{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:04:32Z","timestamp":1784329472100,"version":"3.55.0"},"reference-count":42,"publisher":"Societatea Romana de Morfologie","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rom J Morphol Embryol"],"published-print":{"date-parts":[[2026,7,10]]},"abstract":"<jats:p>Inflammatory radicular cysts are among the most frequently diagnosed odontogenic cysts and arise as a consequence of chronic periapical inflammation of endodontic origin. Their development and persistence are associated with continuous microbial stimulation and activation of local immune responses. Toll-like receptor 4 (TLR4) is a member of the pattern recognition receptor (PRR) family. In periapical pathology, TLR4 is essential for detecting microbial antigens derived from the infected root canal system. The purpose of this study was to evaluate the immunohistochemical (IHC) expression of TLR4 in inflammatory radicular cysts and to assess its involvement in the local inflammatory response. Biopsy specimens from 39 patients diagnosed with radicular cysts were processed for routine histological examination and IHC analysis using anti-TLR4 antibodies. Histological evaluation revealed a chronic lymphoplasmacytic inflammatory infiltrate with a high density of macrophage-like cells and large mononuclear cells in all samples. IHC findings demonstrated strong cytoplasmic TLR4 expression in macrophage-like cells and large mononuclear cells, key innate immune cells, along with a discrete membranous distribution, supporting active recognition of pathogen-associated molecular patterns. Moderate TLR4 expression was also observed in neutrophils, suggesting focal areas of acute inflammatory activity superimposed on a chronic inflammatory background. These results indicate that TLR4 plays a significant role in the immunopathogenesis of inflammatory radicular cysts by mediating innate immune activation and sustaining local inflammation. A better understanding of TLR4 signaling involvement may contribute to improved insights into lesion behavior and support future targeted therapeutic approaches aimed at modulating persistent inflammatory processes in periapical pathology.<\/jats:p>","DOI":"10.47162\/rjme.67.1.13","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:55:06Z","timestamp":1784328906000},"page":"129-138","source":"Crossref","is-referenced-by-count":0,"title":["TLR4 expression and its immunopathogenic role in inflammatory radicular cysts: a clinicopathological study"],"prefix":"10.47162","volume":"67","author":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra C\u0103t\u0103lina","family":"Iacov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona Mihaela","family":"Liliac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania; Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Munteanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Camen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Ionovici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela Jana","family":"\u0162uculin\u0103","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin Octavian","family":"Mateescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Dan","family":"Popescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian Lauren\u0163iu","family":"P\u0103tru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Aurelia","family":"Mogoant\u0103","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Cristina","family":"Andrei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania; Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania; Department of Histology, Faculty of","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26736","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"\"[1] Du C, Wang Z, Lan D, Zhu R, Wang D, Wang H, Wan C, Gao T, Han R, Liu L, Zhang K. Clinical