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Periodontitis and myocardial infarction (MI) are major global causes of death. They are prevalent inflammatory diseases with a bidirectional pathophysiological connection. Although there is an urgent need for non-invasive treatment methods that can alleviate local periodontal damage and reduce related systemic cardiovascular complications, there is currently no comprehensive treatment approach. To address this challenge, a protein-loaded antibacterial hydrogel thiolated chitosan/BMP-2-PEG-maleimide (C1.5P4/BMP-2) has been developed, which has new sustained protein release properties. This hydrogel has an interconnected microporous structure, (1) achieving efficient BMP-2 protein encapsulation, (2) maintaining protein biological activity while ensuring continuous release, thereby addressing the recognized challenges in protein delivery of hydrogels, (3) having potent antibacterial properties, and (4) promoting remote cardiac function improvement by addressing periodontal inflammation. In mouse models, local inhibition of alveolar bone loss (bone regeneration rate was twice that of the control group) was achieved, while systemic improvement of cardiac function after myocardial infarction was achieved (ejection fraction increased by 75.6%). Mechanistically, the protein protection microenvironment of the hydrogel and its antibacterial effect work synergistically, selectively inhibiting Gram-negative (G−) anaerobic pathogens (the main periodontal cause), while enriching Gram-positive (G+) commensals, and regulating the G−/G+ ratio of biofilms. At the same time, this dual effect regulates the oral-cardiac inflammation axis, particularly down-regulating B2 cells/TNF-α signaling pathway, to alleviate systemic inflammation associated with myocardial infarction. Overall, this study proposes a novel non-invasive protein-stabilized hydrogel that addresses the co-morbidity of periodontitis and myocardial infarction through continuous bone-derived factor delivery combined with microbiota-immune regulation. This study was published in Bioactive Materials under the title "Local periodontal injection, systemic heart repair: A dual-functional hydrogel for non-invasive concurrent treatment of periodontitis and myocardial infarction".
Reference News: DOI: 10.1016/j.bioactmat.2026.02.049
