- ters for efficient application are hard to establish because the action may rely on largely unrelated effects.
• WO 2010/077795 A2 relates to compositions to improve oral health comprising a therapeutically effective amount of beneficial bacteria selected from specific strains of streptococci and lactobacilli.
• beneficial bacteria selected from specific strains of streptococci and lactobacilli.
• the prevention of gingivitis and plaque by balancing the mouth flora towards beneficial bacteria is addressed in this context.
• Probiotics containing teeth and oral care products are disclosed as being capable of preventing parodontits and gingivitis according to DE 20 2009 01 1 370 U1 , which recites a large variety of probiotic bacteria including lactobacilli, bifidobacteria, enterococci, sporolactobacilli and streptococci. Specific strains are not mentioned, however, and the mechanism of the alleged probiotic action is not further evaluated.
• WO 2010/008879 A2 provides a confectionary composition containing an inactive probiotic, which is activable upon contact with water.
• probiotics different strains of lactobacilli and bifidobacteria are disclosed.
• Probiotic effects mentioned in WO 2010/008879 A2 include the reduction of gum inflammation for example by suppressing pathogenic bacteria.
• EP 1 852 122 A1 relates to dental and gingival health compositions containing dehydrated, reactivable microorganisms. It is explained that the microorganisms may combat virulent pathogenic bacterial flora by re-establishing the equilibirium of the affected tissue due to competition.
• WO 2005018342 also refers to a competition effect whereby probiotic bacteria are able to inhibit colonization or out growth of a pathogen by competing for nutrients or attachment sites.
• probiotic bacteria may be capable to form co-aggregates with the pathogens which are easily flushed out of the mouth and thus reduce the pathogen load.
• exogenous lactic bacteria for prophylaxis or treatment of dental caries, dental plaque and periodontal infection is disclosed in WO 00/09080. Colonization via specific binding to resident microflora (co-aggregation) is mentioned but the use of probiotics according to WO 00/09080 relies on the effect that certain lactic bacteria, which are not part of resident microflora, are capable of adhering directly to the pellicle of the teeth and thus displace pathogens or prevent their attachment.
• WO 2012/022773 A1 is primarily concerned with probiotic compositions for oral health comprising effective amounts of Lactobacillus plantarum CECT 7481 and Lactobacillus brevis CECT 7480, which are demonstrated to have antibacterial properties against certain pathogens, while a formation of co- aggregates is not evaluated.
• WO 2012028759 (EP 2 612 904 A2) provides anti-microbial bacterial strains of the genus streptococcus for use in treatment of infectious disease in the oral cavity, which is based on the formation of co-aggregates of S. mutans with the probiotic strains.
• WO 2012/100991 discloses the use of binder organisms (lactic acid bacteria) to bind streptococci in the oral cavity, which are then flushed out thus preventing colonization by the pathogens and the formation of caries.
• Effective binder organisms according to WO 2012/100991 are certain strains of Lactobacillus paracasei and Lactobacillus rhamnosus.
• probiotic bacteria While the effect of probiotic bacteria to form aggregates with streptococci has been reported in the prior art, known probiotic bacterial strains have never been evaluated individually with respect to their ability to aggregate with other oral bacteria.
• peridontitis-associated bacteria such as Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum are to be considered highly relevant in this context.
• certain strains In the extensive investigations leading up to the present invention, certain strains have been found to strongly aggregate with the above mentioned pathogens and have therefore been identified as highly efficient active agents for use in the treatment and/or prevention of gingivitis and/or peridontitis.
• the present invention now allows to optimize the use of (commercially) available probiotic bacteria by selecting and/or combining the over-all most efficient strains.
• An objective of the present invention was to provide microorganisms or mixtures thereof which can be used in highly effective treatment and/or prevention of inflammation in the oral cavity, in particular in the treatment and/or prevention of gingivitis and/or peridontitis.