analysis of 1,038 cases of odontogenic jawbone cysts. BMC Oral Health, 2024, 24(1):1387. https:\/\/doi.org\/10.1186\/s12903-024-05167-9","DOI":"10.1186\/s12903-024-05167-9"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"[2] Johnson NR, Gannon OM, Savage NW, Batstone MD. Frequency of odontogenic cysts and tumors: a systematic review. J Investig Clin Dent, 2014, 5(1):9-14. https:\/\/doi.org\/10.1111\/jicd.12044","DOI":"10.1111\/jicd.12044"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"[3] Leonardi R, Perrotta RE, Loreto C, Musumeci G, Crimi S, Dos Santos JN, Rusu MC, Bufo P, Barbato E, Pannone G. Toll-like receptor 4 expression in the epithelium of inflammatory periapical lesions. An immunohistochemical study. Eur J Histochem, 2015, 59(4):2547. https:\/\/doi.org\/10.4081\/ejh.2015.2547","DOI":"10.4081\/ejh.2015.2547"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"[4] Chen JH, Tseng CH, Wang WC, Chen CY, Chuang FH, Chen YK. Clinicopathological analysis of 232 radicular cysts of the jawbone in a population of southern Taiwanese patients. Kaohsiung J Med Sci, 2018, 34(4):249-254. https:\/\/doi.org\/10.1016\/j.kjms.2018.01.011","DOI":"10.1016\/j.kjms.2018.01.011"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"[5] Tsesis I, Krepel G, Koren T, Rosen E, Kfir A. Accuracy for diagnosis of periapical cystic lesions. Sci Rep, 2020, 10(1):14155. https:\/\/doi.org\/10.1038\/s41598-020-71029-3","DOI":"10.1038\/s41598-020-71029-3"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"[6] Rios Osorio N, Caviedes-Bucheli J, Mosquera-Guevara L, Adames-Martinez JS, Gomez-Pinto D, Jimenez-Jimenez K, Avendano Maz H, Bornacelly-Mendoza S. The paradigm of the inflammatory radicular cyst: biological aspects to be considered. Eur Endod J, 2023, 8(1):20-36. https:\/\/doi.org\/10.14744\/eej.2022.26918","DOI":"10.14744\/eej.2022.26918"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"[7] Milojevic N, Krdzovic Lazic E, Lukic L, Puresevic D, Mirkovic M, Jakovljevic A. Inflammatory mediators' essence in apical periodontitis. Eur Oral Res, 2024, 58(3):160-168. https:\/\/doi.org\/10.26650\/eor.20241423117","DOI":"10.26650\/eor.20241423117"},{"key":"ref7","unstructured":"[8] Qureshi WR, Asif M, Qari IH, Qazi JA. Role of interleukin-1 in pathogenesis of radicular cyst. J Ayub Med Coll Abbottabad, 2010, 22(2):86-87."},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"[9] Santos SCLT, Couto LA, Fonseca JM, Xavier FCA, Figueiredo ACL, Freitas VS, Freitas RA, Santos JN, Henriques ACG. Participation of osteoclastogenic factors in immunopathogenesis of human chronic periapical lesions. J Oral Pathol Med, 2017, 46(9):846-852. https:\/\/doi.org\/10.1111\/jop.12618","DOI":"10.1111\/jop.12618"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"[10] Visarnta S, Ratisoontorn C, Panichuttra A, Sinpitaksakul P, Chantarangsu S, Dhanuthai K. Macrophage polarization in human periapical lesions in relation to histopathological diagnosis, clinical features and lesion volume: an ex vivo study. Int Endod J, 2024, 57(12):1829-1847. https:\/\/doi.org\/10.1111\/iej.14138","DOI":"10.1111\/iej.14138"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"[11] R\u00edos-Osorio N, Bri\u00f1ez-Rodr\u00edguez S, Betancur-Calle D, Grajales M, Jim\u00e9nez-Pe\u00f1a OM, Guerrero-Torres M, Fern\u00e1ndez-Grisales R. Biological mechanisms underlying the inflammatory radicular cyst formation - focus on epithelial proliferation: a systematic review of experimental cell and tissue models. Restor Dent Endod, 2026, 51(1):e7. https:\/\/doi.org\/10.5395\/rde.2026.51.e7","DOI":"10.5395\/rde.2026.51.e7"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"[12] Nair PNR. New perspectives on radicular cysts: do they heal? Int Endod J, 1998, 31(3):155-160. https:\/\/doi.org\/10.1046\/j.1365-2591.1998.00146.x","DOI":"10.1046\/j.1365-2591.1998.00146.x"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"[13] Ledesma-Montes