The Effect of an Extract of Sappanwood, Protosappanin A and Protosappanin B on Osteogenesis in Periodontitis

Background: Sappanwood is widely used in the prevention and treatment in diseases due to its ability to seal blood vessels, dissipate stasis, and relieve pain. Important monomer components of sappanwood, Protosappanin A (PA) and Protosappanin B (PB) have anti-tumour and antimicrobial medicinal properties. This study investigated the anti-inflammatory and osteogenic differentiation effects of a crude extract of Sappanwood (ESP), PA and PB against periodontitis in periodontal ligament stem cells (PDLSCs). Methods: Oil Red O staining was used to assess the ability of adipocytes to differentiate. Alizarin Red staining was used to assess the capacity to differentiate into osteoblasts. Third-passage PDLSCs were grown in either basic medium alone or basic media with varying doses of ESP (0.0625 mg/mL, 0.03125 mg/mL and 0.125 mg/mL), PA and PB (2.5 µM, 5 µM, 10 µM). The CCK-8 assay was used to measure cell proliferation. Real Time PCR (RT-qPCR) and Enzyme-Linked Immunosorbnent Assay (ELISA) assay were used to measure gene expression. The capacity to differentiate into osteoblasts was evaluated using Alizarin Red staining, and Alkaline Phosphatase (ALP) staining and activity. Results: The development of lipid droplets and mineralized nodules was examined using Oil Red O staining and Alizarin Red staining. Flow cytometry revealed that PDLSCs were CD29 (98.23%) and CD44 (98.81%) positive, but CD34 (0.16%) and CD45 (0.09%) negative. CCK-8 assay showed that ESP at three concentrations (0.03125 mg/mL, 0.0625 mg/mL and 0.125 mg/mL) and 2.5 µM, 5 µM and 10 µM PA and PB had no cytotoxicity at 5 and 7 days (p < 0.05). qRT-PCR and ELISA assay indicated that ESP, PA and PB downregulated the inflammatory cytokines IL-8, IL-6, IL-1β, IL-10 and IL-4 and elevated the mRNA expression of osteogenesis cytokines RUNX2 , OSX and OCN in PDLSCs (p < 0.05). Alizarin red staining, and ALP staining and activity showed that ESP, PA and PB increased mineralized nodules and the ALP content of in PDLSCs (p < 0.05). Conclusions: ESP, PA and PB can reduce the inflammatory response and amplify the osteogenic differentiation of PDLSCs. Therefore, ESP, PA and PB may have potential pharmacological effects in controlling the progression of periodontitis and promoting periodontal tissue regeneration.