{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:31:04Z","timestamp":1784824264886,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T00:00:00Z","timestamp":1373587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Faculty of Dentistry, Mahidol University, research grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Periodontal Research"],"published-print":{"date-parts":[[2014,6]]},"abstract":"Background and Objective<\/jats:title>Diabetes is one important risk factor of chronic periodontitis. However, the roles of toll\u2010like receptor (TLR<\/jats:styled-content>) 2 and TLR<\/jats:styled-content>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<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 might be involved in the relationship between chronic periodontitis and diabetes by examining TLR<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 expression in gingival tissues from subjects with chronic periodontitis without diabetes (CP<\/jats:styled-content>) and with diabetes (CP<\/jats:styled-content>+DM<\/jats:styled-content>) and from periodontally healthy subjects without diabetes (PH<\/jats:styled-content>) and with diabetes (PH<\/jats:styled-content>+DM<\/jats:styled-content>).<\/jats:p><\/jats:sec>Material and Methods<\/jats:title>Gingival tissues were collected from 23 CP<\/jats:styled-content> subjects, 21 CP<\/jats:styled-content>+DM<\/jats:styled-content> subjects, 22 PH<\/jats:styled-content> subjects and 20 PH<\/jats:styled-content>+DM<\/jats:styled-content> subjects. The expression of TLR<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 in gingival tissues was determined using an immunohistochemical method. In gingival epithelium, staining patterns and intensity levels of TLR<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 expression were studied. In connective tissues, the percentages of TLR<\/jats:styled-content>2\u2010 and TLR<\/jats:styled-content>4\u2010positive cells were calculated. The intensity levels and the percentages of positive cells were statistically analyzed.<\/jats:p><\/jats:sec>Results<\/jats:title>Chronic periodontitis or diabetes showed no significant effect on TLR<\/jats:styled-content>2 expression in the oral epithelium. However, diabetes increased the expression of TLR<\/jats:styled-content>2 in sulcular epithelium and changed the pattern of TLR<\/jats:styled-content>2 expression in gingival epithelium. Chronic periodontitis decreased the expression of TLR<\/jats:styled-content>4 in gingival epithelium. In connective tissue under sulcular epithelium, CP<\/jats:styled-content>+DM<\/jats:styled-content> subjects showed statistically significant higher percentages of TLR<\/jats:styled-content>2\u2010 and TLR<\/jats:styled-content>4\u2010positive cells compared with PH<\/jats:styled-content> and PH<\/jats:styled-content>+DM<\/jats:styled-content> subjects.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our results suggest that hyperglycemia and chronic periodontitis had effects on TLR<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 expression in gingival tissue. The differences in TLR<\/jats:styled-content>2 and TLR<\/jats:styled-content>4 expression could contribute to a greater inflammatory response, leading to periodontal disease initiation and progression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jre.12112","type":"journal-article","created":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T09:28:51Z","timestamp":1373621331000},"page":"346-354","source":"Crossref","is-referenced-by-count":36,"title":["The role of T<\/scp>oll\u2010like receptor 2 and 4 in gingival tissues of chronic periodontitis subjects with type 2 diabetes"],"prefix":"10.1111","volume":"49","author":[{"given":"A.","family":"Promsudthi","sequence":"first","affiliation":[{"name":"Department of Oral Medicine and Periodontology Faculty of Dentistry Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Poomsawat","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Pathology Faculty 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