C, Hern\u00e1ndez-Guerrero JC, Garc\u00e9s-Ort\u00edz M. Clinico-pathologic study of odontogenic cysts in a Mexican sample population. Arch Med Res, 2000, 31(4):373-376. https:\/\/doi.org\/10.1016\/s0188-4409(00)00069-2","DOI":"10.1016\/S0188-4409(00)00069-2"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"[14] Siqueira JF Jr, R\u00f4\u00e7as IN. Present status and future directions: microbiology of endodontic infections. Int Endod J, 2022, 55(Suppl 3):512-530. https:\/\/doi.org\/10.1111\/iej.13677","DOI":"10.1111\/iej.13677"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"[15] Koju S, Chaurasia NK, Marla V, Niroula D, Poudel P. Radicular cyst of the anterior maxilla: an insight into the most common inflammatory cyst of the jaws. J Dent Res Rev, 2019, 6(1):26-29. https:\/\/doi.org\/10.4103\/jdrr.jdrr_64_18","DOI":"10.4103\/jdrr.jdrr_64_18"},{"key":"ref15","unstructured":"[16] Bava FA, Umar D, Bahseer B, Baroudi K. Bilateral radicular cyst in mandible: an unusual case report. J Int Oral Health, 2015, 7(2):61-63"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"[17] Kabak SL, Kabak YS, Anischenko SL. Light microscopic study of periapical lesions associated with asymptomatic apical periodontitis. Ann Anat, 2005, 187(2):185-194. https:\/\/doi.org\/10.1016\/j.aanat.2004.05.001","DOI":"10.1016\/j.aanat.2004.05.001"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"[18] Juerchott A, Pfefferle T, Flechtenmacher C, Mente J, Bendszus M, Heiland S, Hilgenfeld T. Differentiation of periapical granulomas and cysts by using dental MRI: a pilot study. Int J Oral Sci, 2018, 10(2):17. https:\/\/doi.org\/10.1038\/s41368-018-0017-y","DOI":"10.1038\/s41368-018-0017-y"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"[19] Altaie AM, Venkatachalam T, Samaranayake LP, Soliman SSM, Hamoudi R. Comparative metabolomics reveals the microenvironment of common T-helper cells and differential immune cells linked to unique periapical lesions. Front Immunol, 2021, 12:707267. https:\/\/doi.org\/10.3389\/fimmu.2021.707267","DOI":"10.3389\/fimmu.2021.707267"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"[20] Khetan RR, Reche A, Basra AS, Awghad SS. Radicular cyst: the sequelae of untreated caries. Cureus, 2024, 16(5):e60269. https:\/\/doi.org\/10.7759\/cureus.60269","DOI":"10.7759\/cureus.60269"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"[21] Park BS, Song DH, Kim HM, Choi BS, Lee H, Lee JO. The structural basis of lipopolysaccharide recognition by the TLR4-MD-2 complex. Nature, 2009, 458(7242):1191-1195. https:\/\/doi.org\/10.1038\/nature07830","DOI":"10.1038\/nature07830"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"[22] Krithika C, Kota S, Gopal KS, Koteeswaran D. Mixed periapical lesion: differential diagnosis of a case. Dentomaxillofac Radiol, 2011, 40(3):191-194. https:\/\/doi.org\/10.1259\/dmfr\/89370676","DOI":"10.1259\/dmfr\/89370676"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"[23] R\u0103deanu AC, Surp\u0103\u0163eanu M, Munteanu CM, Liliac IM, Popescu AD, Andrei EC, P\u0103tru CL. Periodontal changes induced by fixed orthodontic therapy. Med Pharm Rep, 2024, 97(3):370-379. https:\/\/doi.org\/10.15386\/mpr-2725","DOI":"10.15386\/mpr-2725"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"[24] Cump\u0103t\u0103 CN, Munteanu MC, Andrei EC, Liliac IM, Busuioc CJ, Di Francesco P, Moldovan MA, Enache SI, Burcea A, P\u0103tru CL, Roman CR. Comprehensive insights into Pindborg tumor: etiology, advanced diagnostic approaches, and evidence-based management strategies - review of literature. Rom J Morphol Embryol, 2024, 65(4):617-625. https:\/\/doi.org\/10.47162\/RJME.65.4.08","DOI":"10.47162\/RJME.65.4.08"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"[25] R\u0103deanu