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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Bioeng. Biotechnol.</journal-id>
<journal-title>Frontiers in Bioengineering and Biotechnology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Bioeng. Biotechnol.</abbrev-journal-title>
<issn pub-type="epub">2296-4185</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">788574</article-id>
<article-id pub-id-type="doi">10.3389/fbioe.2021.788574</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Bioengineering and Biotechnology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Enhanced Spontaneous Antibacterial Activity of &#x3b4;-MnO<sub>2</sub> by Alkali Metals Doping</article-title>
<alt-title alt-title-type="left-running-head">Yan et&#x20;al.</alt-title>
<alt-title alt-title-type="right-running-head">Antibacterial Activity of Doped &#x3b4;-MnO2</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Yan</surname>
<given-names>Yali</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jiang</surname>
<given-names>Ning</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Liu</surname>
<given-names>Xin</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/985071/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Pan</surname>
<given-names>Jie</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Mai</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Chunrui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Camargo</surname>
<given-names>Pedro H. C.</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Wang</surname>
<given-names>Jiale</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1553223/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>College of Science, Donghua University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Oral and Craniomaxillofacial Science, Shanghai Key Laboratory of Stomatology, College of Stomatology, Ninth People&#x2019;s Hospital, Shanghai Jiao Tong University School of Medicine</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Dental Materials, Shanghai Key Laboratory of Stomatology, Shanghai Biomaterials Research and Testing Center, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People&#x2019;s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>Department of Chemistry, University of Helsinki</institution>, <addr-line>Helsinki</addr-line>, <country>Finland</country>
</aff>
<aff id="aff7">
<sup>7</sup>
<institution>Shanghai Institute of Intelligent Electronics and Systems, Donghua University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/732303/overview">Rui Guo</ext-link>, Jinan University, China</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1015421/overview">Ehsan Nazarzadeh Zare</ext-link>, Damghan University,&#x20;Iran</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1485190/overview">Yan Li</ext-link>, Sun Yat-sen University, China</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Xin Liu, <email>liuxin0556@163.com</email>; Jie Pan, <email>jiepan@fudan.edu.cn</email>; Jiale Wang, <email>jiale.wang@dhu.edu.cn</email>
</corresp>
<fn fn-type="equal" id="fn1">
<label>
<sup>&#x2020;</sup>
</label>
<p>These authors have contributed equally to this&#x20;work</p>
</fn>
<fn fn-type="other">
<p>This article was submitted to Biomaterials, a section of the journal Frontiers in Bioengineering and Biotechnology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>04</day>
<month>01</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>9</volume>
<elocation-id>788574</elocation-id>
<history>
<date date-type="received">
<day>02</day>
<month>10</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>15</day>
<month>11</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Yan, Jiang, Liu, Pan, Li, Wang, Camargo and Wang.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Yan, Jiang, Liu, Pan, Li, Wang, Camargo and Wang</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these&#x20;terms.</p>
</license>
</permissions>
<abstract>
<p>Recently, the widespread use of antibiotics is becoming a serious worldwide public health challenge, which causes antimicrobial resistance and the occurrence of superbugs. In this context, MnO<sub>2</sub> has been proposed as an alternative approach to achieve target antibacterial properties on <italic>Streptococcus</italic> mutans (S. mutans). This requires a further understanding on how to control and optimize antibacterial properties in these systems. We address this challenge by synthesizing &#x3b4;-MnO<sub>2</sub> nanoflowers doped by magnesium (Mg), sodium (Na), and potassium (K) ions, thus displaying different bandgaps, to evaluate the effect of doping on the bacterial viability of S. mutans. All these samples demonstrated antibacterial activity from the spontaneous generation of reactive oxygen species (ROS) without external illumination, where doped MnO<sub>2</sub> can provide free electrons to induce the production of ROS, resulting in the antibacterial activity. Furthermore, it was observed that &#x3b4;-MnO<sub>2</sub> with narrower bandgap displayed a superior ability to inhibit bacteria. The enhancement is mainly attributed to the higher doping levels, which provided more free electrons to generate ROS for antibacterial effects. Moreover, we found that &#x3b4;-MnO<sub>2</sub> was attractive for <italic>in vivo</italic> applications, because it could nearly be degraded into Mn ions completely following the gradual addition of vitamin C. We believe that our results may provide meaningful insights for the design of inorganic antibacterial nanomaterials.</p>
</abstract>
<kwd-group>
<kwd>MnO<sub>2</sub>
</kwd>
<kwd>doping</kwd>
<kwd>antibacterial property</kwd>
<kwd>reactive oxygen species</kwd>
<kwd>alkali metal ions</kwd>
</kwd-group>
<contract-sponsor id="cn001">Natural Science Foundation of Shanghai<named-content content-type="fundref-id">10.13039/100007219</named-content>
</contract-sponsor>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>Manganese oxides (MnO<sub>2</sub>) have been extensively studied due to the structural multiformity. The various structures, corresponding to different chemical and physical properties, have been widely applied in catalysis, batteries, sensors, molecular sieves, energy storage, etc. (<xref ref-type="bibr" rid="B15">Dawadi et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B72">Ye et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B46">Marciniuk et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B51">Ouyang et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B67">Wang et&#x20;al., 2021</xref>). Particularly, &#x3b4;-MnO<sub>2</sub> has attracted considerable attention due to its unique layered structure, where its bandgap can be tuned by filling ions between the layers (<xref ref-type="bibr" rid="B45">Luo et&#x20;al., 2000</xref>; <xref ref-type="bibr" rid="B66">Wang et&#x20;al., 2017</xref>). Herein, &#x3b4;-MnO<sub>2</sub> samples with different bandgaps, doped by alkali metals such as magnesium (Mg), sodium (Na), or potassium (K), has been used as antibacterial materials.</p>