• a further objective of the present invention was to provide microorganisms or mixtures thereof which can be used as probiotic agent for forming co-aggregates with oral bacterial species associated with gingivitis and/or peridontitis, in particular with species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• compositions or products for delivering the microorganism according to the invention and a method for producing such compositions or products are also provided.
• microorganism or mixture comprising or consisting of two or more microorganisms for use in the treatment and/or prevention of gingivitis and/or peridontitis, wherein the microorganism(s) is/are selected from the group consisting of Lactobacillus delbrueckii subsp.
• lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ).
• the bacterial strains according to the invention have been found to form aggregates as recited above while surprisingly many closely related strains fail to show any aggregation with the pathogens.
• the prior art has not evaluated the efficacy of different bacterial strains with respect to the formation of aggregates with the mentioned pathogens.
• an aggregation index has been individually determined for the tested probiotic strains to allow direct selection of the most potent strains for application in oral care.
• the strain Lactobacillus delbrueckii subsp. lactis LL-G41 has been deposited under the Budapest Treaty at the China Center for Type Culture Collection (CCTCC), Wuhan University, Wuhan 430072, China under the accession number CCTCC M 2016652 by BioGrowing Co., Ltd., No. 10666 Songze Rd., Qingpu Shanghai 201700, China, on 17 November 2016.
• the strain Lactobacillus fermentum 35D has been deposited under the Budapest Treaty at the Leibniz Institut Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH (DSMZ), Inhoffenstr.
• strains Streptococcus salivarius NS18 and Streptococcus salivarius NS19 have been deposited under the Budapest Treaty in the CBS collection at the Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 AD Utrecht, The Netherlands, under the accession numbers CBS 142430 and CBS 142431 by NIZO Food Research BV, Kernhemseweg 2, 6718 ZB Ede, The Netherlands, on 8 March 2017.
• Microorganism(s) according to the invention may preferably be used as probiotic agent for forming co-aggregates with oral bacterial species associated with gingivitis and/or peridontitis, in particular with disease-associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• disease-associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• the recited disease-associated species are known to be involved in the development of peridontitis and associated diseases and therefore are highly desirable target disease-associated species for aggregation.
• the microorganisms for use in the prevention and/or treatment of inflammation in the oral cavity according to the invention includes the use in the prevention and/or treatment of plaque and plaques associated diseases and conveniently aides to balance the mouth flora towards a healthy state by promoting removal of the disease associated species from the mouth.
• the microorganism(s) described above is/are (an) attenuated or (a) dead microorganism(s), preferably (a) heat-inactivated microorganism(s), preferably (a) microorganism(s) heat- inactivated by incubation for 2 to 8 minutes at a temperature between 70 and 100 °C.
• the microorganism according to the invention additionally has/have an inhibitory activity on the growth of disease- associated species, in particular on the growth of one or more disease- associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis, Eubacterium saphenum, Parvimonas micra, Lachnoanaerobaculum saburreum, when the microorganism is Lactobacillus salivarius NS13 (NCIMB 8816).
• one or more disease- associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis, Eubacterium saphenum, Parvimonas micra, Lachnoanaerobaculum saburreum, when the microorganism is Lactobacillus salivarius NS13 (NCIMB 88
• probiotic strains according to the invention may, in addition to the anti-inflammatory activity, also exhibited growth-inhibiting effects on certain disease-associated species as demonstrated in the examples below.
• the present invention relates to the microorganism(s) recited above, wherein the microorganism(s) are additionally capable of treating and/or preventing inflammation in the oral cavity, preferably for reducing or inhibiting the release of one or more inflammatory factors selected from the group consisting of interleukin 1 (IL-1 ), interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF), prostaglandin E2 (PGE2), isoprostanes, matrix metallopeptidase 9 (MMP9) and NF- ⁇ , wherein the microorganism(s) is/are selected from the group consisting of Lactobacillus delbrueckii subsp. lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130) and Lactobacillus salivarius NS13 (NCIMB 8816).
