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一种基于壳聚糖的水凝胶,用于调节高脂饮食诱导的牙周炎大鼠模型中的免疫细胞并促进牙周炎愈合。

A Chitosan-based Hydrogel to Modulate Immune Cells and Promote Periodontitis Healing in the High-Fat Diet-induced Periodontitis Rat Model.

作者信息

Zhu Yi, Ali Aiman, Mulinari Dos Santos Gabriel, Franciscon João Paulo Soares, de Molon Rafael Scaf, Goh Cynthia, Ervolino Edilson, Theodoro Leticia Helena, Shrestha Annie

机构信息

Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON, M5G 1G6, Canada.

Department of Diagnostic and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.

出版信息

Acta Biomater. 2025 Jun 15;200:452-463. doi: 10.1016/j.actbio.2025.05.034. Epub 2025 May 14.

Abstract

Periodontitis is a multifactorial inflammatory disease driven by prolonged, dysregulated inflammation between dysbiotic microbiota and the host immune system. Risk factors such as metabolic syndrome exacerbate periodontitis progression through systemic inflammation. Current treatments primarily focus on removing pathogenic dental plaque, but subsequent healing relies mainly on the host immune response. Modulating the local immune environment, particularly dendritic cells (DCs) and T-cells, in periodontitis complicated by metabolic syndrome could enhance the healing process. The objective of this study is to develop a biomaterial-based adjuvant therapy to immunomodulate DCs and T-cells and promote healing in periodontitis complicated by metabolic syndrome. We developed and characterized a chitosan-based thermosensitive injectable self-assembled hydrogel (TISH), which exhibited an interconnected porous structure conducive to cell migration and adhesion. TISH was loaded with granulocyte-macrophage colony-stimulating factor (GM-CSF) and resveratrol (TISH(GR)), enabling sustained release over time. Mechanistically, TISH(GR) suppressed inflammatory signalling pathways (MAPKs and NF-κB) downstream of Toll-like receptor-4 in DCs. In a high-fat diet-induced periodontitis rat model, TISH(GR) administered as an adjuvant to SRP significantly alleviated periodontal inflammation and tissue destruction compared to SRP alone. TISH(GR) treatment was associated with decreased TH17 cell infiltration and elevated expression of the Tregs-associated cytokine IL-10 in the periodontium. In conclusion, TISH(GR) was developed and optimized as an injectable immunomodulatory hydrogel targeting DCs and T-cells. It demonstrated promising potential to attenuate inflammation and enhance periodontal healing, particularly in immunocompromised patients with metabolic syndrome. STATEMENT OF SIGNIFICANCE: Current treatments for periodontitis primarily focus on dental plaque removal, with healing heavily dependent on the host immune system. However, metabolic diseases can dysregulate the local immune response, exacerbating periodontal inflammation and impairing post-treatment healing. In this study, we developed a chitosan-based hydrogel designed to immunomodulate dendritic cells and T-cells, polarizing them toward an anti-inflammatory phenotype that promotes tissue repair. When administered as an adjuvant to scaling and root planing, this combination therapy significantly enhanced periodontal healing and reduced tissue damage in a high-fat diet complicated periodontitis model. These findings highlight the clinical potential of this hydrogel formulation to improve treatment outcomes, particularly in challenging clinical cases involving metabolic comorbidities.

摘要

牙周炎是一种多因素炎症性疾病,由失调的微生物群与宿主免疫系统之间长期、失调的炎症驱动。代谢综合征等风险因素通过全身炎症加剧牙周炎进展。目前的治疗主要集中在去除致病性牙菌斑,但随后的愈合主要依赖于宿主免疫反应。在合并代谢综合征的牙周炎中调节局部免疫环境,特别是树突状细胞(DCs)和T细胞,可促进愈合过程。本研究的目的是开发一种基于生物材料的辅助疗法,以免疫调节DCs和T细胞,并促进合并代谢综合征的牙周炎的愈合。我们开发并表征了一种基于壳聚糖的热敏可注射自组装水凝胶(TISH),其呈现出有利于细胞迁移和黏附的相互连接的多孔结构。TISH负载了粒细胞-巨噬细胞集落刺激因子(GM-CSF)和白藜芦醇(TISH(GR)),能够随时间持续释放。从机制上讲,TISH(GR)抑制了DCs中Toll样受体-4下游的炎症信号通路(MAPKs和NF-κB)。在高脂饮食诱导的牙周炎大鼠模型中,与单独使用龈下刮治术(SRP)相比,将TISH(GR)作为SRP的辅助剂给药可显著减轻牙周炎症和组织破坏。TISH(GR)治疗与牙周组织中TH17细胞浸润减少和Tregs相关细胞因子IL-10表达升高有关。总之,TISH(GR)被开发并优化为一种靶向DCs和T细胞的可注射免疫调节水凝胶。它显示出减轻炎症和促进牙周愈合的有前景的潜力,特别是在合并代谢综合征的免疫受损患者中。重要性声明:目前牙周炎的治疗主要集中在去除牙菌斑,愈合在很大程度上依赖于宿主免疫系统。然而,代谢性疾病可使局部免疫反应失调,加剧牙周炎症并损害治疗后的愈合。在本研究中,我们开发了一种基于壳聚糖的水凝胶,旨在免疫调节树突状细胞和T细胞,使其向促进组织修复的抗炎表型极化。当作为龈下刮治术的辅助剂给药时,这种联合疗法在高脂饮食合并牙周炎模型中显著增强了牙周愈合并减少了组织损伤。这些发现突出了这种水凝胶制剂改善治疗效果的临床潜力,特别是在涉及代谢合并症的具有挑战性的临床病例中。

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