<p>Recently, the abuse of antibiotics is becoming a serious worldwide public health challenge, which causes antimicrobial resistance and the occurrence of superbugs (<xref ref-type="bibr" rid="B54">Podder et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B64">Teng et&#x20;al., 2020</xref>). It not only prolongs treatment but also declines life expectancy due to higher morbidity/mortality risk (<xref ref-type="bibr" rid="B54">Podder et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B41">Liu et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B18">Estes et&#x20;al., 2021</xref>). These serious public health challenges require the development of new bactericidal methods (<xref ref-type="bibr" rid="B27">Herman and Herman, 2014</xref>; <xref ref-type="bibr" rid="B19">Gatadi et&#x20;al., 2021</xref>). With the development of nanotechnology, new antibacterial agents have arisen (<xref ref-type="bibr" rid="B27">Herman and Herman, 2014</xref>; <xref ref-type="bibr" rid="B41">Liu et&#x20;al., 2020</xref>). These nanoscale agents may provide more effective and/or more convenient routes (<xref ref-type="bibr" rid="B16">Dizaj et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B27">Herman and Herman, 2014</xref>). Particularly, nanomaterials based on inorganic metal oxide semiconductors, i.e.,&#x20;CuO, ZnO, MgO, etc., have been considered as alternative antibacterial materials (<xref ref-type="bibr" rid="B73">Zhang et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B32">Bafekr and Jalal, 2018</xref>; <xref ref-type="bibr" rid="B29">Hong et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B10">Chandra et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B49">Ogunyemi et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B73">Zhang et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B5">Baruah et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B23">Haider et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B24">Han et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B55">Qian et&#x20;al., 2021</xref>), whose activities can easily be tuned by altering their morphology and/or component (<xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>).</p>
<p>Generally, reactive oxygen species (ROS) can injure biomolecules by its strong oxidation potential (<xref ref-type="bibr" rid="B58">Sharifi et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>; <xref ref-type="bibr" rid="B54">Podder et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B71">Yao et&#x20;al., 2020</xref>). The oxidant activity of metal oxide semiconductor nanomaterials usually originates from light-induced oxidative properties to generate ROS, including hydroxyl radicals (&#xb7;OH), superoxide anions radicals (&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup>), and singlet oxygen (<sup>1</sup>O<sub>2</sub>) (<xref ref-type="bibr" rid="B54">Podder et&#x20;al., 2018</xref>). The generation of ROS under light exposure comes from the photo-generated electron-hole pairs excited on the appropriate band levels through the absorption of light, which interact with water and then produce ROS (<xref ref-type="bibr" rid="B28">Hirakawa and Nosaka, 2002</xref>; <xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>). In addition to photoexcitation, the ROS can also be produced by electrons trapped by the defects at the surface of materials in the absence of light (<xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>; <xref ref-type="bibr" rid="B25">Hao et&#x20;al., 2017</xref>). However, we found that doped agents, which can provide free electrons to induce the production of ROS, also result in the antibacterial activity without external light exposure. MnO<sub>2</sub> has five different phases (&#x3b1;, &#x3b2;, &#x3b3;, &#x3bb;, and &#x3b4;) and the different properties of each phase make it be extensively studied in the fields of catalysis (<xref ref-type="bibr" rid="B61">Suib, 2008</xref>; <xref ref-type="bibr" rid="B65">Truong et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B74">Zhou et&#x20;al., 2017</xref>). Moreover, MnO<sub>2</sub> can effectively enhance the produce of &#xb7;OH in the aqueous solution <italic>via</italic> the excitation and formation of electron-hole pairs (<xref ref-type="bibr" rid="B14">Das et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B69">Xiao et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B11">Chhabra et&#x20;al., 2019</xref>). Particularly, &#x3b4;-MnO<sub>2</sub>, with a unique layered crystalline structure, has aroused much investigation. By changing the quantity of filling ions between MnO<sub>2</sub> layers, its doping level can easily be tuned (<xref ref-type="bibr" rid="B21">Golden et&#x20;al., 1986</xref>; <xref ref-type="bibr" rid="B44">Luo et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B20">Geng et&#x20;al., 2016</xref>).</p>
<p>We report herein the synthesis of &#x3b4;-MnO<sub>2</sub> nanoflowers doped by Mg, Na, and K ions to evaluate the effect of doping on the bacterial viability of <italic>Streptococcus</italic> mutans (S. mutans), a recognized cariogenic bacterium (<xref ref-type="bibr" rid="B60">Song et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B1">Afrasiabi et&#x20;al., 2021</xref>). Here, the antibacterial properties of &#x3b4;-MnO<sub>2</sub> were probed in the dark (without external illumination). It was observed that all &#x3b4;-MnO<sub>2</sub> nanoflowers demonstrated an excellent antibacterial activity without external light exposure. Our data showed that in doped MnO<sub>2</sub> nanoflowers the free electrons due to doping could induce the production of ROS, resulting in the antibacterial activity. Moreover, &#x3b4;-MnO<sub>2</sub> nanoflowers with narrower bandgap displayed a superior antibacterial ability, in which higher doping levels, providing more free electrons to induce the production of ROS, led to better antibacterial properties (following the order: K<sup>&#x2b;</sup>&#x3e;Na<sup>&#x2b;</sup>&#x3e;Mg<sup>2&#x2b;</sup>). Furthermore, following the gradual addition of vitamin C, the &#x3b4;-MnO<sub>2</sub> could nearly be degraded into Mn ions completely, making this materials potential for <italic>in vivo</italic> applications (<xref ref-type="bibr" rid="B42">Liu et&#x20;al., 2021</xref>).</p>