• IL-1 interleukin 1
• IL-6 interleukin 6
• IL-8
• probiotic strains are capable of efficiently inhibiting the release of a number of different pro-inflammatory factors. It is therefore possible to optimize the use of commercially available probiotic strains for the treatment and/or prevention of inflammatory conditions in the oral cavity be selecting the overall most efficient strain(s) with respect to multiple probiotic actions.
• fragments of one or more microorganism(s) as defined in any of the aspects described above may be used in the treatment and/or prevention of inflammation in the oral cavity, preferably in the treatment and/or prevention of gingivitis and/or peridontitis, preferably for use as probiotic agent for forming co-aggregates with oral bacterial species associated with gingivitis and/or peridontitis, in particular with disease-associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• fragments of one or more microorganism(s) therefore preferably refers to any part(s) or combination of parts of a cell that is/are capable of providing the aggregation effect described herein.
• the present invention also relates to an oral pharmaceutical composition, oral care product or product for nutrition or pleasure, comprising one or more microorganism(s) selected from the group consisting of Lactobacillus delbrueckii subsp.
• lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ) or fragments thereof, wherein the total amount of the microorganism(s) or the fragments thereof is sufficient for treating and/or preventing gingivitis and/or peridontitis, preferably by forming co- aggregates with oral bacterial species associated with gingivitis and/or peridontitis, in particular with disease-associated species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum, further preferably wherein the total amount of the
• probiotic organisms used in a composition or product according to the present invention represent biologic material the activity of which may vary with the batch and depend also on the production or processing method. Therefore, the suitable amount can be adjusted accordingly within the given range.
• Products for pleasure are products that are consumed for the purpose of enjoyment such as e.g. confectionery (e.g. chocolates, chocolate bar products, other bar products, fruit gums, hard-boiled sweets, toffees, chewing gum, ice cream), alcoholic or non-alcoholic beverages (e.g. coffee, tea, wine, wine-containing beverages, beer, beer-containing beverages, liqueurs, spirits, brandies, fruit- containing lemonades, isotonic beverages, refreshing beverages, nectars, fruit and vegetable juices, fruit or vegetable juice preparations).
• confectionery e.g. chocolates, chocolate bar products, other bar products, fruit gums, hard-boiled sweets, toffees, chewing gum, ice cream
• alcoholic or non-alcoholic beverages e.g. coffee, tea, wine, wine-containing beverages, beer, beer-containing beverages, liqueurs, spirits, brandies, fruit- containing lemonades, isotonic beverages, refreshing beverages, nectars, fruit and vegetable juices, fruit or vegetable juice preparations.
• the present invention relates to a composition or product as described above for use in the treatment and/or prevention of inflammation in the oral cavity, preferably for use in the treatment and/or prevention of gingivitis and/or peridontitis, preferably for use as probiotic agent for forming co- aggregates with oral bacterial species associated with gingivitis and/or peridontitis, in particular with disease-associates species selected from the group consisting of Porphyromonas gingivalis, Porphyromonas endodontalis, Tannerella forsythia, Filifactor alocis and Eubacterium saphenum.
• a composition according to the invention may further comprise one or more components selected from the group consisting of carriers, excipients or further active ingredients such as, for example, active agents from the group of nonsteroidal antiphlogistics, antibiotics, steroids, anti-TNF-alpha antibodies or other biotechnologically produced active agents and/or substances as well as analgetics, dexpanthenol, prednisolon, polyvidon iodide, chlorhexidine-bis-D- gluconate, hexetidine, benzydamine HCI, lidocaine, benzocaine, macrogol lauryl ether, benzocaine in combination with cetidyl pyridinium chloride or macrogol lauryl ether in combination with protein free hemodialysate from calf blood, as well as for example fillers (e.g.
• cellulose, calcium carbonate), plasticizer or flow improves e.g. talcum, magnesium stearate
• coatings e.g. polyvinyl acetate phtalate, hydroxyl propyl methyl cellulose phtalate
• disintegrants e.g. starch, cross-linking polyvinyl pyrrolidone
• softener e.g. triethyl citrate, dibutyl phthalate
• substances for granulation lactose, gelatin
• retardation e.g.
