US Air Force Dental Research and Consultation Service, San Antonio, Texas, USA.
Clinical Technology Integration, US Army Institute of Surgical Research, San Antonio, Texas, USA.
Clin Exp Dent Res. 2024 Dec;10(6):e943. doi: 10.1002/cre2.943.
The effective control of dental plaque is crucial for oral health, given that pathogenic bacteria in plaque are the primary cause of dental caries. Current antimicrobial agents, although effective, disrupt the oral microbiome and lead to oral dysbiosis, hindering efforts to curb dental caries. Novel antimicrobial peptides offer a promising solution due to their selective bactericidal activity against cariogenic bacteria. This study explores the initial safety and efficacy of KSL-W formulated into chewing gum through a Phase 1 and 2a clinical trial.
The combined trial, approved by the FDA, follows a double-blind, randomized, placebo-controlled design. Phase 1 assessed safety with single doses (2-100 mg), whereas Phase 2a explored both safety and proof of concept in reducing oral bacteria with multiple doses (4-75 mg). Besides adverse events (Phase 1), outcome measures included whole-mouth plaque and gingival index scores and bleeding on probing (Phase 2a).
KSL-W demonstrated safety in both phases, with no severe adverse events. The proof-of-concept analysis revealed a decrease in plaque and gingival inflammation, particularly at doses ≥ 20 mg. The 30 mg dose appeared to yield optimal effects without any adverse reactions in subjects.
Results from this study indicate that KSL-W is safe for use in humans and provides initial evidence of its potential efficacy in reducing plaque and gingival inflammation. Further research is essential to determine optimal usage and ultimate safety, and to assess its potential in diverse populations.
The trial is registered with the FDA (Trial Registration Number: NCT01877421). The clinical trials were registered in the clinicaltrials.gov database under the title "Safety and Tolerability of Antiplaque Chewing Gum in a Gingivitis Population" and the identifier number is NCT01877421. The URL for accessing the study in clinicaltrials.gov is https://clinicaltrials.gov/study/NCT01877421?intr=Antiplaque%20chewing&rank=1.
鉴于牙菌斑中的致病菌是龋齿的主要成因,有效控制牙菌斑对于口腔健康至关重要。虽然目前的抗菌剂具有一定效果,但它们会破坏口腔微生物群,导致口腔生态失调,从而阻碍龋齿的防治。新型抗菌肽具有选择性杀菌活性,对抗致龋菌具有潜在作用。本研究通过一项 1 期和 2a 期临床试验,探索了 KSL-W 制成口香糖的初步安全性和有效性。
这项由美国食品和药物管理局(FDA)批准的联合试验采用双盲、随机、安慰剂对照设计。1 期试验评估了单次剂量(2-100mg)的安全性,2a 期试验则在多剂量(4-75mg)下同时评估了安全性和概念验证,以减少口腔细菌。除不良事件(1 期)外,结果测量包括全口菌斑和牙龈指数评分以及探诊出血(2a 期)。
KSL-W 在两个阶段均表现出安全性,无严重不良事件。概念验证分析显示,在 20mg 及以上剂量时,菌斑和牙龈炎症均有下降。30mg 剂量在受试者中似乎产生了最佳效果,且无不良反应。
本研究结果表明,KSL-W 对人体使用安全,并初步证明其在减少菌斑和牙龈炎症方面具有潜在疗效。需要进一步研究以确定最佳使用方法和最终安全性,并评估其在不同人群中的潜力。
该试验在美国 FDA 注册(试验注册号:NCT01877421)。该临床试验在 clinicaltrials.gov 数据库中注册,标题为“在牙龈炎人群中使用抗菌斑口香糖的安全性和耐受性”,标识符为 NCT01877421。在 clinicaltrials.gov 上访问该研究的网址为 https://clinicaltrials.gov/study/NCT01877421?intr=Antiplaque%20chewing&rank=1。