</sec>
<sec id="s2">
<title>Experimental Section</title>
<sec id="s2-1">
<title>Materials and Instrumentation</title>
<p>Potassium permanganate (KMnO<sub>4</sub>, &#x3e;99.5%, Sinopharm), sodium permanganate monohydrate (NaMnO<sub>4</sub>&#xb7;H<sub>2</sub>O, &#x2265;97%, Sigma-Aldrich), magnesium permanganate hydrate (Mg(MnO<sub>4</sub>)<sub>2</sub>&#xb7;xH<sub>2</sub>O, Sigma-Aldrich), manganese sulfate monohydrate (MnSO<sub>4</sub>&#xb7;H<sub>2</sub>O, &#x3e;99.0%, Sigma-Aldrich), superoxide dismutase (SOD, 15KU, Gunn reagent), vitamin C (VC, 99%, Adamas), and all the chemicals were used without any further purification. De-ionized (DI) water (18.2&#xa0;M&#x3a9;) was used throughout the experiments.</p>
<p>SEM images were obtained by field-emission scanning electron microscopy (FESEM, Hitachi S-4800) which worked at 5&#xa0;kV. To prepare the samples of SEM, the aqueous suspension including the nanoflowers was dripped on a Si wafer, followed by drying under the air condition. HRTEM images were obtained with a high-resolution transmission electron microscopy (HRTEM, TECHAI G2S-TWIN) operated at 200&#xa0;kV. To prepare the samples of HRTEM, the alcoholic suspension including the nanoflowers was dripped on a copper grid, followed by drying under the air condition. UV-VIS spectra were obtained from the powder of MnO<sub>2</sub> with a Shimadzu UV-3600 spectrophotometer. X-ray diffraction (XRD) was characterized by a Rigaku D/Max-2550. X-ray photoelectron spectroscopy (XPS) was carried out using a Thermo Science ESCALAB 250Xi with monochromatic Al K&#x3b1; (1486.7&#xa0;eV). The binding energy (BE) was scaled, which regarded the C 1s line at 284.6&#xa0;eV as the standard for calibration. All data were processed by using the CasaXPS software. The electron spin resonance (ESR) spectra were conducted on a Bruker A300 Electron Paramagnetic Resonance (EPR) Spectrometer.</p>
</sec>
<sec id="s2-2">
<title>Synthesis of MnO<sub>2</sub> Nanoflowers</title>
<p>MnO<sub>2</sub> nanoflowers were synthesized through hydrothermal methods as reported previously (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B75">Zhu et&#x20;al., 2019</xref>). For K-doped MnO<sub>2</sub> nanoflowers, 1.0&#xa0;g KMnO<sub>4</sub> and 0.4&#xa0;g MnSO<sub>4</sub> were added into the Teflon-lined stainless steel autoclave, together with 30&#xa0;ml DI water. After stirring for 30&#xa0;min, the Teflon-lined stainless-steel autoclave was heated and stirred at 140&#xb0;C for 1&#xa0;h and then cooled down to room temperature. The obtained MnO<sub>2</sub> nanoflowers were washed three times with ethanol and three times with DI water by successive cycles of centrifugation and removal of supernatant. Finally, the materials were dried at 60&#xb0;C for 12&#xa0;h in a vacuum oven for further use. The Na-doped and Mg-doped samples were prepared with the same procedure, except that the 1.0&#xa0;g KMnO<sub>4</sub> was replaced by 1.012&#xa0;g NaMnO<sub>4</sub>&#xb7;H<sub>2</sub>O or 0.84&#xa0;g&#xa0;Mg(MnO<sub>4</sub>)<sub>2</sub>&#xb7;xH<sub>2</sub>O, respectively.</p>
</sec>
<sec id="s2-3">
<title>Bacteria Culture of <italic>Streptococcus</italic> Mutans</title>
<p>
<italic>Streptococcus</italic> mutans (S. mutans) (UA159) were obtained from Shanghai Key Laboratory of Stomatology, Ninth People&#x2019;s Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China). S. mutans was cultured in brain heart infusion broth (BHI broth, Difco laboratories, United&#x20;States) at 37&#xb0;C in anaerobic system (N<sub>2</sub> 80%, H<sub>2</sub> 10%, CO<sub>2</sub> 10%). Bacteria were harvested at the exponential growth phase for the use of subsequent experiments.</p>
</sec>
<sec id="s2-4">
<title>Bacterial Viability Test by MTT Assay</title>
<p>The bacterial viability was assessed by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay. Briefly, S. mutans suspensions at a density of 1&#x20;&#xd7; 10<sup>6</sup> colony forming units (CFUs)/ml were treated with the different concentrations of Mg-, Na-, and K-doped MnO<sub>2</sub> nanoflowers (100, 200, 400, and 800&#xa0;&#x3bc;g/ml) in BHI at 37&#xb0;C under standard anaerobic conditions (N<sub>2</sub> 80%, H<sub>2</sub> 10%, CO<sub>2</sub> 10%) for 24&#xa0;h. After 24&#xa0;h of anaerobic culture, 5&#xa0;mg/ml MTT solution was added to each well and incubated in dark for 2&#xa0;h. The supernatant was discarded, and the substrate was reacted in solution by dimethyl sulfoxide (DMSO). The absorbance was tested at 490&#xa0;nm wavelength using a microplate reader (Bio-Rad, United&#x20;States). All samples were performed in triplicate. The negative control was the S. mutans group without MnO<sub>2</sub> nanoflowers treatment. By comparing the OD values (490&#xa0;nm) of the negative control with that of Mg-, Na-, and K-doped MnO<sub>2</sub> nanoflowers, the inhibition percentage of bacterial viability was calculated by using the equation: [(OD (negative control)-OD (sample))/OD (negative control)]&#xd7;100%.</p>
</sec>
<sec id="s2-5">
<title>Biofilm Formation Test by Crystal Violet Assay</title>
<p>Firstly, 1&#x20;&#xd7; 1&#xa0;cm sterile glass slides were placed in a 24-well plate, and 50&#xa0;&#x3bc;l &#x223c;10<sup>6</sup>&#xa0;CFU/ml&#xa0;S. mutans was added to each well. Then, 150&#xa0;&#x3bc;l suspensions with different concentrations of Mg-, Na-, and K-doped MnO<sub>2</sub> nanoflowers (100, 200, 400, and 800&#xa0;&#x3bc;g/ml) were added into the mixture, respectively. In addition, 200&#xa0;&#x3bc;l &#x223c;10<sup>6</sup>&#xa0;CFU/ml&#xa0;S. mutans was added to the control wells and anaerobically cultured for 24&#x20;h at 37&#xb0;C. After 24&#xa0;h of anaerobic culture, the crystal violet was fixed with methanol, stained with 0.1% (w/v) crystal violet, moistened with sterile double steam water, and washed overnight. After drying, the crystal violet was dissolved with 90% ethanol and the absorbance was tested at 550&#xa0;nm wavelength using a microplate reader (Bio-Rad, United&#x20;States). All samples were performed in triplicate. The negative control was the biofilm without MnO<sub>2</sub> nanoflowers. By comparing the OD values (550&#xa0;nm) of the negative control with that of Mg-, Na-, and K-doped MnO<sub>2</sub> nanoflowers, the inhibition percentage of biofilm formation was calculated by using the equation: [(OD (negative control)-OD (sample))/OD (growth control)]&#xd7;100%</p>
</sec>
<sec id="s2-6">
<title>
<italic>In vitro</italic> Cytotoxicity Assays</title>
