Extracellular Vesicles in Periodontitis: Bidirectional Crosstalk Between Periodontal Inflammation and Systemic Diseases.
- 1The Center of Stomatology, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, People's Republic of China.
- 2Department of Stomatology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, People's Republic of China.
Abstract
Periodontitis is a chronic inflammatory disease that leads to the destruction of tooth supporting tissues, including gingival inflammation, periodontal attachment loss, and alveolar bone resorption. Increasing evidence suggests that periodontitis also increases susceptibility to a range of systemic conditions and there is a reciprocal communication between the periodontum and systemic organs. Extracellular vesicles (EVs), as key mediators of intercellular communication, can transport proteins, lipids, and nucleic acids across biological barriers and may play an important role in this crosstalk. In this review, we synthesize current evidence for the involvement of EVs in communication between periodontitis and distant organs. Compared with previous reviews that mainly focus on Porphyromonas gingivalis EVs or one-way effects, we synthesize evidence across multiple EV sources (bacterial, host periodontal, and circulating biofluid EVs) and explicitly review both directions of signaling. At present, the evidence is considerably stronger for periodontal-to-systemic EV effects, particularly in endothelial dysfunction, metabolic reprogramming, osteoclastogenic signaling, and barrier disruption in distant organs, whereas the evidence of systemic EVs on periodontitis remains limited, fragmented, and largely preclinical. This marked imbalance identifies the systemic-to-oral EV pathway as a major knowledge gap in the field. Further studies are needed to define the sources, cargoes, and functional significance of EVs in oral-systemic crosstalk and to clarify their translational potential as biomarkers and therapeutic targets.
Related
- The Oral–Gut–Systemic Axis in Periodontitis: Microbiome Dysbiosis, Immune Crosstalk and Translational Perspectives
- Extracellular Vesicles in Molecular Crosstalk and Disease Pathogenesis: A Comprehensive Review on Mechanisms and Therapeutic Prospects
- Schwann cell-derived extracellular vesicles promote periodontal tissue regeneration.
- Osteogenic-Preconditioned Dental Follicle Cell-Derived Extracellular Vesicles Attenuate Experimental Periodontitis by Modulating Macrophage Responses.
- Extracellular vesicles at the periodontal immune–regenerative interface: coupled mechanisms and translational challenges
BibTeX
@article{qu2026extracellular,
title = {{Extracellular Vesicles in Periodontitis: Bidirectional Crosstalk Between Periodontal Inflammation and Systemic Diseases.}},
author = {Renfei Qu and Fei Wang},
journal = {International journal of nanomedicine},
year = {2026},
month = nov,
doi = {10.2147/ijn.s646323},
url = {https://europepmc.org/article/MED/42999824},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Extracellular Vesicles in Periodontitis: Bidirectional Crosstalk Between Periodontal Inflammation and Systemic Diseases.
AU - Renfei Qu
AU - Fei Wang
PY - 2026
DA - 2026/11/03
JO - International journal of nanomedicine
DO - 10.2147/ijn.s646323
UR - https://europepmc.org/article/MED/42999824
AB - Periodontitis is a chronic inflammatory disease that leads to the destruction of tooth supporting tissues, including gingival inflammation, periodontal attachment loss, and alveolar bone resorption. Increasing evidence suggests that periodontitis also increases susceptibility to a range of systemic conditions and there is a reciprocal communication between the periodontum and systemic organs. Extracellular vesicles (EVs), as key mediators of intercellular communication, can transport proteins, lipids, and nucleic acids across biological barriers and may play an important role in this crosstalk. In this review, we synthesize current evidence for the involvement of EVs in communication between periodontitis and distant organs. Compared with previous reviews that mainly focus on Porphyromonas gingivalis EVs or one-way effects, we synthesize evidence across multiple EV sources (bacterial, host periodontal, and circulating biofluid EVs) and explicitly review both directions of signaling. At present, the evidence is considerably stronger for periodontal-to-systemic EV effects, particularly in endothelial dysfunction, metabolic reprogramming, osteoclastogenic signaling, and barrier disruption in distant organs, whereas the evidence of systemic EVs on periodontitis remains limited, fragmented, and largely preclinical. This marked imbalance identifies the systemic-to-oral EV pathway as a major knowledge gap in the field. Further studies are needed to define the sources, cargoes, and functional significance of EVs in oral-systemic crosstalk and to clarify their translational potential as biomarkers and therapeutic targets.
SN - 1176-9114
SN - 1178-2013
ER -