Nanomaterial-Mediated Clearance of Circulating Cell-Free DNA Reduces Periodontitis-Associated Arterial Thrombosis

Xuanzhi Zhu , Jinting Ge , Chengxin Weng , Quanxin Ning , Yuhan Qi , Suwan Ding , Huiyi Liang , Biao Jing , Xiao Chen , Shouzheng Cheng , Jichun Zhao , Ding Yuan , Tiehao Wang , Huawei Zhang , Fangman Chen , Bing Shi , Lei Zhao , Xianglong Han , Yafei Wu , Dan Shao , Kam W. Leong , Hanyao Huang

Engineering ›› : 202609005

PDF (10138KB)
Engineering ›› :202609005 DOI: 10.1016/j.eng.2026.09.005
research-article
Nanomaterial-Mediated Clearance of Circulating Cell-Free DNA Reduces Periodontitis-Associated Arterial Thrombosis
Author information +
History +
PDF (10138KB)

Abstract

Keywords

Periodontitis

Cite this article

Download citation ▾
Xuanzhi Zhu, Jinting Ge, Chengxin Weng, Quanxin Ning, Yuhan Qi, Suwan Ding, Huiyi Liang, Biao Jing, Xiao Chen, Shouzheng Cheng, Jichun Zhao, Ding Yuan, Tiehao Wang, Huawei Zhang, Fangman Chen, Bing Shi, Lei Zhao, Xianglong Han, Yafei Wu, Dan Shao, Kam W. Leong, Hanyao Huang. Nanomaterial-Mediated Clearance of Circulating Cell-Free DNA Reduces Periodontitis-Associated Arterial Thrombosis. Engineering 202609005 DOI:10.1016/j.eng.2026.09.005

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Alkarithi G, Duval C, Shi Y, Macrae FL, Ariëns RAS . Thrombus structural composition in cardiovascular disease. Arterioscler Thromb Vasc Biol 2021; 41(9): 2370-83.

[2]

ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to the global disease burden. J Thromb Haemost 2014; 12(10): 1580-90.

[3]

van der Meijden PEJ, Heemskerk JWM . Platelet biology and functions: new concepts and clinical perspectives. Nat Rev Cardiol 2019; 16(3): 166-79.

[4]

Nascimento GG, Alves—Costa S, Romandini M . Burden of severe periodontitis and edentulism in 2021, with projections up to 2050: The Global Burden of Disease 2021 study. J Periodontal Res 2024; 59(5): 823-67.

[5]

Slots J . Periodontitis: facts, fallacies and the future. Periodontol 2000 2017; 75(1): 7-23.

[6]

Li X, Wang H, Yu X, Saha G, Kalafati L, Ioannidis C, et al. Maladaptive innate immune training of myelopoiesis links inflammatory comorbidities. Cell 12; 185(10): 1709-27.

[7]

Wang H, Divaris K, Pan B, Li X, Lim JH, Saha G, et al. Clonal hematopoiesis driven by mutated DNMT3A promotes inflammatory bone loss. Cell 2024; 187(14): 3690-711.

[8]

Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez—Juanatey JR, D’Aiuto F, Bouchard P, et al. Periodontitis and cardiovascular diseases: consensus report. J Clin Periodontol 2020; 47(3): 268-88.

[9]

Dietrich T, Sharma P, Walter C, Weston P, Beck J . The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol 2013; 40(s14): S70-84.

[10]

Chandy S, Joseph K, Sankaranarayanan A, Issac A, Babu G, Wilson B, et al. Evaluation of C—reactive protein and fibrinogen in patients with chronic and aggressive periodontitis: a clinico—biochemical study. J Clin Diagn Res 2017; 11(3): ZC41-5.

[11]

Sen S, Giamberardino LD, Moss K, Morelli T, Rosamond WD, Gottesman RF, et al. Periodontal disease, regular dental care use, and incident ischemic stroke. Stroke 2018; 49(2): 355-62.

[12]

Devi OM, Gupta J, Chahal GS, Jain A . Is periodontal infection a risk factor for thromboembolic disease? A systematic review. J Indian Soc Periodontol 2023; 27(3): 238-50.