<p>The mouse fibroblast cell line (L929) was obtained from the cell bank of the Chinese Academy of Sciences (Shanghai, China) and cultured in minimum essential medium (Gibco, Life Technologies, Carlsbad, CA) supplemented with 10% fetal bovine serum and 100&#xa0;U/ml penicillin&#x2212;streptomycin (Gibco, CA), at 37&#xb0;C and 5% CO<sub>2</sub> humidified atmosphere. Cells without any exposure to nanoparticles served as the negative control. Cytotoxicity was assessed by using the MTT assay. Briefly, to evaluate the mitochondrial function and cell viability of L929 cells treated with different concentrations of Mg-, Na-, and K-doped MnO<sub>2</sub> nanoflowers (100, 200, 400, and 800&#xa0;&#x3bc;g/ml), cells were seeded at a density of 10<sup>4</sup> cells/well on 96-well plates and then treated with particles at different concentrations for 24&#xa0;h. After 24&#xa0;h treatment, MTT solution (20&#xa0;&#x3bc;l, 5&#xa0;mg/ml) (Amersco, Solon, OH, United&#x20;States) was added into each well and incubated for an additional 4&#xa0;h in 37&#xb0;C incubator. Subsequently, 150&#xa0;&#x3bc;l DMSO was added to dissolve the formazan crystals. The absorbance at 570 and 630&#xa0;nm was measured by a microplate reader (Multiskan GO, Thermo Scientific, MA, United&#x20;States).</p>
</sec>
<sec id="s2-7">
<title>ESR Determination</title>
<p>ESR spectroscopy was employed to detect ROS using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as a spin trap (<xref ref-type="bibr" rid="B7">Bosnjakovic and Schlick, 2006</xref>; <xref ref-type="bibr" rid="B62">Szterk et&#x20;al., 2011</xref>). DMPO traps &#xb7;OH to form DMPO&#x2212;&#x2219;OH spin adduct which gives a quadrant signal. It also traps &#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> to form DMPO&#x2212;&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> spin adduct which also gives a quadrant signal. To suspension of MnO<sub>2</sub>, DMPO was added and the ESR spectra were recorded. All the experiments were performed in&#x20;dark.</p>
</sec>
<sec id="s2-8">
<title>The Calculation of Atomic Ratios</title>
<p>Take K-doped MnO<sub>2</sub> nanoflowers as example, the atomic radio between Mn and K was obtained with the quantitative analysis of high-resolution XPS spectra. We regarded I<sup>Mn</sup> and I<sup>K</sup> as the Mn and K intensities from one Mn and K atom, respectively. The total intensities of Mn 2p<sub>3/2</sub> and K 2p<sub>3/2</sub> can be expressed by following expression (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B75">Zhu et&#x20;al., 2019</xref>):<disp-formula id="e1">
<mml:math id="m1">
<mml:mrow>
<mml:msub>
<mml:mtext>I</mml:mtext>
<mml:mrow>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mtext>TOT</mml:mtext>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mtext>Mn&#xa0;&#xa0;</mml:mtext>
<mml:mn>2</mml:mn>
<mml:mtext>p</mml:mtext>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mo>&#x3d;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:msup>
<mml:mtext>I</mml:mtext>
<mml:mrow>
<mml:mtext>Mn</mml:mtext>
</mml:mrow>
</mml:msup>
<mml:msup>
<mml:mtext>k</mml:mtext>
<mml:mrow>
<mml:mtext>Mn</mml:mtext>
</mml:mrow>
</mml:msup>
</mml:mrow>
<mml:mrow>
<mml:mn>1</mml:mn>
<mml:mo>&#x2212;</mml:mo>
<mml:msup>
<mml:mtext>k</mml:mtext>
<mml:mn>2</mml:mn>
</mml:msup>
</mml:mrow>
</mml:mfrac>
</mml:mrow>
</mml:math>
<label>(1)</label>
</disp-formula>
<disp-formula id="e2">
<mml:math id="m2">
<mml:mrow>
<mml:msub>
<mml:mtext>I</mml:mtext>
<mml:mrow>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mtext>TOT</mml:mtext>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mtext>K&#xa0;&#xa0;</mml:mtext>
<mml:mn>2</mml:mn>
<mml:mtext>p</mml:mtext>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mo>&#x3d;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:msup>
<mml:mtext>I</mml:mtext>
<mml:mtext>K</mml:mtext>
</mml:msup>
<mml:msup>
<mml:mtext>k</mml:mtext>
<mml:mtext>K</mml:mtext>
</mml:msup>
</mml:mrow>
<mml:mrow>
<mml:mn>1</mml:mn>
<mml:mo>&#x2212;</mml:mo>
<mml:msup>
<mml:mtext>k</mml:mtext>
<mml:mn>2</mml:mn>
</mml:msup>
</mml:mrow>
</mml:mfrac>
</mml:mrow>
</mml:math>
<label>(2)</label>
</disp-formula>where the layer-by-layer attenuation factor is given by k &#x3d; exp (&#x2212;c/&#x3bb; sin&#x3b8;). The c is the depth of atoms, &#x3bb; is the photoelectron inelastic mean free path, and &#x3b8; is the takeoff angle relative to the sample surface. Owing to the isotropic property of nanoflowers, k should be integrated to obtain the average. Thus, the layer-by-layer attenuation factor is given by the following expression:<disp-formula id="e3">
<mml:math id="m3">
<mml:mrow>
<mml:mtext>k</mml:mtext>
<mml:mo>&#x3d;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x222b;</mml:mo>
</mml:mstyle>
<mml:mn>0</mml:mn>
<mml:mtext>&#x3c0;</mml:mtext>
</mml:msubsup>
<mml:mtext>exp</mml:mtext>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mo>&#x2212;</mml:mo>
<mml:mfrac>
<mml:mtext>c</mml:mtext>
<mml:mrow>
<mml:mtext>&#x3bb;sin&#x3b8;</mml:mtext>
</mml:mrow>
</mml:mfrac>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mtext>d&#x3b8;</mml:mtext>
</mml:mrow>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x222b;</mml:mo>
</mml:mstyle>
<mml:mn>0</mml:mn>
<mml:mtext>&#x3c0;</mml:mtext>
</mml:msubsup>
<mml:mtext>d&#x3b8;</mml:mtext>
</mml:mrow>
</mml:mfrac>
</mml:mrow>
</mml:math>
<label>(3)</label>
</disp-formula>
</p>
<p>The parameter c can be obtained by XRD. The photoelectron inelastic mean free path (&#x3bb;<sub>Mn</sub> &#x3d; 1.73&#xa0;nm, &#x3bb;<sub>K</sub> &#x3d; 2.25&#xa0;nm) was calculated by using the National Institute of Standards and Technology (NIST) database.</p>
</sec>
</sec>
<sec sec-type="results|discussion" id="s3">
<title>Results and Discussion</title>
<p>We started by using Mg(MnO<sub>4</sub>)<sub>2</sub> as precursor to synthesize Mg-doped &#x3b4;-MnO<sub>2</sub> materials. <xref ref-type="fig" rid="F1">Figure&#x20;1A</xref> shows the SEM image of Mg-doped MnO<sub>2</sub>, which presented a flower-like morphology and the size was &#x223c;380&#xa0;nm in diameter. <xref ref-type="sec" rid="s10">Supplementary Figure S1A</xref> shows the XRD patterns of Mg-doped &#x3b4;-MnO<sub>2</sub> nanoflowers. All the peaks correspond to the crystal planes of &#x3b4;-MnO<sub>2</sub> (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B39">Li et&#x20;al., 2019</xref>), and no other crystalline phases were detected. <xref ref-type="fig" rid="F1">Figures 1B,C</xref> present the TEM and HRTEM images of Mg-doped MnO<sub>2</sub> nanoflowers. The lattice spacings of 1.42 and 2.45&#xa0;&#xc5; coincide with the (110) and (101) interlayer distance in &#x3b4;-MnO<sub>2</sub>. This is also supported by the SAED patters shown in <xref ref-type="sec" rid="s10">Supplementary Figure&#x20;S2A</xref>.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>SEM <bold>(A,D,G)</bold>, TEM <bold>(B,E,H)</bold>, and HRTEM <bold>(C,F,I)</bold> images of Mg-, Na-, and K-doped &#x3b4;-MnO<sub>2</sub> nanoflowers.</p>