• DL-alpha-tocopherol, ascorbic acid substances for modifying pH (lactic acid, citric acid), blowing agents or inert gases (e.g. fluorinated chlorinated hydrocarbons, carbon dioxide), dyes (iron oxide, titanium oxide), basic ingredients for ointment (e.g. paraffines, bees wax) and others as described in the literature (e.g. in Schmidt, Christin. Wirk- und Hilfsscher fur Manualur, De Stammur und ⁇ - her thoroughly. 1999; Stuttgarttechnische Verlagsgesellschaft mbH Stuttgart oder Bauer, Fromming Fijhrer. Lehrbuch der Pharmazeutician Technologie. 8. Auf- lage, 2006. Amsterdam Verlagsgesellschaft mbH Stuttgart).
• a composition or product according to the present invention may also be coated or encapsulated.
• Encapsulation of a composition according to the invention may have the advantage of allowing a controlled release, for example upon contact with water, or a continuous release over an extended period of time. Moreover, the composition may be protected from degradation improving the shelf life of the product.
• Methods for encapsulation of active ingredients are well known in the art and a number of encapsulation materials as well as methods how to apply them to a composition according to specific requirements are available.
• composition or product according to the invention may be in the form of a solution, suspension, emulsion, tablets, granules, powder or capsules.
• composition or product according to the invention may be selected form the group consisting of toothpaste, tooth gel, tooth powder, tooth cleaning liquid, tooth cleaning foam, mouth wash, mouth spray, dental floss, chewing gum and lozenges.
• compositions or products may contain abrasive systems (abrasive and/or polishing components) such as silicates, calcium carbonate, calcium phosphate, aluminum oxide and/or hydroxyl apatite, surfactants such as e.g. sodium lauryl sulfate, sodium lauryl sarcosinate and/or cocamidopropyl betaine, humectants such as glycerol and/or sorbitol, thickening agents, e.g. carboxy methyl cellulose, poly ethylene glycols, carrageenans and/or Laponite ® , sweeteners such as saccharine, aroma and taste correcting agents for unpleasant taste impressions, taste modifying substances (e.g.
• inositol phosphate nucleotides, e.g. guanosine monophosphate, adenosine monophosphate or other substances, e.g. sodium glutamate or 2-phenoxy propionic acid
• cooling agents such as menthol derivates (e.g.
• active agents such as sodium fluoride, sodium monofluoro phosphate, tin difluoride, quarternary ammonium fluorides, zinc citrate, zinc sulfate, tin pyrophosphate, tin dichloride, mixtures of different pyrophosphates,
• Chewing gums or dental care chewing gums may comprise a chewing gum base comprising elastomers, e.g. polyvinyl acetate (PVA), polyethylene, (low or medium molecular) polyiso butane (PIB), polybutadiene, isobutene/isoprene copolymers, polyvinyl ethyl ether (PVE), polyvinyl butyl ether, copolymers of vinyl esters and vinyl ethers, styrene/butadiene copolymers (SBR) or vinyl elastomers, e.g.
• PVA polyvinyl acetate
• PIB low or medium molecular polyiso butane
• PVE polyvinyl ethyl ether
• SBR styrene/butadiene copolymers
• vinyl elastomers e.g.
• chewing gum bases may contain further ingredients, e.g. (mineral) filers, e.g. calcium carbonate, titanium dioxide, silicone dioxide, talcum, aluminum oxide, dicalcium phosphate, tricalcium phosphate, magnesium hydroxide and mixtures thereof, plasticisers (e.g.
• lanolin stearic acid, sodium stearate, ethyl acetate, diacetin (glycerol diacetate), triacetin (glycerol triacetate) and trietyhl citrate
• emulsifiers e.g. phosphatides, such as lecithin and mono and diglycerides of fatty acids, e.g. glycerol monostearate
• antioxidants es (e.g. paraffine waxes, candelilla waxes, carnauba waxes, microcrystalline waxes and polyethylene waxes), fats or fatty oils (e.g. hardened (hydrogenated) plant or animal fats) and mono, di or triglycerides.