[13]

Cowan LT, Lakshminarayan K, Lutsey PL, Folsom AR, Beck J, Offenbacher S, et al. Periodontal disease and incident venous thromboembolism: the atherosclerosis risk in communities study. J Clin Periodontol 2019; 46(1): 12-9.

[14]

Cho DH, Song IS, Choi J, Gwon JG . Risk of peripheral arterial disease in patients with periodontitis: a nationwide, population—based, matched cohort study. Atherosclerosis 2020; 297: 96-101.

[15]

Han Z, Bao L, Yu Y, Zhao Y, Wang M, Sun Y, et al. Injectable short—fiber hydrogel with fatigue resistance and antibacterial properties for synergistic periodontitis therapy. Chem Eng J 2025; 520: 166298.

[16]

Mutailifu D, Aini A, Maimaitiaili A . Integrated bioinformatics analysis and machine learning approach for the identification of immune—related genes in the diagnosis of aortic valve calcification with periodontitis. Biomed Technol 2025; 10: 100087.

[17]

Zhu X, Huang H, Zhao L . PAMPs and DAMPs as the bridge between periodontitis and atherosclerosis: the potential therapeutic targets. Front Cell Dev Biol 2022; 10: 856118.

[18]

Lo YMD, Han DSC, Jiang P, Chiu RWK . Epigenetics, fragmentomics, and topology of cell—free DNA in liquid biopsies. Science 2021; 372(6538): 372.

[19]

Yang L, Liu Q, Zhang X, Liu X, Zhou B, Chen J, et al. DNA of neutrophil extracellular traps promotes cancer metastasis via CCDC25. Nature 2020; 583(7814): 133—8.

[20]

White P, Sakellari D, Roberts H, Risafi I, Ling M, Cooper P, et al. Peripheral blood neutrophil extracellular trap production and degradation in chronic periodontitis. J Clin Periodontol 2016; 43(12): 1041-9.

[21]

Huang H, Pan W, Wang Y, Kim HS, Shao D, Huang B, et al. Nanoparticulate cell—free DNA scavenger for treating inflammatory bone loss in periodontitis. Nat Commun 2022; 13(1): 5925.

[22]

Huang H, Zhu X, Chen X, et al. Therapeutic targeting inflammation linking periodontitis and atherosclerotic comorbidities using cell—free DNA—capturing nanomaterials. 2026. bioRxiv:708715

[23]

Hemmi H, Takeuchi O, Kawai T, Kaisho T, Sato S, Sanjo H, et al. A Toll—like receptor recognizes bacterial DNA. Nature 2000; 408(6813): 740-5.

[24]

Panigrahi S, Ma Y, Hong L, Gao D, West XZ, Salomon RG, et al. Engagement of platelet Toll—like receptor 9 by novel endogenous ligands promotes platelet hyperreactivity and thrombosis. Circ Res 2013; 112(1): 103-12.

[25]

Zhang Q, Raoof M, Chen Y, Sumi Y, Sursal T, Junger W, et al. Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature 2010; 464(7285): 104—7.

[26]

Mallavia B, Liu F, Lefrançais E, Cleary SJ, Kwaan N, Tian JJ, et al. Mitochondrial DNA stimulates TLR9—dependent neutrophil extracellular trap formation in primary graft dysfunction. Am J Respir Cell Mol Biol 2020; 62(3): 364-72.

[27]

Stark K, Massberg S . Interplay between inflammation and thrombosis in cardiovascular pathology. Nat Rev Cardiol 2021; 18(9): 666-82.

[28]

Liu F, Sheng S, Shao D, Xiao Y, Zhong Y, Zhou J, et al. A cationic metal—organic framework to scavenge cell—free DNA for severe sepsis management. Nano Lett 2021; 21(6): 2461—9.

[29]

Dawulieti J, Sun M, Zhao Y, Shao D, Yan H, Lao YH, et al. Treatment of severe sepsis with nanoparticulate cell—free DNA scavengers. Sci Adv 2020; 6(22): eaay7148.

