As the exfoliated keratinocytes (EKs) in oral mucosa are aging and degenerating cells, of which cytoplasms are almost replaced by cross-linked keratin materials. Consequently, the EKs become apoptotic with nuclear lysis. A question is arisen what is the biological role of these EKs in oral cavity? Are they simply degrading as aging keratinocytes or do they have some essential function still remained in the exfoliated status? The buccal smear samples from ten healthy adult subjects were observed under scanning electron microscope. On the outer surface of the EKs the features of bacterial adhesion were explored. The microorganisms attached on the surface of EKs were much deformed, shrunken and teared. Only a few microorganisms were found on the EK surface, aggregated focally. The attached microorganisms were gradually fused on the cell membrane of EKs, and subsequently endocytosed. Resultantly, many round endocytotic concave cavities similar size to the cocci were remained on the surface of EKs similar to the sequels of caveolae endocytosis. These data indicate that the degenerating EKs can actively engulf microorganisms attached on their cell surface via the processes of caveolae endocytosis. Therefore, it is presumed that the oral EKs still play a role for endocytotic scavenging of oral microorganisms using the denatured cell bodies themselves, which become highly adherent to oral microorganisms and still function for caveolae endocytosis in mixed saliva environment.
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