Targeting iron overload and macrophage polarization to treat diabetic periodontitis: Mechanisms and therapeutic strategies.

Diabetic periodontitis (T2DM-CP, type 2 diabetes mellitus-associated chronic periodontitis) is exacerbated by iron overload and macrophage imbalance, but therapeutic strategies remain limited. We analyzed macrophage polarization and iron metabolism markers in T2DM-CP patients and high glucose-treated macrophages, then evaluated deferoxamine (DFO) and chitosan hydrogel containing black phosphorus (BP) nanosheets and Dl-3-n-butylphthalide (NBP) (CH-BPNs-NBP) as targeted therapies. Clinical T2DM-CP samples and high glucose-stimulated macrophages showed increased M1 markers (iNOS) with decreased M2 markers (ARG-1), along with iron dysregulation (elevated TfR1, reduced FPN1 and GPX4).