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Extracellular vesicles (EVs) are circulating nanoparticles released by microbes and host cells involved in cell\u2010to\u2010cell communication, found in body biofluids, such as saliva and gingival crevicular fluid (GCF). EVs are mainly involved in cell\u2010to\u2010cell communication,\u00a0and may hold promise for diagnostic and therapeutic purposes. Periodontal research has examined the potential involvement of bacterial\u2010 and host\u2010cell\u2010derived EVs in disease pathogenesis, diagnosis, and therapy, but data remains scarce on immune cell\u2010 or microbial\u2010derived EVs. In this narrative review, we first provide an overview of the role of microbial and host\u2010derived EVs on disease pathogenesis. Recent studies reveal that\n                    <jats:italic>Porphyromonas gingivalis<\/jats:italic>\n                    and\n                    <jats:italic>Aggregatibacter actinomycetemcomitans<\/jats:italic>\n                    \u2010derived outer membrane vesicles (OMVs) can activate inflammatory cytokine release in host cells, while M1 macrophage EVs may contribute to bone loss. Additionally, we summarised current in\u00a0vitro and pre\u2010clinical research on the utilisation of immune cell and microbial\u2010derived EVs as potential therapeutic tools in the context of periodontal treatment. Studies indicate that EVs from M2 macrophages and dendritic cells promote bone regeneration in animal models. While bacterial EVs remain underexplored for periodontal therapy, preliminary research suggests that\n                    <jats:italic>P. gingivalis OMVs<\/jats:italic>\n                    hold promise as vaccine candidates. Finally, we acknowledge the current limitations present in the field of translating immune cell derived EVs and microbial derived EVs in periodontology. It is concluded that microbial and host immune cell\u2010derived EVs have a role in periodontitis pathogenesis and hence may be useful for studying disease pathophysiology, and as diagnostic and treatment monitoring biomarkers.\n                  <\/jats:p>","DOI":"10.1111\/jre.13283","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T13:26:18Z","timestamp":1715952378000},"page":"1115-1129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Microbial\u2010 and host immune cell\u2010derived extracellular vesicles in the pathogenesis and therapy of periodontitis: A narrative review"],"prefix":"10.1111","volume":"59","author":[{"given":"Jenny","family":"Wang","sequence":"first","affiliation":[{"name":"School of Dentistry, Center for Oral\u2010facial Regeneration, Rehabilitation and Reconstruction (COR3), Epigenetics Nanodiagnostic and Therapeutic Group The University of Queensland  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