• the present invention also relates to a method of producing an oral pharmaceutical composition, an oral care product or a product for nutrition or pleasure as described above, comprising the following step: combining one or more microorganism(s), selected from the group consisting of Lactobacillus delbrueckii subsp.
• lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ) or fragments thereof to one or more further components, preferably to one or more components selected form the group consisting of carriers, excipients or further active ingredients.
• a method of treating a subject or, respectively, patient, in particular for treating and/or preventing of inflammation in the oral cavity comprising adminis- tering the herein described microorganisms or mixtures to a subject/patient, preferably to a subject/patient in need thereof, preferably in an amount sufficient to treat or prevent inflammation, preferably to treat or prevent gingivitis and/or peridontitis.
• Figure 1 shows the aggregative power of the indicated probiotics against type strains of disease-associated bacteria in a co-aggregation assay.
• lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ) from left to right.
• Figure 2 shows the aggregative power of indicated probiotics against wildtype (wt) strains of disease-associated Filifactor alocis and type strain Filifactor alocis(ATCC 35896 T ) in a co-aggregation assay.
• Results feature the decrease of total optical density upon co-incubation of pathogenic and probiotic bacteria expressed as aggregation index in percent.
• Aggregation index [%] (OD to t a r
• ODsupernatant/ODtotal ODtarget strain + OD probiotic strain-
• wt wildtype strain of disease-associated Filifactor alocis and type strain Filifactor alocis
• ATCC 35896 T wildtype strain of disease-associated Filifactor alocis and type strain Filifactor alocis shown on the x-axis the aggregation index is represented for Lactobacillus delbrueckii subsp. lactis LL-G41 (CCTCC M 2016652) (left columns) and for Lactobacillus fermentum 35D (DSM 32130) (right columns).
• Figure 3 shows the aggregative power of indicated probiotics against wildtype (wt) strains of disease-associated Porphyromonas gingivalis and type strain Porphyromonas gingivalis (ATCC 33277 T ) in a co-aggregation assay.
• Results feature the decrease of total optical density upon co-incubation of pathogenic and probiotic bacteria expressed as aggregation index in percent.
• Aggregation index
• ODtotai ODtarget strain + OD pro iotic strain- Aggregation indices are represented by grouped columns for each of the probiotics Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ) from left to right and within each group the columns for the Porphyromonas gingivalis strains represent ATCC 33277T, 1807 (wt), 2836 (wt), 7681 (wt), 2103 (wt) and 9066 (wt) from left to right.
• Figure 4 shows the aggregative power of indicated viable or attenuated probiotics against wildtype (wt) strains of disease-associated Porphyromonas gingivalis and type strain Porphyromonas gingivalis (ATCC 33277 T ) in a co-aggregation assay.
• Results feature the decrease of total optical density upon co-incubation of pathogenic and probiotic bacteria expressed as aggregation index in percent.
• Aggregation index [%]
• Example 1 Establishing the cultivation and handling of probiotic strains
• CFU colony forming units
• the frozen (-80°C) pro-biotic stocks were thawed over night at 4°C and 6 ml of sterile 9% NaCI solution added to the 1 .2 ml of bacteria at the next morning.
• the samples were centrifuged (5 min, 5000 rpm), the supernatant discarded, the pellet washed with 8 ml 9% NaCI and again centrifuged for 5 min at 5000 rpm.
• the pellet was then resuspended in 1 ,2 ml 9% NaCI and 1 ml of the sample added to 50 ml 37°C warm media (MRS Bouillon, Carl Roth KG, Düsseldorf) and incubated at 37°C.
• the incubations were performed in a 50 ml sterile polypro- pylen tube (Greiner) and probes were harvested at different time points to evaluate the growth curve.
• OD-determination 500 ⁇ of the bacterial suspension were removed and diluted in 1 ml MRS Bouillon in a 1 ,5ml-PS-cuvette (Brand). OD-determination was performed at 600 nm (ThermoScientific, Helios Epsilon) 1 .5 ml MRS Bouillon were used as blanc.
