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The role of T oll‐like receptor 2 and 4 in gingival tissues of chronic periodontitis subjects with type 2 diabetes
Author(s) -
Promsudthi A.,
Poomsawat S.,
Limsricharoen W.
Publication year - 2014
Publication title -
journal of periodontal research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 83
eISSN - 1600-0765
pISSN - 0022-3484
DOI - 10.1111/jre.12112
Subject(s) - periodontitis , diabetes mellitus , chronic periodontitis , medicine , connective tissue , epithelium , junctional epithelium , immunohistochemistry , endocrinology , pathology
Background and Objective Diabetes is one important risk factor of chronic periodontitis. However, the roles of toll‐like receptor ( TLR ) 2 and TLR 4, which are implicated in the inflammatory process in both chronic periodontitis and diabetes, have not been studied. This study aimed to determine whether TLR 2 and TLR 4 might be involved in the relationship between chronic periodontitis and diabetes by examining TLR 2 and TLR 4 expression in gingival tissues from subjects with chronic periodontitis without diabetes ( CP ) and with diabetes ( CP + DM ) and from periodontally healthy subjects without diabetes ( PH ) and with diabetes ( PH + DM ). Material and Methods Gingival tissues were collected from 23 CP subjects, 21 CP + DM subjects, 22 PH subjects and 20 PH + DM subjects. The expression of TLR 2 and TLR 4 in gingival tissues was determined using an immunohistochemical method. In gingival epithelium, staining patterns and intensity levels of TLR 2 and TLR 4 expression were studied. In connective tissues, the percentages of TLR 2‐ and TLR 4‐positive cells were calculated. The intensity levels and the percentages of positive cells were statistically analyzed. Results Chronic periodontitis or diabetes showed no significant effect on TLR 2 expression in the oral epithelium. However, diabetes increased the expression of TLR 2 in sulcular epithelium and changed the pattern of TLR 2 expression in gingival epithelium. Chronic periodontitis decreased the expression of TLR 4 in gingival epithelium. In connective tissue under sulcular epithelium, CP + DM subjects showed statistically significant higher percentages of TLR 2‐ and TLR 4‐positive cells compared with PH and PH + DM subjects. Conclusion Our results suggest that hyperglycemia and chronic periodontitis had effects on TLR 2 and TLR 4 expression in gingival tissue. The differences in TLR 2 and TLR 4 expression could contribute to a greater inflammatory response, leading to periodontal disease initiation and progression.