Manganese-based nanozymes for the dynamic regulation of the osteogenic microenvironment.

In recent years, manganese-based nanozymes (MBNs)-featuring the combined advantages of nanomaterial properties, manganese-specific characteristics, and multi-enzyme mimetic activities-have demonstrated revolutionary potential in modulating the osteogenic microenvironment. This work systematically reviews the multidimensional regulatory pathways by which MBNs modulate the osteogenic microenvironment, including dynamic regulation of reactive oxygen species (ROS), remodelling of the immune microenvironment, synergistic promotion of neurovascularisation, antibacterial activity and infection control, and regulation of osteogenic cell fate. Additionally, the review outlines their specific applications in various pathological contexts, such as infected bone defects, osteosarcoma, osteoporosis, and periodontitis. Finally, the current challenges hindering the clinical translation of MBNs are critically analysed, and precision-oriented strategies for their development are proposed. These insights are pivotal for advancing the clinical translation of MBNs, particularly in treating refractory bone defects.