AC, Liliac IM, Munteanu MC, Surp\u0103\u0163eanu M, P\u0103tru CL, Andrei EC. Gingival overgrowth in fixed orthodontic therapy. Rom J Morphol Embryol, 2024, 65(4):759-764. https:\/\/doi.org\/10.47162\/RJME.65.4.22","DOI":"10.47162\/RJME.65.4.22"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"[26] Cump\u0103t\u0103 CN, Liliac IM, Bu\u015fu OV, Predescu AM, Iacov CA, Popescu AD, Sl\u0103voiu R, Andrei EC, Busuioc CJ, Munteanu CM. The progressive integration of AI software in the histopathological diagnosis of oral cancers. BRAIN Broad Res Artif Intell Neurosci, 2025, 16(1):205-215. https:\/\/doi.org\/10.70594\/brain\/16.1\/15","DOI":"10.70594\/brain\/16.1\/15"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"[27] Munteanu CM, P\u0103tru CL, Popescu DA, Boldeanu G, Predescu AM, R\u0103deanu AC, Andrei EC, Liliac IM. Oral cancer: etiology and therapeutic aspects. Literature review. Rom J Oral Rehabil, 2024, 16(2):204-213. https:\/\/doi.org\/10.62610\/RJOR.2024.2.16.20","DOI":"10.62610\/RJOR.2024.2.16.20"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"[28] R\u0103deanu AC, Surp\u0103\u0163eanu M, Popescu DA, P\u0103tru CL, Liliac IM, Andrei EC, Munteanu CM, Cump\u0103t\u0103 CN. Clinical and morphological aspects of gingival overgrowth induced by fixed orthodontic therapy. Rom J Oral Rehabil, 2024, 16(2):456-460. https:\/\/doi.org\/10.62610\/RJOR.2024.2.16.40","DOI":"10.62610\/RJOR.2024.2.16.40"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"[29] Cump\u0103t\u0103 CN, Predescu AM, P\u0103tru L, Totan M, Munteanu CM, Bu\u015fu OV, Liliac IM, Andrei EC, Amarascu M, P\u0103tru CL. Artificial intelligence in oral and maxillofacial oncology: AI-driven histopathological, imaging, and surgical insights into oral squamous cell carcinoma. BRAIN Broad Res Artif Intell Neurosci, 2025, 16(4):350-371. https:\/\/doi.org\/10.70594\/brain\/16.4\/22","DOI":"10.70594\/brain\/16.4\/22"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"[30] Cump\u0103t\u0103 CN, Munteanu CM, Predescu AM, P\u0103tru CL, Popescu AD, Iacov CA, Busuioc CJ, Bu\u015fu OV, Andrei EC, Georgescu E, Am\u0103r\u0103scu M, Liliac IM. Pleomorphic adenoma of the parotid gland - histopathological, neurological, intraoperative and machine learning insights. BRAIN Broad Res Artif Intell Neurosci, 2025, 16(4):331-349. https:\/\/doi.org\/10.70594\/brain\/16.4\/21","DOI":"10.70594\/brain\/16.4\/21"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"[31] Weber M, Ries J, B\u00fcttner-Herold M, Geppert CI, Kesting M, Wehrhan F. Differences in inflammation and bone resorption between apical granulomas, radicular cysts, and dentigerous cysts. J Endod, 2019, 45(10):1200-1208. https:\/\/doi.org\/10.1016\/j.joen.2019.06.014","DOI":"10.1016\/j.joen.2019.06.014"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"[32] Albagieh H, Aldosari M, Alkhathlan A, Alfawaz N, Almutairi M. Radiolucent lesions that may resemble inflammatory periapical lesions: a review article. Saudi Dent J, 2023, 35(8):916-919. https:\/\/doi.org\/10.1016\/j.sdentj.2023.11.003","DOI":"10.1016\/j.sdentj.2023.11.003"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"[33] Das S, Adhikari HD. Reliability of ultrasonography in differentially diagnosing periapical lesions of endodontic origin in comparison with intra-oral periapical radiography and cone-beam computed tomography: an in vivo study. J Conserv Dent, 2021, 24(5):445-450. https:\/\/doi.org\/10.4103\/jcd.jcd_254_21","DOI":"10.4103\/jcd.jcd_254_21"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"[34] Diaconu OA, Gheorghi\u0163\u0103 LM, Gheorghe AG, \u0162uculin\u0103 MJ, Munteanu MC, Iacov CA, R\u0103dulescu VM, Ionescu M, Mirea AA, B\u0103nic\u0103 CA. A retrospective study of CBCT-based detection of endodontic failures and periapical lesions in a Romanian cohort. J Clin Med, 2025, 