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Meta-Analysis
. 2025 Jan 9;20(1):27.
doi: 10.1186/s13018-024-05403-6.

Therapeutic effect of mesenchymal stem cell-derived exosome therapy for periodontal regeneration: a systematic review and meta-analysis of preclinical trials

Liping Zhou  1   2   3 , Wenjia Cai  1   2   3 , Yuhan Zhang  1   2   3 , Wenjie Zhong  1   2   3 , Ping He  4 , Jingsong Ren  5 , Xiang Gao  6   7   8
Affiliations
Meta-Analysis

Therapeutic effect of mesenchymal stem cell-derived exosome therapy for periodontal regeneration: a systematic review and meta-analysis of preclinical trials

Liping Zhou et al. J Orthop Surg Res. .

Abstract

Background: To assess the therapeutic effects of mesenchymal stem cell (MSC)-derived exosome therapy on periodontal regeneration and identify treatment factors associated with enhanced periodontal regeneration in recent preclinical studies.

Methods: Searches were conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases until October 10, 2024. A risk of bias (ROB) assessment was performed using the SYRCLE tool. Osteogenic-related parameters were used as the primary outcome measures.

Results: In total, 1360 articles were identified, of which 17 preclinical studies were based on MSC-derived exosome therapy, and they demonstrated a beneficial effect on BV/TV (SMD = 13.99; 95% Cl = 10.50, 17.48; p < 0.00001), CEJ-ABC (SMD = -0.22; 95% Cl = -0.31, -0.13; p < 0.00001), BMD (SMD = 0.29; 95% Cl = 0.14, 0.45; p = 0.0002), and Tp.Sp (SMD = -0.08; 95% Cl= -0.15, -0.02; p = 0.02) compared with the control group. However, no significant differences were observed in Tp.Th (SMD = 0.03; 95% CI = 0.00, 0.07; p = 0.09) between the exosome-treated group and control group. Additionally, subgroup analysis indicated that preconditioned exosomes (p = 0.03) significantly improved BV/TV. In contrast, there were no significant differences in the enhancement of BV/TV with respect to the application method (p = 0.29), application frequency (p = 0.10), treatment duration (p = 0.15), or source of MSCs (p = 0.31).

Conclusions: MSC-derived exosomes show great promise for enhancing the quality of periodontal regeneration. However, more standardized and robust trials are needed to reduce heterogeneity and bias across studies and to confirm the therapeutic parameters associated with the enhancement of periodontal regeneration by MSC-derived exosomes.

Registration: CRD42024546236.

Keywords: Exosomes; Mesenchymal stem cell; Periodontal regeneration; Periodontitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram for the study selection procedure
Fig. 2
Fig. 2
Forest plot analysis evaluating the effects of MSC-derived exosome therapy on BV/TV compared with controls
Fig. 3
Fig. 3
Forest plot analysis assessing the effects of MSC-derived exosome therapy on CEJ-ABC compared with controls
Fig. 4
Fig. 4
Forest plot analysis evaluating the effects of MSC-derived exosome therapy on BMD compared with controls
Fig. 5
Fig. 5
Forest plot analysis evaluating the effects of MSC-derived exosome therapy on Tp.Th compared with controls
Fig. 6
Fig. 6
Forest plot analysis evaluating the effects of MSC-derived exosome therapy on Tp.Sp compared with controls
Fig. 7
Fig. 7
Various preconditioning methods and administration routes for MSC-sEV
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References

    1. Hajishengallis G, Chavakis T. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol. 2021 2021;21(7):426 – 40. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...10.1038/s41577-020-00488-6 - PMC - PubMed
    1. Meyle J, Chapple I. Molecular aspects of the pathogenesis of periodontitis., Periodontol. 2000. 2015 2015;69(1):7–17. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...10.1111/prd.12104 - PubMed
    1. Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J Clin Periodontol. 2009 2009;36(6):458 – 67. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...10.1111/j.1600-051X.2009.01408.x - PubMed
    1. Papageorgiou SN, Hagner M, Nogueira AV, Franke A, Jäger A, Deschner J. Inflammatory bowel disease and oral health: systematic review and a meta-analysis. J Clin Periodontol. 2017 2017;44(4):382 – 93. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...10.1111/jcpe.12698 - PubMed
    1. Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol. 2017. 2017;44(5):456 – 62. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...10.1111/jcpe.12732 - PubMed

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