[30]

Lee J, Sohn JW, Zhang Y, Leong KW, Pisetsky D, Sullenger BA . Nucleic acid—binding polymers as anti—inflammatory agents. Proc Natl Acad Sci USA 2011; 108(34): 14055-60.

[31]

Holl EK, Frazier V, Landa K, Boczkowski D, Sullenger B, Nair SK . Controlling cancer—induced inflammation with a nucleic acid scavenger prevents lung metastasis in murine models of breast cancer. Mol Ther 2021; 29(5): 1772-81.

[32]

Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, et al. Editor’s Choice—European Society for Vascular Surgery (ESVS) 2024 clinical practice guidelines on the management of asymptomatic lower limb peripheral arterial disease and intermittent claudication. Eur J Vasc Endovasc Surg 2024; 67(1): 9-96.

[33]

Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, et al. ; EFP Workshop Participants and Methodological Consultants. Treatment of stage I—III periodontitis—the EFP S3 level clinical practice guideline. J Clin Periodontol 2020; 47(Suppl 22): 4-60.

[34]

Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967; 38(6 Suppl): 610—6.

[35]

Ramfjord SP . Indices for prevalence and incidence of periodontal disease. J Periodontol 1959; 30(1): 51-9.

[36]

Wassall RR, Preshaw PM . Clinical and technical considerations in the analysis of gingival crevicular fluid. Periodontol 2000 2016; 70(1): 65-79.

[37]

Henson BS, Wong DT . Collection, storage, and processing of saliva samples for downstream molecular applications. Methods Mol Biol 2010; 666: 21-30.

[38]

Freixer G, Zekri—Nechar K, Zamorano—León JJ, Hugo—Martínez C, Butta NV, Monzón E, et al. Pro—apoptotic properties and mitochondrial functionality in platelet—like—particles generated from low aspirin—incubated Meg—01 cells. Platelets 2021; 32(8): 1063-72.

[39]

Gupta D, Shah HP, Malu K, Berliner N, Gaines P . Differentiation and characterization of myeloid cells. Curr Protoc Immunol 2014; 104: 22F.5.1-28.

[40]

Persson KM, Kneller PV, Livingston MW, Bush LM, Deans TL . High—throughput production of platelet—like particles. Methods Mol Biol 2021; 2258: 273-83.

[41]

Gavillet M, Martinod K, Renella R, Harris C, Shapiro NI, Wagner DD, et al. Flow cytometric assay for direct quantification of neutrophil extracellular traps in blood samples. Am J Hematol 2015; 90(12): 1155—8.

[42]

Marsh KM, Rastogi R, Zhang A, Wu D, Kron IL, Yang Z . Hydroxychloroquine attenuates myocardial ischemic and post—ischemic reperfusion injury by inhibiting the Toll—like receptor 9—type I interferon pathway. Cardiol Cardiovasc Med 2022; 6(4): 416-23.

[43]

Jackman JG, Juwarker H, Poveromo LP, Levinson H, Leong KW, Sullenger BA . Polycationic nanofibers for nucleic acid scavenging. Biomacromolecules 2016; 17(11): 3706—13.

[44]

Lee J, Jackman JG, Kwun J, Manook M, Moreno A, Elster EA, et al. Nucleic acid scavenging microfiber mesh inhibits trauma—induced inflammation and thrombosis. Biomaterials 2017; 120: 94-102.

[45]

Liang H, Peng B, Dong C, Liu L, Mao J, Wei S, et al. Cationic nanoparticle as an inhibitor of cell—free DNA—induced inflammation. Nat Commun 2018; 9(1): 4291.

[46]

Peng B, Liang H, Li Y, Dong C, Shen J, Mao HQ, et al. Tuned cationic dendronized polymer: molecular scavenger for rheumatoid arthritis treatment. Angew Chem Int Ed Engl 2019; 58(13): 4254—8.

