Jing Lin, Wang Hong-Yu, Zhang Ning, Zhang Wen-Jie, Chen Yuzhe, Deng Dao-Kun, Li Xuan, Chen Fa-Ming, He Xiao-Tao
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, People's Republic of China.
Cadet Regiment, School of Basic Medical Sciences, Air Force Medical University, Xi'an 710032, People's Republic of China.
Stem Cells Transl Med. 2025 Mar 18;14(3). doi: 10.1093/stcltm/szae092.
Extracellular vesicles (EVs) are evolutionarily conserved communication mediators that play key roles in the development of periodontal disease as well as in regeneration processes. This concise review first outlines the pathogenic mechanisms through which EVs derived from bacteria lead to the progression of periodontitis, with a focus on the enrichment of virulence factors, the amplification of immune responses, and the induction of bone destruction as key aspects influenced by bacterial EVs. This review aims to elucidate the positive effects of EVs derived from mesenchymal stem cells (MSC-EVs) on periodontal tissue regeneration. In particular, the anti-inflammatory properties of MSC-EVs and their impact on the intricate interplay between MSCs and various immune cells, including macrophages, dendritic cells, and T cells, are described. Moreover, recent advancements regarding the repair-promoting functions of MSC-EVs are detailed, highlighting the mechanisms underlying their ability to promote osteogenesis, cementogenesis, angiogenesis, and the homing of stem cells, thus contributing significantly to periodontal tissue regeneration. Furthermore, this review provides insights into the therapeutic efficacy of MSC-EVs in treating periodontitis within a clinical context. By summarizing the current knowledge, this review aims to provide a comprehensive understanding of how MSC-EVs can be harnessed for the treatment of periodontal diseases. Finally, a discussion is presented on the challenges that lie ahead and the potential practical implications for translating EV-based therapies into clinical practices for the treatment of periodontitis.
细胞外囊泡（EVs）是进化上保守的通讯介质，在牙周病的发展以及再生过程中发挥关键作用。本简要综述首先概述了细菌来源的EVs导致牙周炎进展的致病机制，重点关注毒力因子的富集、免疫反应的放大以及骨破坏的诱导，这些是受细菌EVs影响的关键方面。本综述旨在阐明间充质干细胞来源的EVs（MSC-EVs）对牙周组织再生的积极作用。特别描述了MSC-EVs的抗炎特性及其对间充质干细胞与各种免疫细胞（包括巨噬细胞、树突状细胞和T细胞）之间复杂相互作用的影响。此外，详细介绍了MSC-EVs促进修复功能的最新进展，突出了其促进成骨、牙骨质生成、血管生成和干细胞归巢能力的潜在机制，从而对牙周组织再生做出了重大贡献。此外，本综述还探讨了MSC-EVs在临床环境中治疗牙周炎的疗效。通过总结当前的知识，本综述旨在全面了解如何利用MSC-EVs治疗牙周疾病。最后，讨论了未来面临的挑战以及将基于EVs的疗法转化为治疗牙周炎临床实践的潜在实际意义。
