中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (13): 3392-3401.doi: 10.12307/2026.358

• 干细胞综述 stem cell review • 上一篇    下一篇

外泌体在口腔疾病诊断监测中的应用

黄家曜1，顾  瑜1，2   

  1. 1遵义医科大学珠海校区，广东省珠海市   519041；2 贵州省高等学校口腔疾病研究特色重点实验室，贵州省遵义市   563000
  • 接受日期:2025-09-12 出版日期:2026-05-08 发布日期:2025-12-26
  • 通讯作者: 顾瑜，硕士，副教授，遵义医科大学珠海校区，广东省珠海市 519041；贵州省高等学校口腔疾病研究特色重点实验室，贵州省遵义市 563000
  • 作者简介:黄家曜，男，2001年生，贵州省遵义市人，汉族，遵义医科大学珠海校区本科在读。
  • 基金资助:
    地方高校国家级大学生创新创业训练计划项目(2024106610916)，项目负责人：黄家曜

Application of exosomes in the diagnosis and monitoring of oral diseases

Huang Jiayao1, Gu Yu1, 2   

  1. 1Zhuhai Campus of Zunyi Medical University, Zhuhai 519041, Guangdong Province, China; 2Key Laboratory of Guizhou Province for Stomatological Disease Research, Zunyi 563000, Guizhou Province, China
  • Accepted:2025-09-12 Online:2026-05-08 Published:2025-12-26
  • Contact: Gu Yu, MS, Associate professor, Zhuhai Campus of Zunyi Medical University, Zhuhai 519041, Guangdong Province, China; Key Laboratory of Guizhou Province for Stomatological Disease Research, Zunyi 563000, Guizhou Province, China
  • About author:Huang Jiayao, Zhuhai Campus of Zunyi Medical University, Zhuhai 519041, Guangdong Province, China
  • Supported by:
    National Undergraduate Innovation and Entrepreneurship Training Program for Local Universities, No. 2024106610916 (to HJY)

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摘要：

文题释义：

外泌体：是由多种细胞类型(如免疫细胞、间充质干细胞等)分泌的纳米级(40-160 nm)膜性囊泡，它具有典型的脂质双分子层结构，可携带DNA、RNA、脂质等生物活性分子，广泛分布于血液、唾液等体液，在细胞间通讯中发挥着重要作用。
口腔疾病：是影响口腔及颌面部健康的常见问题，涵盖牙齿、牙龈、舌、黏膜等多个部位。常见的口腔疾病包括龋病、牙周炎、根尖周炎、口腔溃疡等。口腔健康是全身健康的重要指标，早期干预口腔疾病可避免严重并发症。

摘要
背景：作为细胞间的纳米级通讯信使，外泌体通过其囊泡结构内封装的miRNA、蛋白质及脂质成分，形成具有特征性的生物信息编码，能够精准追踪病变细胞的异常活动轨迹，为疾病诊断提供新型检测策略。
目的：简述外泌体的基本概念及其生物发生过程中相关因子的调节作用，归纳总结外泌体在口腔疾病诊断中的研究现状，为外泌体在口腔领域的应用提供新的研究方向和依据。
方法：第一作者于2025年1-3月使用计算机在PubMed、Web of Science、万方数据知识平台和中国知网检索2000年1月至2025年3月发表的相关文献，以“Exosomes，periodontitis，lichenplanus，oral submucous fibrosis，oral leukemia，oral squamous carcinoma，dental caries，Sjögren syndrome，cleft of lip and/or palate，orthodontics，biomarker”为英文检索词，以“外泌体，牙周炎，扁平苔藓，口腔黏膜下纤维化，口腔白斑，口腔癌，龋病，干燥综合征，唇腭裂，正畸治疗，生物标志物”为中文检索词，最终纳入76篇文献进行分析。
结果与结论：外泌体作为一种新型液体活检标志物，在口腔疾病诊断与监测中展现出重要价值。在口腔鳞状细胞癌研究中，唾液外泌体miRNA和蛋白质的异常表达与肿瘤分期、侵袭性密切相关，联合检测2种标志物可实现高灵敏度诊断。在口腔潜在恶性病变中，外泌体miRNA的动态变化可反映白斑恶变风险及扁平苔藓的疾病进展。在牙周炎研究中，外泌体成分与炎症程度及治疗效果的关联，为无创监测提供了新方向。此外，正畸牙移动中力学响应侧的外泌体miRNA差异表达，提示其参与了牙周组织改建的调控。干燥综合征患者外泌体铁死亡相关蛋白及miR-1290的组合检测，突破了传统活检局限性。龋病相关研究尚处起步阶段，变形链球菌外泌体毒力分子及宿主免疫蛋白的检测为早期诊断提供了新思路。然而，当前研究仍面临样本异质性、技术标准不统一及机制解析不足等挑战。未来需整合多组学技术，建立标准化检测流程，推动外泌体在口腔疾病精准诊疗中的临床转化。

