Key points are not available for this paper at this time.
Diabetes mellitus (DM) exacerbates periodontitis as the high-glucose (HG) environment aggravates local inflammation and periodontal bone resorption. Restoring periodontal homeostasis and promoting periodontal bone repair/regeneration are major challenges for the treatment of diabetic periodontitis. This study introduces antler stem cell-derived exosomes (AnSC-exos) as a potent therapeutic for treating diabetic periodontitis via leveraging the shared cranial neural crest cell (CNCC) origin of antlers and periodontal tissues. Using a rat model of diabetic periodontitis, we demonstrate that AnSC-exos effectively alleviate tissue abnormalities and alveolar bone destruction and resorption in periodontitis under DM conditions; the outcome was significantly more potent than human bone marrow mesenchymal stem cell exosomes (hBMSC-exos). Mechanistically, AnSC-exos exhibited dual regenerative actions: (1) restoring the osteogenic ability of resident MSCs by not only reversing high glucose (HG)-induced suppression of proliferation and migration, but more importantly, enhancing cell survival, reducing cell death, and strengthening differentiation toward osteogenic lineages under HG conditions; and (2) attenuating inflammation through potently scavenging excessive ROS production induced by HG, and inhibiting HG-mediated p65 nuclear translocation, thereby leading to a reduced M1/M2 macrophage ratio. In conclusion, the superior efficacy of AnSC-exos highlights their tissue-specific regenerative advantage and establishes AnSC-exos as a promising cell-free therapy that simultaneously targets osteogenic impairment and ROS-driven inflammation in diabetic periodontitis. Further characterization of active components within the exosomes holds significant promise for developing effective clinical treatments for diabetic periodontitis.
Guo et al. (Mon,) studied this question.