</caption>
<graphic xlink:href="fbioe-09-788574-g001.tif"/>
</fig>
<p>The band gap for the Mg-doped MnO<sub>2</sub> nanoflowers was calculated as 1.13&#xa0;eV from the UV-VIS spectrum shown in <xref ref-type="sec" rid="s10">Supplementary Figure S3A</xref>. The narrower bandgap observed here relative to the previously reported (<xref ref-type="bibr" rid="B56">Sakai et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B36">John et&#x20;al., 2016</xref>) might be attributed to the doping of Mg<sup>2&#x2b;</sup> ions between layers of MnO<sub>2</sub> (<xref ref-type="bibr" rid="B45">Luo et&#x20;al., 2000</xref>; <xref ref-type="bibr" rid="B66">Wang et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B75">Zhu et&#x20;al., 2019</xref>), which will be discussed&#x20;later.</p>
<p>
<xref ref-type="fig" rid="F2">Figure&#x20;2A</xref> shows the XPS survey spectrum of Mg-doped MnO<sub>2</sub>. It was detected that, with a &#x223c;15&#xa0;min UV exposure, surface C contamination has a &#x223c;8&#x20;times minor intensity relative to that of Mn 2p<sub>3/2</sub>. The binding energy (BE) values of different elements were presented in <xref ref-type="sec" rid="s10">Supplementary Table S1</xref>. The Mn 2p<sub>3/2</sub> core-level spectrum in <xref ref-type="fig" rid="F2">Figure&#x20;2D</xref> presented two components. The main peak labeled I with low BE at 642.3&#xa0;eV is due to bulk-coordinated Mn, and the other peak with high BE at 645.1&#xa0;eV (peak II) corresponds to MnO<sub>2</sub> interacted with absorbed oxygen from air (<xref ref-type="bibr" rid="B57">Selvakumar et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B40">Li et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B63">Tang et&#x20;al., 2020</xref>). However, no signal corresponding to reduced Mn<sup>3&#x2b;</sup>, which is known to occur as a result of the formation of oxygen vacancies, was observed (<xref ref-type="bibr" rid="B57">Selvakumar et&#x20;al., 2015</xref>). <xref ref-type="fig" rid="F2">Figure&#x20;2E</xref> shows the O 1s core-level spectrum, which presented three components. The main peak (BE 529.9&#xa0;eV) labeled I is due to bulk-coordinated oxygen. Peak II (BE 531.5&#xa0;eV) and peak III (BE 532.9&#xa0;eV) are attributed to the surface component and the carbonate or hydroxyl groups chemically bound on the surface, respectively (<xref ref-type="bibr" rid="B63">Tang et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B2">Arunpandiyan et&#x20;al., 2021</xref>). <xref ref-type="fig" rid="F2">Figure&#x20;2F</xref> presents the Mg 1s spectrum which only has one component. The BE of Mg 1s is 1303.5&#xa0;eV, which is higher than that of Mg<sub>2</sub>Si (&#x223c;1302.3&#xa0;eV) and Mg(OH)<sub>2</sub> (&#x223c;1303&#xa0;eV) (<xref ref-type="bibr" rid="B17">Esaka et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B35">Jiang et&#x20;al., 2017</xref>). The results indicate that Mg<sup>2&#x2b;</sup> is chemically bound to MnO<sub>2</sub> (<xref ref-type="bibr" rid="B48">Nefedov, 1977</xref>). In the Mg 1s spectrum only one component was observed, suggesting that all Mg<sup>2&#x2b;</sup> ions were filled between the MnO<sub>2</sub> layers (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Survey XPS scan of <bold>(A)</bold> Mg-doped, <bold>(B)</bold> Na-doped, and <bold>(C)</bold> K-doped &#x3b4;-MnO<sub>2</sub> nanoflowers. Core-level spectra for Mg-doped <bold>(D&#x2013;F)</bold>, Na-doped <bold>(G&#x2013;I)</bold>, and K-doped &#x3b4;-MnO<sub>2</sub> nanoflowers <bold>(J&#x2013;L)</bold>: <bold>(D,G,J)</bold> Mn 2p<sub>3/2</sub>, <bold>(E,H,K)</bold> O 1s, <bold>(F)</bold> Mg 1s, <bold>(I)</bold> Na 1s, and <bold>(L)</bold> K 2p<sub>3/2</sub>.</p>
</caption>
<graphic xlink:href="fbioe-09-788574-g002.tif"/>
</fig>
<p>Since the biocompatibility of materials is a <ext-link ext-link-type="uri" xlink:href="https://fanyi.so.com/?src=onebox">prerequisite</ext-link> for their intended use in the human body, <italic>in&#x20;vitro</italic> cytotoxicity studies of Mg-doped MnO<sub>2</sub> nanoflowers were carried out prior to antibacterial testing. Specifically, L929 mouse fibroblastic cells were exposed for 24&#xa0;h to different concentrations (0, 100, 200, 400, and 800&#xa0;&#x3bc;g/ml) of MnO<sub>2</sub> nanoflowers and then the cell viability was determined using the MTT assay, a well-established colorimetric method to evaluate the cytotoxicity of biomedical device according to ISO 10993-5:2009. After 24&#xa0;h of incubation, the cell viability of L929 cells was more than 90% with the concentration of Mg-doped MnO<sub>2</sub> nanoflowers at 100&#x2013;400&#xa0;&#x3bc;g/ml, whereas it was reduced to 66&#x20;&#xb1; 5.7% when the dose was increased up to 800&#xa0;&#x3bc;g/ml (<xref ref-type="sec" rid="s10">Supplementary Figure S4</xref>), suggesting that the MnO<sub>2</sub> nanoflowers exhibited no or low cytotoxicity even at high concentration. When the concentration was higher than 400&#xa0;&#x3bc;g/ml, an apparent decrease in cell viability was found, indicating high dose of MnO<sub>2</sub> nanoparticles could induce cell death, which was consistent with our previous studies showing high concentrations of silica nanoparticles could induce cell necrosis in endothelial cells (<xref ref-type="bibr" rid="B43">Liu and Sun, 2010</xref>). It might be attributed to the higher cellular uptake of nanoparticles, which could directly damage cell plasma membranes and thus cause cell necrosis (<xref ref-type="bibr" rid="B43">Liu and Sun, 2010</xref>).</p>