• bacteria were diluted (1 :10.000.000, 1 :50.000.000 and 1 : 100.000.000), plated on MRS-agar-plates (MRS Agar, X924, Carl Roth) and incubated for 2 days at 37°C. The grown colonies were then counted and the CFU was calculated.
• MRS Agar MRS Agar, X924, Carl Roth
• the screening was based on the proprietary OASSYS® co-aggregation.
• the target strain and probiotic strains were cultivated in specific growth conditions, harvested, washed and co-incubated.
• the behavior of the strains was monitored: a) macroscopically, for an appearance of flocculation that was graded 0-3 (with "0" for no flocculation/cloudy supernatant and "3" for a considerable pellet/clear supernatant) b) by estimation of the aggregation index (% aggregation), which expresses the percentage of applied bacterial cells that have aggregated after co-incubation.
• the aggregation index was calculated according to the formula:
• ) OD (ta rget strain) OD(p r j 0 biotic strain)
• the tested strains were then classified into 5 categories according to their aggregation index (Table 1 ).
• a low aggregation index indicates low grade of stable interaction and aggregation between cells, while a high aggregation index indicates high aggregation capacity and little or no planktonic cells left after co- incubation.
• the microorganisms used according to the present invention show an aggregation index of at least 60 %, preferably at least 80 %, against a disease-associated microorganism (as described herein).
• Microbiological methods for cultivation and handling of the target bacteria Eubacterium saphenum, Tanarella forsythia, Filifactor alocis, Porphyromonas endodontalis and Porphyromonas gingivalis were established and adapted.
• the target strains were delivered as bacterial suspension in broth, flushed from an agar plate and collected in a cryotube.
• a variety of media such as BHI (Brain Heart Infusion), TYP (Tryptone-Yeast Extract- Peptone), FAB (Fastidious Anaerobe Broth) in some cases supplemented with arginine, cysteine, vitamine K and haemin, were prepared and tested.
• Optimal growth conditions were established for P. gingivalis, P. endodontalis and F. alocis.
• no appropriate liquid medium could be found for the cultivation of T. forsythia and E.
• Co-aggregation assay was performed in 24-well plates.
• the target and probiotic strains were cultured, washed several times and co-incubated. Additionally, self- aggregation capacity of both analyzed probiotic and target strains was tested.
• the target and probiotic strains were incubated alone and the same parameters - macroscopic observation and measurement of optical density in the supernatant - were recorded, as in case of co-incubation.
• the probiotic strains were classified into categories according to their aggregation indices (see also Table 1 ). The presence of aggregates in several samples with a high aggregation index was confirmed by microscopical analysis.
• the strains Lactobacillus delbrueckii subsp. lactis LL-G41 (CCTCC M 2016652), Lactobacillus fermentum 35D (DSM 32130), Lactobacillus gasseri NS8 (NCIMB 1 1718), Lactobacillus salivarius NS13 (NCIMB 8816), Streptococcus salivarius NS18 (CBS 142430) and Streptococcus salivarius NS19 (CBS 142431 ) showed aggregation indices of over 60% with at least one target strain.
• the aggregative power of the probiotic strains with respect to tested disease- associated strains is shown in Figures 1 to 4.
• the grading for macroscopic co- aggregation and the aggregation category for the probiotic strains is shown in tables 2 and 3.
• Table 2 shows the aggregative power of indicated probiotics against wildtype (wt) strains of disease associated Filifactor alocis and type strain Filifactor alocis (ATCC 35896 T ) in a co-aggregation assay being evaluated macroscopically. Flocculation is graded as "0" for no flocculation and "3" for a considerable pellet or clear supernatant.
• the table shows grading of aggregation indices within aggregation categories for easier interpretation of assay results.
• Table 3 shows the aggregative power of indicated probiotics against wildtype (wt) strains of disease-associated Porphyromonas gingivalis and type strain Porphyromonas gingivalis (ATCC 33277 T ) in a co-aggregation assay being evaluated macroscopically.
