Elevated glucose levels, multiple pro-inflammatory cytokines and the generation of excessive reactive oxygen species (ROS) are pivotal characteristics within the microenvironments of chronic periodontitis with diabetes mellitus (CPDM). Control of inflammation and modulation of immune system are required in the initial phase of CPDM treatment, while late severe periodontitis requires a suitable scaffold to promote osteogenesis, rebuild periodontal tissue and reduce alveolar bone resorption. Herein, a whole-course-repair system is introduced by an injectable hydrogel using phenylboronic acid functionalized oxidized sodium alginate (OSA–PBA) and carboxymethyl chitosan (CMC). Epigallocatechin-3-gallate (EGCG) was loaded to simultaneously adjust the mechanical property of the OSA–PBA/CMC + EGCG hydrogel (OPCE). This hydrogel has distinctive adaptability, injectability, and ROS/glucose-triggered release of EGCG, making it an ideal drug delivery carrier. As expected, OPCE hydrogel shows favourable antioxidant and anti-inflammatory properties, along with a regulatory influence on the phenotypic transition of macrophages, providing a favourable immune microenvironment. Apart from that, it provides a favourable mechanical support for osteoblast/osteoclast differentiation regulation at the late proliferation stage of periodontal regeneration. The practical therapeutic effects of OPCE hydrogels were also confirmed when applied for treating periodontitis in diabetic rats. In summary, OPCE hydrogel may be a promising whole-course-repair system for the treatment of CPDM.

中文翻译：

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基于ROS/葡萄糖刺激响应EGCG释放和可调节机械性能的全程修复系统，有效治疗糖尿病大鼠慢性牙周炎

血糖水平升高、多种促炎细胞因子和过量活性氧（ROS）的产生是慢性牙周炎伴糖尿病（CPDM）微环境的关键特征。 CPDM治疗初期需要控制炎症和调节免疫系统，而晚期严重牙周炎则需要合适的支架来促进成骨、重建牙周组织并减少牙槽骨吸收。在此，通过使用苯基硼酸官能化氧化海藻酸钠（OSA-PBA）和羧甲基壳聚糖（CMC）的可注射水凝胶引入了全程修复系统。负载表没食子儿茶素-3-没食子酸酯（EGCG）以同时调节 OSA-PBA/CMC + EGCG 水凝胶（OPCE）的机械性能。这种水凝胶具有独特的适应性、可注射性以及ROS/葡萄糖触发的EGCG释放，使其成为理想的药物输送载体。正如预期的那样，OPCE 水凝胶显示出良好的抗氧化和抗炎特性，以及对巨噬细胞表型转变的调节影响，提供了有利的免疫微环境。除此之外，它还为牙周再生增殖后期的成骨细胞/破骨细胞分化调节提供了有利的机械支持。 OPCE水凝胶用于治疗糖尿病大鼠牙周炎的实际治疗效果也得到证实。综上所述，OPCE水凝胶可能是一种有前途的治疗CPDM的全程修复系统。