<p>Then, the antibacterial activity of Mg-doped MnO<sub>2</sub> sample was evaluated by detection of the bacterial viability and biofilm formation of S. mutans (<xref ref-type="bibr" rid="B6">Bijle et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B13">Daood et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B60">Song et&#x20;al., 2020</xref>). Firstly, MTT assay was applied to evaluate the effect of Mg-doped MnO<sub>2</sub> sample on the bacterial viability of S. mutans. As shown in <xref ref-type="fig" rid="F3">Figure&#x20;3A</xref>, Mg-doped MnO<sub>2</sub> can effectively inhibit bacterial viability. When the Mg-doped MnO<sub>2</sub> nanoflowers at 100, 200, 400, and 800&#xa0;&#x3bc;g/ml concentration were added, the percentage of inhibition was 11.86&#x20;&#xb1; 2.18, 13.73&#x20;&#xb1; 1.45, 16.0&#x20;&#xb1; 1.83, and 20.79&#x20;&#xb1; 0.94%, respectively, reflecting that as the concentration of Mg-doped MnO<sub>2</sub> nanoflowers increases, the inhibition of bacterial viability shows an upward&#x20;trend.</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>The inhibition effect of Mg-, Na-, and K-doped &#x3b4;-MnO<sub>2</sub> nanoflowers on S. mutans bacterial viability and biofilm formation at 24&#xa0;h. <bold>(A)</bold> Bacterial viability by MTT assay. <bold>(B)</bold> Biofilm formation by crystal violet assay. Bacteria without nanoparticle treatment served as the negative control. Data represents mean&#x20;&#xb1; standard deviation (SD), <italic>n</italic>&#x20;&#x3d; 3. &#x2a;&#x2a;<italic>p</italic>&#x20;&#x3c; 0.01 vs. the negative control group; &#x23;&#x23;<italic>p</italic>&#x20;&#x3c; 0.01 significant difference as compared groups.</p>
</caption>
<graphic xlink:href="fbioe-09-788574-g003.tif"/>
</fig>
<p>Generally, the MTT assay for assessment of antibacterial activity revealed the function of bacterial dehydrogenase system involved in metabolism (<xref ref-type="bibr" rid="B26">He et&#x20;al., 2015</xref>). Furthermore, bacterial biofilm formation is known to increase resistance against the antibiotic and plays a critical role in the pathogenesis of infections (<xref ref-type="bibr" rid="B4">Banerjee et&#x20;al., 2020</xref>). Then, we also examined the effect of Mg-doped MnO<sub>2</sub> nanoflowers on S. mutans biofilm formation by crystal violet staining (<xref ref-type="bibr" rid="B3">Asgharpour et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B9">Chan et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B34">Jiang et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B60">Song et&#x20;al., 2020</xref>), and the results showed the same trend as the MTT assay (<xref ref-type="fig" rid="F3">Figure&#x20;3B</xref>). In the presence of Mg-doped MnO<sub>2</sub>, the inhibition percentage of biofilm formation was 4.1&#x20;&#xb1; 1.45% at 100&#xa0;&#x3bc;g/ml, 21.02&#x20;&#xb1; 0.49% at 200&#xa0;&#x3bc;g/ml, 39.86&#x20;&#xb1; 1.59% at 400&#xa0;&#x3bc;g/ml, and 51.99&#x20;&#xb1; 1.18% at 800&#xa0;&#x3bc;g/ml concentration, respectively, showing a dose-dependent enhanced antibacterial activity and reduced biofilm formation against S. mutans induced by Mg-doped MnO<sub>2</sub> nanoflowers. Interestingly, these antibacterial tests were all performed in the&#x20;dark.</p>
<p>From the above results, it was intriguing to find that the Mg-doped &#x3b4;-MnO<sub>2</sub> nanoflowers exhibited spontaneous antibacterial properties in the dark. Since it is established that ROS is responsible for antibacterial activity in the dark (<xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>), their formation was investigated by electron spin resonance (ESR) using DMPO as a quencher without external illumination. <xref ref-type="fig" rid="F4">Figures 4A,B</xref> show the characteristic DMPO-&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> and DMPO-&#xb7;OH signals in the case of Mg-doped MnO<sub>2</sub> nanoflowers at 800&#xa0;&#x3bc;g/ml concentration (<xref ref-type="bibr" rid="B52">Peng et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B76">Zong et&#x20;al., 2021</xref>). The results show that both superoxide radicals (O<sub>2</sub>
<sup>&#x2212;</sup>) and hydroxyl radical (<inline-formula id="inf1">
<mml:math id="m4">
<mml:mrow>
<mml:mtext>OH</mml:mtext>
</mml:mrow>
</mml:math>
</inline-formula>) were generated under dark conditions.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>ESR spin trapping spectra of <bold>(A)</bold> DMPO-&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> and <bold>(B)</bold> DMPO-&#xb7;OH on Mg-, Na-, and K-doped &#x3b4;-MnO<sub>2</sub> nanoflowers in the&#x20;dark.</p>
</caption>
<graphic xlink:href="fbioe-09-788574-g004.tif"/>
</fig>
<p>It has been reported that ZnO and MgO nanoparticles produced ROS in the dark due to the transfer of electrons trapped by the oxygen vacancies at the surface of materials (<xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>; <xref ref-type="bibr" rid="B25">Hao et&#x20;al., 2017</xref>). However, in our case, the presence of oxygen vacancies on the &#x3b4;-MnO<sub>2</sub> surface was not detected from the XPS results (<xref ref-type="bibr" rid="B57">Selvakumar et&#x20;al., 2015</xref>). For the Mg 1s core-level spectrum in <xref ref-type="fig" rid="F2">Figure&#x20;2F</xref>, it can be observed that Mg is chemically bound to MnO<sub>2</sub>, and thus, the valence electrons of Mg were transferred to MnO<sub>2</sub>, becoming free electrons. It implies that the production of ROS in the dark might be produced by the free electrons in &#x3b4;-MnO<sub>2</sub> coming from doping.</p>
<p>In order to further confirm this hypothesis, NaMnO<sub>4</sub> and KMnO<sub>4</sub> were employed to synthesize the Na- and K-doped &#x3b4;-MnO<sub>2</sub> as similarly described for Mg-doped &#x3b4;-MnO<sub>2</sub>. In this case, it has been established that these &#x3b4;-MnO<sub>2</sub> samples can enable higher doping levels relative to Mg-doped &#x3b4;-MnO<sub>2</sub>, which can lead to an increase number of free electrons (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>). <xref ref-type="fig" rid="F1">Figures 1D,G</xref> present their SEM images. These MnO<sub>2</sub> samples showed similar flower-like morphology as that of Mg-doped ones, and the sizes were &#x223c;460&#xa0;nm in diameter (Na-doped MnO<sub>2</sub>) and &#x223c;500&#xa0;nm in diameter (K-doped MnO<sub>2</sub>), respectively. From the XRD patterns in <xref ref-type="sec" rid="s10">Supplementary Figures S1B,C</xref>, it was observed that they all presented very similar crystalline structures to Mg-doped sample. <xref ref-type="fig" rid="F1">Figures 1E,H</xref> present their TEM images. The HRTEM images depicted in <xref ref-type="fig" rid="F1">Figures 1F,I</xref>, as well as SAED patterns in <xref ref-type="sec" rid="s10">Supplementary Figure S2B,C</xref>, display the same lattice spacings (1.42 and 2.45&#xa0;&#xc5;) of MnO<sub>2</sub> as that of Mg-doped &#x3b4;-MnO<sub>2</sub>. The bandgaps were calculated from UV-VIS spectra (<xref ref-type="sec" rid="s10">Supplementary Figures S3B,C</xref>, respectively), which were 1.06 (Na-doped MnO<sub>2</sub>) and 0.75&#xa0;eV (K-doped MnO<sub>2</sub>), respectively.</p>
<p>