• Flocculation is graded as "0" for no flocculation and "3" for a considerable pellet or clear supernatant.
• the table shows grading of aggregation indices within aggregation categories for easier interpretation of assay results.
• the inhibitory activity of selected probiotic strains inter alia L. salivarius NS 13, against peridontitis-associated oral bacterial species (indicator strains) was determined.
• the indicator strains were:
• a delayed antagonism method was performed in triplicate.
• the test strains were grown on blood agar as streak for 24 or 48 h and then killed by exposure to chloroform. Indicator strains were cross-streaked and incubated for up to 72 h.
• Components 1 and 6 are dried in a vacuum compartment drier at 50 °C and a pressure of max. 10 mbar for 16 hours.
• the probiotic material is applied in lyophilized form having an activity of about 10 5 to 10 12 colony forming units (CFU) per gram.
• Block A is subsequently added to component 6 and mixed thoroughly for 5 minutes.
• Component 7 is dried in a vacuum compartment drier at 50 °C and a pressure of max. 10 mbar for 16 hours.
• compositions 5 and 6 are, if necessary, combined and thoroughly mixed (block B).
• the probiotic material is applied in lyophilized form having an activity of about 10 5 to 10 12 colony forming units (CFU) per gram.
• Blocks A and B are subsequently combined and thoroughly mixed together.
• the powder mixture is made up into portions of 0.5 g each storage at RT together with 1 g of desiccant per portion (activated by 3 h storage at 105°C in a vacuum compartment drier) in sealed aluminum sachets.
• Components 6, 9 and 10 are dried in a vacuum compartment drier at 50 °C and a pressure of max. 10 mbar for 16 hours.
• the probiotic material is applied in lyophilized form having an activity of about 10 5 to 10 12 colony forming units (CFU) per gram.
• Blocks A and B are subsequently combined and thoroughly mixed together.
• Block A/B and Block C The two mixtures (Block A/B and Block C) are combined and mixed thoroughly for 5 minutes.
• otablet weight 0,3 g • Storage at RT in sealed aluminum sachets. Per 3 tablets 1 g of desiccant is used for dehumidification (activated by 3 h storage at 105°C in a vacuum compartment drier).
• Example 7 Chewing gum
• Component 2 is dried in a vacuum compartment drier at 50 °C and a pressure of max. 10 mbar for 16 hours.
• Component 1 is tempered to 45 - 59 °C in a chewing gum lab-kneader with the heating kneaded until a homogenous mass is obtained. The heating is on during the whole mixing process.
• component 6 is either worked into component 5 (block C) or component 7 (block D).
• the probiotic material is applied in ly- ophilized form having an activity of about 10 5 to 10 12 colony forming units (CFU) per gram.
• the components are mixed until an even suspension is obtained.
• Example 8 Probiotic beadlets
• a 2% calcium chloride solution is produced from distilled water and calcium chloride. Care has to be taken that the CaCI 2 is completely dissolved. Production of the alginate solution (instead of alginate also pectin or gellan gum may be used):
• the aroma and the dye are provided if required and thoroughly mixed In case no aroma is used, the dye is mixed with glycerol.
• the batch is stirred for further at least 15 minutes at a low speed to remove potentially present air.
• the alginate dispersion is moved to a tightly sealable pressure stable reaction vessel having two outlets. At one outlet pressurized air is applied. The second outlet leads to the nozzles of the dripping unit via a tube.
• the reaction vessel is tempered over a heating plate so that the alginate solution reaches a temperature of approx. 45 °C.
• the solution is slightly stirred with a magnet stirrer.
• alginate solution is pressed towards the nozzles, which are set to oscillation by an oscillator.
• the size oft he resulting drops at the tips of nozzles may be adjusted.
• the beadlets are dried in an Aeromatic flowbed-drier at an supply air temperature of 80 °C until an exhaust air temperature of 45 °C is reached.

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