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Gene & Protein in Disease Exosomes connect periodontitis and systemic diseases

are activated by LPS and secrete pro-inflammatory factors. peripheral injection and ameliorated AD‐like pathology
However, M2 cells are activated by IL-4 produced by Th2 in mice [173] . In addition, exosomes have great potential in
cells, and then release some other cytokines to inhibit the treatment of stroke. Li et al. found that injection of
inflammatory response and promote tissue repair [165] . Wang enriched plasma exosomes from mice treated with remote
et al. co-cultured macrophages and exosomes that were ischemic preconditioning could significantly reduce the
isolated from GMSC and stimulated by LPS, and found that infarct size in a murine model of cerebral ischemia and
the levels of M1 markers, including TNF-α, IL-12, CD86, improve the neurological function [174] . Inoue et al. found
and IL-1β, were significantly decreased but the level of M2 that dental pulp stem cells-derived exosomes can induce
marker such as IL-10 increased moderately. GMSC-derived angiogenesis and neurogenesis, and then reduce the
exosomes may promote M1 macrophage transformation infarct volume [175] . The important value of exosomes in the
into M2 macrophages, reducing the pro-inflammatory diagnosis and treatment of cardiovascular diseases cannot
factors which are produced by M1 macrophages [166] . All be neglected. Preclinical studies have shown that the
of these provide us a new direction for the treatment of exosomes play a protective role in ischemic heart disease
periodontitis. As a non-surgical periodontal treatment by reducing myocardial ischemia-reperfusion injury
tool, exosomes showed superior effects on cells, with the and promoting vascular regeneration [176] . Luo et al. used
additional advantages of safety and easy preparation. myocardial infarction rats as animal model and injected
They can be applied as a suspension injected locally to exosomes enriched with miR-126, and the results showed
the periodontal defects, without additional cost in the that the release of inflammatory factors decreased and the
preparation of scaffolds [167] . Mohammed et al. compared infarct size decreased significantly [177] .
the effects of exosomes and adipose-derived stem cells on
the periodontitis mice, and found that the exosomes group 7. Conclusion
showed the most evident proliferation in periodontal tissue Exosomes, as functional carriers of nucleic acids, lipids,
with increased cellularity and significant organization, and proteins, and other substances, play an important role in
the alveolar bone was more organized with an osteoid the occurrence and progression of periodontitis. Exosomes
tissue layer [98,168] . carrying some specific substances can promote the
In addition to periodontitis, the potential of using occurrence of periodontitis, while exosomes carrying other
exosomes to treat other diseases has also been discovered by specific substances can play an anti-periodontitis role. This
more and more researchers. Wei et al. found that exosomes shows that the exosomes from periodontal tissue or cells are
from SHED can directly promote the osteogenesis, pivotal in the occurrence and recovery of periodontitis. In
differentiation and bone formation of bone marrow MSCs. addition, exosomes with different contents playing a bridge
They applied SHED-exosomes to the mouse model with role in patients with periodontitis and other systemic
a bone loss, and then found that Runx2 and Smad5, the diseases. Exosomes can cause periodontal inflammatory
key transcription factors for osteogenic differentiation, mediators to spread to the whole body, thus promoting or
were upregulated and bone loss was restored after injecting antagonizing the occurrence of specific diseases. The current
of SHED-exosomes [169] . Xie et al. reported that MSCs- study of exosomes is helpful to explain the pathogenesis of
derived exosomes could promote osteoblast proliferation periodontitis and how to regulate the progression of other
through inhibiting cell apoptosis, and significantly systemic diseases in patients with periodontitis.
increase the expression level of GLUT3, which eventually At present, the understanding of exosomes is still
stimulates the osteogenesis differentiation of osteoblasts; limited. Nevertheless, exosomes could serve as an
this provides a theoretical basis for the clinical treatment important biomarker of clinical diagnosis, treatment of
of osteoporosis [170] . Recent studies have shown that MSC- periodontitis, and intervention of systemic diseases in
derived exosomes therapy improves renal outcomes in future.
several animal models of AKI and CKD, such as ureteral
obstruction, ischemia-reperfusion injury, drug/toxin Acknowledgments
induced nephropathy, and renal vascular disease [171] . The
exosomes derived from MSCs can regulate the expression None.
of intercellular adhesion molecule-1 and then inhibit Funding
the infiltration of dendritic cells into the kidney. In
addition, these exosomes can reduce the production of This work was supported by grants from the Foundation
pro-inflammatory cytokines and inhibit renal fibrosis [172] . of Science & Technology Department of Henan
Sato et al. found that exosomes containing β‐secretase Province, China (No. 212102310103), the Natural
1 (BACE1) siRNA or curcumin reached the brain after Science Foundation of Education Department of Henan

Volume 1 Issue 2 (2022) 10 https://doi.org/10.36922/gpd.v1i2.99