<xref ref-type="fig" rid="F2">Figures 2B,C</xref> display the XPS survey spectra of Na- and K-doped MnO<sub>2</sub>. In <xref ref-type="fig" rid="F2">Figure&#x20;2I,L</xref>, it presented only one component in both Na 1s and K 2p<sub>3/2</sub> spectra. The BE of Na 1s (1070.9&#xa0;eV) is higher than that of NaOH (&#x223c;1069.6&#xa0;eV), while the BE of K 2p<sub>3/2</sub> (292.5&#xa0;eV) is higher than that of KF (&#x223c;292.2&#xa0;eV) (<xref ref-type="bibr" rid="B50">Oh et&#x20;al., 2013</xref>). Thus, it indicates that Na<sup>&#x2b;</sup> or K<sup>&#x2b;</sup> ions were also filled between the layers of MnO<sub>2</sub> (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>). In <xref ref-type="fig" rid="F2">Figures 2G,J</xref>, Mn 2p<sub>3/2</sub> core-level spectra presented 2 components, which was consistent with the Mg-doped MnO<sub>2</sub> sample. The BE of peak II are 644.9 (Na-doped MnO<sub>2</sub>) and 644.7&#xa0;eV (K-doped MnO<sub>2</sub>), respectively, which are 0.2 and 0.4&#xa0;eV lower than the corresponding peaks of Mg-doped MnO<sub>2</sub>. Meanwhile, the BE of peak II and III of O 1s peak for Na-doped and K-doped samples also shift to lower BE values relative to those of Mg-doped sample. These variations demonstrate that between MnO<sub>2</sub> and doped ions, it occurred a charge transfer (<xref ref-type="bibr" rid="B45">Luo et&#x20;al., 2000</xref>; <xref ref-type="bibr" rid="B22">Gupta et&#x20;al., 2018</xref>). The reason can be explained by the different doping levels as follows.</p>
<p>The atomic ratios calculated from the XPS data for Mg/Mn (Mg-doped MnO<sub>2</sub>), Na/Mn (Na-doped MnO<sub>2</sub>), and K/Mn (K-doped MnO<sub>2</sub>) were 1:626, 1:52, and 1:7, respectively. Details on these calculations are described in the experimental section (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>; <xref ref-type="bibr" rid="B75">Zhu et&#x20;al., 2019</xref>). This difference might be that the bigger size of ions results in larger interaction between ions and MnO<sub>2</sub> layers, because the ions presented the size of K<sup>&#x2b;</sup>&#x3e;Na<sup>&#x2b;</sup>&#x3e;Mg<sup>2&#x2b;</sup> (<xref ref-type="bibr" rid="B30">Hu et&#x20;al., 2019</xref>). Therefore, the difference in the amounts of doping ions in MnO<sub>2</sub> results in the variance in the bandgap values, and meanwhile contribute to the lower BE of Mn and O peaks in Na- and K-doped samples relative to those of Mg-doped&#x20;ones.</p>
<p>Then, MnO<sub>2</sub> doped by Na<sup>&#x2b;</sup> and K<sup>&#x2b;</sup> ions were employed to evaluate the effect of free electrons quantity on the bacterial viability and biofilm formation of S. mutans in the dark. <italic>In vitro</italic> cytotoxicity studies were also tested. The experimental procedure was the same as that of Mg-doped MnO<sub>2</sub> samples, and the results were described in <xref ref-type="sec" rid="s10">Supplementary Figure S4</xref>. Consistent with the cytotoxicity results of Mg-doped MnO<sub>2</sub>, neither Na- nor K-doped MnO<sub>2</sub> had a significant effect on cell viability at concentration below 400&#xa0;&#x3bc;g/ml, while a slight reduction in cell viability was observed at 800&#xa0;&#x3bc;g/ml. Thus, the MTT assay showed no significant cytotoxicity for MnO<sub>2</sub> against L929 cells when the concentration was no more than 400&#xa0;&#x3bc;g/ml. It was noted that K-doped MnO<sub>2</sub> had the least cytotoxicity, while Mg-doped MnO<sub>2</sub> displayed higher cytotoxicity than Na-doped MnO<sub>2</sub> sample. According to ISO 10993-5:2009, the biocompatibility of K-doped MnO<sub>2</sub> was very much within the acceptable limits even at a concentration as high as 800&#xa0;&#x3bc;g/ml.</p>
<p>Subsequently, we used both the MTT assay and crystal violet staining assay to evaluate the effect of MnO<sub>2</sub> nanoflowers with different doping on the bacterial viability and biofilm formation of S. mutans. As shown in <xref ref-type="fig" rid="F3">Figure&#x20;3A</xref>, the inhibition of S. mutans bacterial viability exposed to Na-doped MnO<sub>2</sub> nanoflowers at 100, 200, 400, and 800&#xa0;&#x3bc;g/ml concentration was 15.25&#x20;&#xb1; 1.11, 19.26&#x20;&#xb1; 1.39, 23.81&#x20;&#xb1; 1.83, and 27.46&#x20;&#xb1; 1.82%, respectively. Meanwhile the inhibition with K-doped MnO<sub>2</sub> at concentrations of 100, 200, 400, and 800&#xa0;&#x3bc;g/ml was 16.22&#x20;&#xb1; 1.38, 23.26&#x20;&#xb1; 0.65, 27.13&#x20;&#xb1; 0.98, and 30.20&#x20;&#xb1; 0.77%, respectively, reflecting that as the concentrations of MnO<sub>2</sub> nanoflowers increases, the antibacterial activity shows an upward&#x20;trend.</p>
<p>From <xref ref-type="fig" rid="F3">Figure&#x20;3B</xref>, in the presence of Na-doped MnO<sub>2</sub>, the inhibition of biofilm formation was 8.25&#x20;&#xb1; 1.48% at 100&#xa0;&#x3bc;g/ml, 44.0&#x20;&#xb1; 2.40% at 200&#xa0;&#x3bc;g/ml, 56.0&#x20;&#xb1; 0.46% at 400&#xa0;&#x3bc;g/ml, and 61.57&#x20;&#xb1;&#x20;0.24% at 800&#xa0;&#x3bc;g/ml, respectively. In the presence of K-doped MnO<sub>2</sub>, the inhibition of biofilm formation was 35.44&#x20;&#xb1; 2.28% at 100&#xa0;&#x3bc;g/ml, 53.56&#x20;&#xb1; 1.00% at 200&#xa0;&#x3bc;g/ml, 62.38&#x20;&#xb1; 0.46% at 400&#xa0;&#x3bc;g/ml, and 67.61&#x20;&#xb1; 0.61% at 800&#xa0;&#x3bc;g/ml, respectively. Obviously, both MTT assay and crystal violet staining have shown that K-doped MnO<sub>2</sub> has the superior antibacterial and antibiofilm formation ability, which is better than that of Na-doped sample. Meanwhile, the Mg-doped MnO<sub>2</sub> had the lowest antibacterial activity. Therefore, these results confirm the hypothesis that higher doping levels could provide more free electrons, which enhanced the antibacterial properties in doped &#x3b4;-MnO<sub>2</sub>.</p>
<p>
<xref ref-type="fig" rid="F4">Figures 4A,B</xref> also show the characteristic DMPO-&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> and DMPO-&#xb7;OH signals in the case of Na- and K-doped MnO<sub>2</sub> (<xref ref-type="bibr" rid="B52">Peng et&#x20;al., 2021</xref>; <xref ref-type="bibr" rid="B76">Zong et&#x20;al., 2021</xref>). The results show that both <inline-formula id="inf2">
<mml:math id="m5">
<mml:mrow>
<mml:msubsup>
<mml:mtext>O</mml:mtext>
<mml:mn>2</mml:mn>
<mml:mo>&#x2212;</mml:mo>
</mml:msubsup>
</mml:mrow>
</mml:math>
</inline-formula> and OH produced in the dark were following the order of K<sup>&#x2b;</sup>&#x3e;Na<sup>&#x2b;</sup>&#x3e;Mg<sup>2&#x2b;</sup>, which further confirm that the production of ROS in the dark might be produced by the free electrons in &#x3b4;-MnO<sub>2</sub> coming from doping.</p>
<p>In aqueous solutions, the free electrons in &#x3b4;-MnO<sub>2</sub> coming from doping can transfer to the water around it and form &#xb7;O<sub>2</sub>
<sup>&#x2212;</sup>, while &#xb7;OH is known as a derivative of <inline-formula id="inf3">
<mml:math id="m6">
<mml:mrow>