14(18):6364. https:\/\/doi.org\/10.3390\/jcm14186364","DOI":"10.3390\/jcm14186364"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"[35] Talpo\u015f-Niculescu R, Veja I, Neagu CS, Rusu LC, Talpo\u015f-Niculescu \u015e, Popa M, Nica LM. Nonsurgical endodontics and decompression-based management of extensive periapical cystic-like lesions: a comparative and radiological study with a two-year follow-up. J Clin Med, 2025, 14(17):6127. https:\/\/doi.org\/10.3390\/jcm14176127","DOI":"10.3390\/jcm14176127"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"[36] Tamiolakis P, Thermos G, Tosios KI, Sklavounou-Andrikopoulou A. Demographic and clinical characteristics of 5294 jaw cysts: a retrospective study of 38 years. Head Neck Pathol, 2019, 13(4):587-596. https:\/\/doi.org\/10.1007\/s12105-019-01011-7","DOI":"10.1007\/s12105-019-01011-7"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"[37] Schvartzman Cohen R, Goldberger T, Merzlak I, Tsesis I, Chaushu G, Avishai G, Rosen E. The development of large radicular cysts in endodontically versus non-endodontically treated maxillary teeth. Medicina (Kaunas), 2021, 57(9):991. https:\/\/doi.org\/10.3390\/medicina57090991","DOI":"10.3390\/medicina57090991"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"[38] Neelakantan P, Romero M, Vera J, Daood U, Khan AU, Yan A, Cheung GSP. Biofilms in endodontics - current status and future directions. Int J Mol Sci, 2017, 18(8):1748. https:\/\/doi.org\/10.3390\/ijms18081748","DOI":"10.3390\/ijms18081748"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"[39] de Oliveira RCM, Beghini M, Borges CRB, Alves PM, de Ara\u00fajo MS, Pereira SAL, Rodrigues V Jr, Rodrigues DBR. Higher expression of galectin-3 and galectin-9 in periapical granulomas than in radicular cysts and an increased Toll-like receptor-2 and Toll-like receptor-4 expression are associated with reactivation of periapical inflammation. J Endod, 2014, 40(2):199-203. https:\/\/doi.org\/10.1016\/j.joen.2013.10.031","DOI":"10.1016\/j.joen.2013.10.031"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"[40] da Silva RAB, Ferreira PDF, De Rossi A, Nelson-Filho P, Silva LAB. Toll-like receptor 2 knockout mice showed increased periapical lesion size and osteoclast number. J Endod, 2012, 38(6):803-813. https:\/\/doi.org\/10.1016\/j.joen.2012.03.017","DOI":"10.1016\/j.joen.2012.03.017"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"[41] Rider D, Furusho H, Xu S, Trachtenberg AJ, Kuo WP, Hirai K, Susa M, Bahammam L, Stashenko P, Fujimura A, Sasaki H. Elevated CD14 (cluster of differentiation 14) and Toll-like receptor (TLR) 4 signaling deteriorate periapical inflammation in TLR2 deficient mice. Anat Rec (Hoboken), 2016, 299(9):1281-1292. https:\/\/doi.org\/10.1002\/ar.23383","DOI":"10.1002\/ar.23383"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"[42] Enache I, Ioni\u0163\u0103 E, Anghelina F, Mogoant\u0103 CA, Ciolofan MS, C\u0103pit\u0103nescu AN, V\u00eelcea AM, Florescu AM, Simionescu CE. Involvement of inflammatory cells in chronic rhinosinusitis with nasal polyps. Rom J Morphol Embryol, 2020, 61(3):871-877. https:\/\/doi.org\/10.47162\/rjme.61.3.25\"","DOI":"10.47162\/RJME.61.3.25"}],"container-title":["Romanian Journal of Morphology and Embryology"],"original-title":[],"link":[{"URL":"https:\/\/rjme.ro\/RJME\/resources\/files\/670126129138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:01:17Z","timestamp":1784329277000},"score":1,"resource":{"primary":{"URL":"https:\/\/rjme.ro\/archive\/67\/1\/13\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,7,12]]},"published-print":{"date-parts":[[2026,7,12]]}},"URL":"https:\/\/doi.org\/10.47162\/rjme.67.1.13","relation":{},"ISSN":["1220-0522","2066-8279"],"issn-type":[{"value":"1220-0522","type":"print"},{"value":"2066-8279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}