Chen Mengbing, Huang Bo, Su Xiaoxia
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases &, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
J Mol Med (Berl). 2025 Feb;103(2):137-156. doi: 10.1007/s00109-025-02513-4. Epub 2025 Jan 16.
Periodontitis is a chronic inflammatory disease that destroys tooth-supporting structures and poses significant public health challenges due to its high prevalence and links to systemic health conditions. Traditional treatments are effective in reducing the inflammatory response and improving the clinical symptoms of periodontitis. However, these methods are challenging to achieve an ideal treatment effect in alveolar bone repair. Mesenchymal stem cells (MSCs) represent a potential alternative for the treatment of periodontal bone defects due to their self-renewal and differentiation capabilities. Recent research indicates that MSCs exert their effects primarily through paracrine mechanisms. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) serve as pivotal mediators in intercellular communication, transferring microRNAs (miRNAs), messenger RNAs (mRNAs), proteins, and cytokines to recipient cells, thereby emulating the therapeutic effects of MSCs. In periodontitis, MSC-EVs play a pivotal role in immunomodulation and bone remodeling, thereby facilitating periodontal bone repair. As a cell-free therapy, MSC-EVs demonstrate considerable clinical potential due to their specialized membrane structure, minimal immunogenicity, low toxicity, high biocompatibility, and nanoscale size. This review indicates that MSC-EVs represent a promising approach for periodontitis treatment, with the potential to overcome the limitations of traditional therapies and offer a more effective solution for bone repair in periodontal disease. In this review, we introduce MSC-EVs, emphasizing their mechanisms and clinical applications in periodontal bone repair. It synthesizes recent advances, existing challenges, and future prospects to present up-to-date information and novel techniques for periodontal regeneration and to guide the improvement of MSC-EV therapy in clinical practice.
牙周炎是一种慢性炎症性疾病，会破坏牙齿支持结构，因其高患病率以及与全身健康状况的关联而对公共卫生构成重大挑战。传统治疗方法在减轻炎症反应和改善牙周炎临床症状方面是有效的。然而，这些方法在实现牙槽骨修复的理想治疗效果方面具有挑战性。间充质干细胞（MSCs）因其自我更新和分化能力，代表了一种治疗牙周骨缺损的潜在替代方法。最近的研究表明，MSCs主要通过旁分泌机制发挥作用。间充质干细胞衍生的细胞外囊泡（MSC-EVs）作为细胞间通讯的关键介质，将微小RNA（miRNAs）、信使RNA（mRNAs）、蛋白质和细胞因子传递给受体细胞，从而模拟MSCs的治疗效果。在牙周炎中，MSC-EVs在免疫调节和骨重塑中起关键作用，从而促进牙周骨修复。作为一种无细胞疗法，MSC-EVs因其特殊的膜结构、最小的免疫原性、低毒性、高生物相容性和纳米级尺寸而显示出相当大的临床潜力。这篇综述表明，MSC-EVs是一种有前景的牙周炎治疗方法，有可能克服传统疗法的局限性，并为牙周疾病的骨修复提供更有效的解决方案。在这篇综述中，我们介绍了MSC-EVs，强调了它们在牙周骨修复中的机制和临床应用。它综合了最新进展、现有挑战和未来前景，以提供牙周再生的最新信息和新技术，并指导临床实践中MSC-EV疗法的改进。