<mml:msubsup>
<mml:mtext>O</mml:mtext>
<mml:mn>2</mml:mn>
<mml:mo>&#x2212;</mml:mo>
</mml:msubsup>
</mml:mrow>
</mml:math>
</inline-formula> (<xref ref-type="bibr" rid="B47">Morrison et&#x20;al., 1988</xref>; <xref ref-type="bibr" rid="B70">Xu et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B71">Yao et&#x20;al., 2020</xref>). To clarify the role of O<sub>2</sub>
<sup>&#x2212;</sup> in the mechanism of ROS production, ESR was then carried out with the addition of superoxide dismutase (SOD), a well-known superoxide scavenger (<xref ref-type="bibr" rid="B8">Carre et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B53">Piccaro et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B33">Jiang et&#x20;al., 2016</xref>). The results in <xref ref-type="sec" rid="s10">Supplementary Figure S5</xref> demonstrate that in the dark both DMPO-&#xb7;O<sub>2</sub>
<sup>&#x2212;</sup> and DMPO-&#xb7;OH signal disappeared in the presence of SOD, revealing that ROS mediated through superoxide plays a major role in antibacterial activity without external illumination (<xref ref-type="bibr" rid="B38">Prasanna and Vijayaraghavan, 2015</xref>; <xref ref-type="bibr" rid="B31">Ijaz et&#x20;al., 2020</xref>). Thus, the antibacterial mechanism of doped &#x3b4;-MnO<sub>2</sub> could be proposed as in <xref ref-type="fig" rid="F5">Figure&#x20;5</xref>. When the alkali metal atoms are chemically bound to MnO<sub>2</sub> by doping, the valence electrons of alkali metals will transfer to MnO<sub>2</sub>. Then, the doped MnO<sub>2</sub> can provide free electrons to induce the production of O<sub>2</sub>
<sup>&#x2212;</sup> in aqueous solutions, which could penetrate into the bacteria cell membrane and then damage cellular components such as DNA and proteins (<xref ref-type="bibr" rid="B68">Xia et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B37">Kasemets et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B12">Dadi et&#x20;al., 2019</xref>), resulting in the antibacterial activity without external illumination. Furthermore, by comparing the &#x3b4;-MnO<sub>2</sub> with different doping level, the ROS generation following the doping levels of K<sup>&#x2b;</sup>&#x3e;Na<sup>&#x2b;</sup>&#x3e;Mg<sup>2&#x2b;</sup> can be observed. With higher doping levels, more free electrons can be transferred to MnO<sub>2</sub>, which induce the production of more ROS, and thus present superior antibacterial activity. Compared to the antibacterial activities of MnO<sub>2</sub> with other iron oxide nanoparticles such as ZnO, CuO, Fe<sub>3</sub>O<sub>4</sub>, and Al<sub>2</sub>O<sub>3</sub> (<xref ref-type="sec" rid="s10">Supplementary Table S2</xref>), it was observed that MnO<sub>2</sub> displayed a superior antibacterial ability.</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Schematic diagram for the mechanism of antibacterial activity on doped &#x3b4;-MnO<sub>2</sub>.</p>
</caption>
<graphic xlink:href="fbioe-09-788574-g005.tif"/>
</fig>
<p>
<xref ref-type="sec" rid="s10">Supplementary Figure S6</xref> presented the controllable degradation behavior of &#x3b4;-MnO<sub>2</sub>. Following the gradual addition of vitamin C into the suspension with &#x3b4;-MnO<sub>2</sub> samples, it started to fade color, which indicated that MnO<sub>2</sub> could be degraded in the presence of vitamin C. When the quantity of vitamin C was 14&#x20;times over MnO<sub>2</sub> samples, it observed a nearly complete degradation of MnO<sub>2</sub> into water soluble Mn ions, which can be rapidly excreted from the body, making this materials potential for <italic>in vivo</italic> applications, presenting not only an outstanding antibacterial efficacy but also an excellent biosafety (<xref ref-type="bibr" rid="B42">Liu et&#x20;al., 2021</xref>).</p>
</sec>
<sec sec-type="conclusion" id="s4">
<title>Conclusion</title>
<p>&#x3b4;-MnO<sub>2</sub> nanoflowers doped by Mg, Na, and K ions were successful synthesized and their bandgap tunable antibacterial properties and controllable degradability mediated by vitamin C were systematically investigated. Interestingly, it was observed that all the samples showed antibacterial activity in the dark, and the antibacterial activity increased with doping levels, which was favored in the K<sup>&#x2b;</sup>&#x3e;Na<sup>&#x2b;</sup>&#x3e;Mg<sup>2&#x2b;</sup> order. Our data suggest that doped MnO<sub>2</sub> can provide free electrons to induce the production of ROS and result in the antibacterial activity in the dark. Moreover, it is shown that higher doping levels can provide more free electrons, which enhance the antibacterial activity of the &#x3b4;-MnO<sub>2</sub> materials. Following the gradual addition of vitamin C, MnO<sub>2</sub> nanoflowers could nearly be degraded into water soluble Mn ions completely, indicating that these materials also display biosafety. We believe that our results shed light on the design and fabrication of antibacterial nanomaterials with tailored properties.</p>
</sec>
</body>
<back>
<sec id="s5">
<title>Data Availability Statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="sec" rid="s10">Supplementary Material</xref>. Further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s6">
<title>Author Contributions</title>
<p>YY (investigation, writing&#x2014;original draft); NJ (methodology, investigation, analysis); XL (conceptualization, project administration); JP (conceptualization, funding acquisition); ML (investigation, analysis); CW (investigation, analysis); PC (methodology, analysis); JW (conceptualization, project administration, funding acquisition).</p>
</sec>
<sec id="s7">
<title>Funding</title>
<p>This work was supported by Shanghai Natural Science Foundation (20ZR1401700), the National Natural Science Foundation of China (21703031, 81971751, 22005046, and 61376017), Shanghai Science and Technology Innovation Fund (19ZR1445500, 20Y11904100), innovative research team of high-level local universities in Shanghai (SSMU-ZDCX20180900), and the Research Discipline fund No. KQYJXK2020 from Ninth People&#x2019;s Hospital, Shanghai Jiao Tong University School of Medicine, and College of Stomatology, Shanghai Jiao Tong University.</p>
</sec>
<sec sec-type="COI-statement" id="s8">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s9">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors, and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s10">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fbioe.2021.788574/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fbioe.2021.788574/full&#x23;supplementary-material</ext-link>
</p>
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