[47]

Naqvi I, Giroux N, Olson L, Morrison SA, Llanga T, Akinade TO, et al. DAMPs/PAMPs induce monocytic TLR activation and tolerance in COVID—19 patients; nucleic acid binding scavengers can counteract such TLR agonists. Biomaterials 2022; 283: 121393.

[48]

Shi C, Dawulieti J, Shi F, Yang C, Qin Q, Shi T, et al. A nanoparticulate dual scavenger for targeted therapy of inflammatory bowel disease. Sci Adv 2022; 8(4): eabj2372.

[49]

Sun M, Chen P, Xiao K, Zhu X, Zhao Z, Guo C, et al. Circulating cell—free DNAs as a biomarker and therapeutic target for acetaminophen—induced liver injury. Adv Sci 2023; 10(16): e2206789

[50]

Xiao Y, Fang H, Zhu Y, Zhou J, Dai Z, Wang H, et al. Multifunctional cationic hyperbranched polyaminoglycosides that target multiple mediators for severe abdominal trauma management. Adv Sci 2024; 11(1): e2305273.

[51]

Chen J, Yang C, Du M, Zhang S, Yang R, Shao D, et al. Engineering danger signal—targeted biomaterials for oral inflammation control. Cell Biomater. In press.

[52]

Cheng X, Sui H, Chen F, Li C, Du M, Zhang S, et al. Nanomaterial—mediated reprogramming of macrophages to inhibit refractory muscle fibrosis. Adv Mater 2024; 36(52): e2410368.

[53]

Chen J, Cheng X, Zhang S, Sui H, Fang K, Li S, et al. Biomaterial—based strategies for cell—free nucleic acids scavenging and macrophage modulation in oral diseases: mechanisms and therapeutic potential. Biomaterials 2026; 327: 123773.

[54]

Sui H, Cheng X, Chen F, Zhang S, Chen J, Yang R, et al. Cationic nanoparticle targets cGAS—STING axis to drive functional orofacial muscle regeneration. Biomaterials 2026; 328: 123831.

[55]

Du M, Wang K, Ning Q, Chen F, Yang R, Ding S, et al. Cationic nanoparticles—enabled mouthwash combats precancerous oral mucosal inflammation. Regen Biomater 2026; 13: rbag011.

[56]

Kattula S, Byrnes JR, Wolberg AS . Fibrinogen and fibrin in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol 2017; 37(3): e13-21.

[57]

Roth GA, Johnson C, Abajobir A, Abd—Allah F, Abera SF, Abyu G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol 2017; 70(1): 1-25.

[58]

Masaebi F, Salehi M, Kazemi M, Vahabi N, Azizmohammad Looha M, Zayeri F . Trend analysis of disability adjusted life years due to cardiovascular diseases: results from the global burden of disease study 2019. BMC Public Health 2021; 21(1): 1268.

[59]

Vidal F, Cordovil I, Figueredo CM, Fischer RG . Non—surgical periodontal treatment reduces cardiovascular risk in refractory hypertensive patients: a pilot study. J Clin Periodontol 2013; 40(7): 681-7.

[60]

Isola G, Polizzi A, Angjelova A, Jovanova E, Pizzo G, Sculean A . Impact and efficacy of systemic antibiotics for peri—implant diseases treatment: a systematic review and meta—analysis on clinical and microbiological outcomes. Periodontol 2000 2025; 99(1): 284-310.

[61]

Polizzi A, Nibali L, Tartaglia GM, Isola G . Impact of nonsurgical periodontal treatment on arterial stiffness outcomes related to endothelial dysfunction: a systematic review and meta—analysis. J Periodontol 2025; 96(4): 330-45.

[62]

Iwai T, Matsui Y, Homma K, Takemura T, Fujiwara M, Aoyama N, et al. Pathological and immunological differences of arterial thrombi and wall caused by three different periodontal bacterial injections in rat models and proposals on the pathogeneses of vascular diseases. Clin Exp Dent Res 2021; 7(5): 637—46.

[63]

Yu KM, Inoue Y, Umeda M, Terasaki H, Chen ZY, Iwai T . The periodontal anaerobe Porphyromonas gingivalis induced platelet activation and increased aggregation in whole blood by rat model . Thromb Res 2011; 127(5): 418-25.

