The potential of plant-derived vesicles in treating periodontitis and associated systemic diseases: current advances and future directions.

Background: Periodontitis, a chronic multifactorial inflammatory disease, represents a significant public health burden among global chronic non-communicable diseases. In addition to affecting oral health, periodontitis is closely associated with a variety of systemic diseases. Current treatments, including surgical and nonsurgical therapies, lack clear superiority, underscoring the need for innovative therapeutic strategies. Plant-derived vesicles (PDVs), as natural products, have the advantages of being highly biocompatible, rich in biologically active components, and easy to cross biological barriers. Recent studies have shown that PDVs may treat periodontitis by maintaining oral microecological balance, remodeling the periodontal immune microenvironment, regulating inflammatory responses and oxidative stress, and promoting periodontal tissue regeneration. This review synthesizes the nomenclature based on MISEV 2023 and the latest research advances from biogenesis to removal, pre-processing, isolation, and characterization methods. It systematically evaluates potential applications of PDVs in periodontitis and associated systemic diseases, and presents the challenges facing current research.

Conclusion: PDVs hold promise as a novel, multitargeted approach for periodontitis and its systemic systemic diseases. However, overcoming limitations in production consistency, mechanistic understanding, and regulatory frameworks is critical to advancing their clinical application. Future research should prioritize interdisciplinary collaboration to harness PDVs' full therapeutic potential while addressing current translational barriers.