BACKGROUND
Aging is a multifactorial process marked by gradual cellular dysregulation, regulated by hallmarks, including genomic instability, mitochondrial dysregulation, and chronic inflammation. Extracellular vesicles (EVs), especially exosomes, have emerged as pivotal mediators of cell-to-cell communication with potential roles in both enhancing and alleviating aging. This review aimed to synthesize existing literature on the mechanistic and therapeutic role of EVs in aging and age-associated disorders.
METHODS
A comprehensive narrative review was performed utilizing Web of Science, Scopus, and PubMed databases. Studies assessing EVs in aging, cellular senescence, regenerative biology, and age-related disorders were included. Both preclinical and clinical studies were qualitatively examined, emphasizing EV origin, molecular pathways, and treatment outcomes.
RESULTS
EVs derived from young or stem cells show strong antiaging features across multiple systems, such as the immune, musculoskeletal, cardiovascular, and nervous systems. These impacts are regulated via mitigating cellular senescence, reestablishing mitochondrial activity, restoring mitophagic and autophagic signaling, regulating inflammatory signaling, and improving tissue regeneration. Contrarily, EVs from diseases or aged cells improve pro-aging phenotypes, such as inflammation, fibrosis, and metabolic dysregulation, underscoring their context-mediated duality. Preclinical evidence consistently supports EV-mediated therapies; nonetheless, clinical translation remains restricted owing to heterogeneity in EV subpopulations, lack of standardized isolation protocols, and variability in bioactive payload.
CONCLUSION
EVs represent promising therapeutic agents and biomarkers in aging biology, with the potential to regulate multiple hallmarks of aging concurrently. Prospective research should prioritize standardization, targeted bioengineering, and rigorous clinical validation to allow successful antiaging interventions.
Paras Ahmad, N. Estrin, A. Sculean et al.· Periodontology 2000· 0 citations
Background Periodontitis is a chronic multifactorial inflammatory condition resulting in the gradual breakdown of periodontal supporting structures. Although non-surgical periodontal therapy (NSPT) is the gold standard first therapeutic option, its effectiveness can be limited in moderate-to-severe cases, hence necessitating the application of adjunctive therapies. Platelet-rich fibrin (PRF) and enamel matrix derivative (EMD) are among the most extensively utilised regenerative biomaterials; nevertheless, direct comparative evidence related to their adjunctive advantage in NSPT is scarce. Aim This split-mouth randomised clinical trial compared the clinical effectiveness of EMD versus PRF as adjunct biological modalities to scaling and root planing (SRP) in the non-surgical management of Stage II/III and Grade A/B periodontitis. Methods and Materials Fifteen participants meeting the eligibility criteria were included, with thirteen completing the trial. Each patient contributed two interproximal sites randomly allocated to either adjunctive EMD or PRF after full-mouth SRP. Before the placement of biomaterial, EMD sites were treated with ethylenediaminetetraacetic acid (EDTA), whereas PRF was prepared utilising the standard horizontal centrifugation approach. Periodontal probing depth (PD), gingival margin (GM) position, clinical attachment level (CAL), and bleeding on probing (BOP) were measured at baseline and 6-month follow-up. Results Both biomaterials yielded significant intra-group improvements. Mean PD scores were reduced by 1.1 ± 0.6 mm in the EMD group and 1.2 ± 0.7 mm in the PRF group. CAL gains were 1.1 ± 0.7 mm and 1.1 ± 0.8 mm for EMD and PRF, respectively. GM levels remained stable across groups, and BOP markedly decreased (EMD: 77% to 23%; PRF: 85% to 31%). Intergroup comparisons revealed no statistically significant differences for PD (p > 0.999), GM (P = 0.174), or CAL (P = 0.556). Moreover, frequency distribution analysis showed that 100% of deep sites (≥ 6 mm) in the EMD group and 90% in the PRF group were reduced to < 6 mm at 6 months. Conclusion Both EMD and PRF showed comparable clinical outcomes as adjunctive regenerative biomaterials in NSPT to manage moderate periodontal pockets. These outcomes support the versatility of clinicians in selecting either biological option based on practitioner and patient preference, availability, and cost, while opening avenues for future studies investigating their application in more complex periodontal cases.
N. Estrin, Paras Ahmad, Savannah Laurey et al.· Oral Health & Preventive Den...· 0 citations
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