[64]

Abe T, Hajishengallis G . Optimization of the ligature—induced periodontitis model in mice. J Immunol Methods 2013; 394(1—2): 49-54.

[65]

Kitamoto S, Nagao—Kitamoto H, Jiao Y, Gillilland MG 3rd, Hayashi A, Imai J, et al. The intermucosal connection between the mouth and gut in commensal pathobiont—driven colitis. Cell 2020; 182(2): 447-62.

[66]

Wang H, Divaris K, Pan B, Li X, Lim JH, Saha G, et al. Clonal hematopoiesis driven by mutated DNMT3A promotes inflammatory bone loss. Cell 2024; 187(14): 3690-711.

[67]

Li X, Wang H, Yu X, Saha G, Kalafati L, Ioannidis C, et al. Maladaptive innate immune training of myelopoiesis links inflammatory comorbidities. Cell 2022; 185(10): 1709—27.

[68]

Bizzarro S, Nicu EA, van der Velden U, Laine ML, Loos BG . Association of serum immunoglobulin G (IgG) levels against two periodontal pathogens and prothrombotic state: a clinical pilot study. Thromb J 2010; 8(1): 16.

[69]

Assinger A, Laky M, Badrnya S, Esfandeyari A, Volf I . Periodontopathogens induce expression of CD40L on human platelets via TLR2 and TLR4. Thromb Res 2012; 130(3): e73-8.

[70]

Zhu X, Chu CJ, Pan W, Li Y, Huang H, Zhao L . The correlation between periodontal parameters and cell—free DNA in the gingival crevicular fluid, saliva, and plasma in Chinese patients: a cross—sectional study. J Clin Med 2022; 11(23): 6902.

[71]

Ohto U, Shibata T, Tanji H, Ishida H, Krayukhina E, Uchiyama S, et al. Structural basis of CpG and inhibitory DNA recognition by Toll—like receptor 9. Nature 2015; 520(7549): 702—5.

[72]

Döring Y, Soehnlein O, Weber C . Neutrophil extracellular traps in atherosclerosis and atherothrombosis. Circ Res 2017; 120(4): 736—43.

[73]

Li M, Liu Y, Wang J, Wang Y, Yang Y, Yang A . Neutrophil extracellular DNA traps activate the TLR9 signaling pathway of pancreatic ductal epithelial cells in patients with type 2 autoimmune pancreatitis. Int Immunopharmacol 2025; 144: 113673.

[74]

Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al. Treatment of periodontitis and endothelial function. N Engl J Med 2007; 356(9): 911—20.

[75]

Teeuw WJ, Slot DE, Susanto H, Gerdes VE, Abbas F, D’Aiuto F, et al. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta—analysis. J Clin Periodontol 2014; 41(1): 70-9.

[76]

Luthra S, Orlandi M, Hussain SB, Leira Y, Botelho J, Machado V, et al. Treatment of periodontitis and C—reactive protein: a systematic review and meta—analysis of randomized clinical trials. J Clin Periodontol 2023; 50(1): 45-60.

[77]

Gould TJ, Vu TT, Swystun LL, Dwivedi DJ, Mai SH, Weitz JI, et al. Neutrophil extracellular traps promote thrombin generation through platelet—dependent and platelet—independent mechanisms. Arterioscler Thromb Vasc Biol 2014; 34(9): 1977-84.

[78]

Paunel—Görgülü A, Wacker M, El Aita M, Hassan S, Schlachtenberger G, Deppe A, et al. cfDNA correlates with endothelial damage after cardiac surgery with prolonged cardiopulmonary bypass and amplifies NETosis in an intracellular TLR9—independent manner. Sci Rep 2017; 7(1): 17421.

[79]

Chen X, Huang H, Guo C, Zhu X, Chen J, Liang J, et al. Controlling alveolar bone loss by hydrogel—based mitigation of oral dysbiosis and bacteria—triggered proinflammatory immune response. Adv Funct Mater 2025; 35(3): 2409121.

