Glucose-Responsive Dual-Enzyme Mimetic Nanoreactor Remodels Diabetic Periodontitis Microenvironment for Augmented Alveolar Bone Regeneration.

Background: Periodontitis in the context of diabetes severely disrupts bone metabolic homeostasis, leading to irreversible alveolar bone loss. The resulting alveolar bone defects face significant challenges in healing due to a pathological microenvironment characterized by the interplay of hyperglycemia, oxidative stress, infection, and inflammation. Existing therapeutic strategies often lack the capability to synchronously and intelligently regulate this complex milieu, resulting in delayed and inefficient bone repair. Methods: A composite material, termed MTS@QP-G@CO, was developed. Its core consists of manganese dioxide (MnO Results: The MTS@QP-G@CO designed sequential action at the defect site involves triggering a "glucose starvation" effect via glucose oxidase, followed by hydrogen peroxide decomposition and oxygen generation catalyzed by the MnO Conclusion: The MTS@QP-G@CO system effectively reverses the pathological microenvironment, coordinates immune modulation and osteogenesis, and transforms delayed healing into efficient, high-quality bone regeneration, offering a promising therapeutic approach for diabetes-related bone defects.