Zhang Ling, Li Xiaotong, Zhang Bin, Li Ruiji
School of Nursing, Jining Medical University, Jining, Shandong, 272067, People's Republic of China.
Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People's Republic of China.
J Inflamm Res. 2025 Jan 28;18:1317-1331. doi: 10.2147/JIR.S504612. eCollection 2025.
Periodontitis is a prevalent yet frequently overlooked oral disease that is linked to a range of systemic conditions. Although basic treatment and periodontal surgery can alleviate the symptoms of periodontitis to a certain extent, the treatment of severe tissue defects or refractory cases is not effective. Extracellular vesicles (EVs) are subcellular lipid bilayer particles that come from a variety of sources and are prevalent in the biological fluids of vertebrates. They play a key role in intercellular communication by transporting multiple signaling molecules. Recent research has indicated that EVs derived from periodontal pathogens can trigger periodontitis, exacerbate the periodontal damage, and potentially disseminate to other parts of the body, leading to systemic conditions. Conversely, extracellular vesicles derived from dental stem cells (DSCs) have demonstrated the ability to regulate the local periodontal immune environment and foster the regeneration and repair of periodontal tissues, positioning them as a promising candidate for cell-free therapeutic approaches to periodontitis. This review aims to summarize the latest research on the involvement of EVs from different sources in the pathogenesis and treatment of periodontitis, especially to systematically elucidate the mechanism of EVs secreted by periodontal pathogens in periodontitis-related systemic diseases for the first time. By uncovering these complex regulatory processes, new and more effective therapeutic approaches can be explored in the battle against periodontitis and its associated systemic diseases.
牙周炎是一种常见但常被忽视的口腔疾病，与一系列全身疾病相关。尽管基础治疗和牙周手术能在一定程度上缓解牙周炎症状，但对于严重组织缺损或难治性病例的治疗效果不佳。细胞外囊泡（EVs）是源自多种来源的亚细胞脂质双层颗粒，在脊椎动物的生物体液中普遍存在。它们通过运输多种信号分子在细胞间通讯中发挥关键作用。最近的研究表明，源自牙周病原体的EVs可引发牙周炎、加剧牙周组织损伤，并可能扩散至身体其他部位，导致全身疾病。相反，源自牙干细胞（DSCs）的细胞外囊泡已证明有能力调节局部牙周免疫环境并促进牙周组织的再生和修复，使其成为牙周炎无细胞治疗方法的有前景的候选者。本综述旨在总结不同来源的EVs参与牙周炎发病机制和治疗的最新研究，尤其是首次系统阐明牙周病原体分泌的EVs在牙周炎相关全身疾病中的作用机制。通过揭示这些复杂的调节过程，有望在对抗牙周炎及其相关全身疾病的斗争中探索出新的、更有效的治疗方法。