[80]

Shao D, Li M, Wang Z, Zheng X, Lao YH, Chang Z, et al. Bioinspired diselenide—bridged mesoporous silica nanoparticles for dual—responsive protein delivery. Adv Mater 2018; 30(29): e1801198.

[81]

Chen X, Chen C, Tu Z, Guo Z, Lu T, Li J, et al. Intranasal PAMAM—G3 scavenges cell—free DNA attenuating the allergic airway inflammation. Cell Death Discov 2024; 10(1): 213.

[82]

Au AE, Josefsson EC . Regulation of platelet membrane protein shedding in health and disease. Platelets 2017; 28(4): 342-53.

[83]

Ząbczyk M, Natorska J, Janion—Sadowska A, Metzgier—Gumiela A, Polak M, Plens K, et al. Prothrombotic fibrin clot properties associated with NETs formation characterize acute pulmonary embolism patients with higher mortality risk. Sci Rep 2020; 10(1): 11433.

[84]

El—Sayed OM, Dewyer NA, Luke CE, Elfline M, Laser A, Hogaboam C, et al. Intact Toll—like receptor 9 signaling in neutrophils modulates normal thrombogenesis in mice. J Vasc Surg 2016; 64(5): 1450—8.

[85]

Ge J, Zhu X, Weng C, Yuan D, Zhao J, Zhao L, et al. Periodontitis impacts on thrombotic diseases: from clinical aspect to future therapeutic approaches. Int J Oral Sci 2024; 16(1): 58.

[86]

Xiao Y, Ding T, Fang H, Lin J, Chen L, Ma D, et al. Innovative bio—based hydrogel microspheres micro—cage for neutrophil extracellular traps scavenging in diabetic wound healing. Adv Sci 2024; 11(21): e2401195.

[87]

Wan MC, Jiao K, Zhu YN, Wan QQ, Zhang YP, Niu LZ, et al. Bacteria—mediated resistance of neutrophil extracellular traps to enzymatic degradation drives the formation of dental calculi. Nat Biomed Eng 2024; 8(9): 1177-90.

[88]

Hajishengallis G, Chavakis T . Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol 2021; 21(7): 426—40.

[89]

Elter JR, Hinderliter AL, Offenbacher S, Beck JD, Caughey M, Brodala N, et al. The effects of periodontal therapy on vascular endothelial function: a pilot trial. Am Heart J 2006; 151(1): 47.

[90]

Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al. Treatment of periodontitis and endothelial function. N Engl J Med 2007; 356(9): 911—20.

[91]

Sanchez P, Everett B, Salamonson Y, Ajwani S, Bhole S, Bishop J, et al. Oral health and cardiovascular care: perceptions of people with cardiovascular disease. PLoS One 2017; 12(7): e0181189.

[92]

Senini V, Amara U, Paul M, Kim H . Porphyromonas gingivalis lipopolysaccharide activates platelet CDC42 and promotes platelet spreading and thrombosis. J Periodontol 2019; 90(11): 1336—45.

[93]

Chen WA, Fletcher HM, Payne KJ, Aka S, Thornburg MB, Gheorghe JD, et al. Platelet and neutrophil responses to Porphyromonas gingivalis in human whole blood . Mol Oral Microbiol 2021; 36(3): 202—13.

[94]

Wang X, Chen L, Teng Y, Xie W, Huang L, Wu J, et al. Effect of three oral pathogens on the TMA—TMAO metabolic pathway. Front Cell Infect Microbiol 2024; 14: 1413787.

[95]

Zhu W, Gregory JC, Org E, Buffa JA, Gupta N, Wang Z, et al. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk. Cell 2016; 165(1): 111—24.

[96]

Branzk N, Lubojemska A, Hardison SE, Wang Q, Gutierrez MG, Brown GD, et al. Neutrophils sense microbe size and selectively release neutrophil extracellular traps in response to large pathogens. Nat Immunol 2014; 15(11): 1017—25.

PDF (10138KB)

0

Accesses

0

Citation

Detail

Sections
Recommended

/

〈 〉