关键词: 外泌体, 口腔鳞状细胞癌, 牙周炎, 口腔潜在恶性疾患, 正畸牙移动, 龋病, 唇腭裂, 舍格伦综合征, 疾病诊断, 生物标志物

Abstract: BACKGROUND: As nanoscale messengers of intercellular communication, exosomes encapsulate miRNAs, proteins, and lipids within vesicles, forming an unique bioinformational code. This can accurately trace the abnormal activity trajectories of diseased cells, providing new approaches for disease diagnosis.
OBJECTIVE: To briefly describe the basic concepts of exosomes and the regulatory role of related factors in their biogenesis, summarize the current research status of exosomes in oral disease diagnosis, and provide new research directions and a basis for the application of exosomes in the field of stomatology. 
METHODS: The first author conducted a computerized literature search from January to March 2025 using PubMed, Web of Science, WanFang Data Knowledge Service Platform, and China National Knowledge Infrastructure (CNKI) databases to retrieve relevant literature published between January 2000 and March 2025. The Chinese and English search terms were “exosomes, periodontitis, lichenplanus, oral submucous fibrosis, oral leukemia, oral squamous carcinoma, dental caries, Sjögren syndrome, cleft of lip and/or palate, orthodontics, biomarker.” A total of 76 articles were included for analysis. 
RESULTS AND CONCLUSION: Exosomes, as a promising class of liquid biopsy biomarkers, have shown notable utility in the diagnosis and monitoring of oral diseases. In oral squamous cell carcinoma research, aberrant expression of miRNAs and proteins in salivary exosomes correlates closely with tumor stage and invasiveness; combining these two biomarkers achieves high sensitivity in diagnosis. For potentially malignant oral lesions, dynamic alterations in exosomal miRNAs mirror the malignant transformation risk of leukoplakia and disease progression in lichen planus. Studies on periodontitis have revealed links between exosomal components and both inflammation severity and treatment response, opening new avenues for non-invasive monitoring. Notably, differential expression of exosomal miRNAs on the mechanically responsive side during orthodontic tooth movement hints at their role in regulating periodontal tissue remodeling. In Sjögren's syndrome, combined detection of ferroptosis-related proteins and miR-1290 in exosomes has surpassed the limitations of traditional biopsy methods. While dental caries research remains in its early stages, investigations into virulence molecules in Streptococcus mutans exosomes and host immune proteins have offered fresh insights for early diagnosis. However, current work is still constrained by challenges such as sample variability, inconsistent technical standards, and gaps in mechanistic understanding. Moving forward, integrating multi-omics approaches, standardizing detection protocols, and advancing exosome-based clinical translation for precision oral disease management will be critical priorities.

Key words: exosomes, oral squamous cell carcinoma, periodontitis, oral potentially malignant disorders, orthodontic tooth movement, dental caries, cleft lip and palate, Sj?gren's syndrome, disease diagnosis, biomarkers

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