Laboratorio de Inmunidad en Mucosas, UBIMED FES-Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México.
J Periodontal Res. 2012 Feb;47(1):62-73. doi: 10.1111/j.1600-0765.2011.01405.x. Epub 2011 Aug 17.
Broad evidence indicates that diabetes both increases the risk and hastens the progression of periodontal disease. Likewise, chronic inflammation or infections seem to provoke insulin resistance and thereby contribute to the development of diabetes and its complications. Innate immune responses, which appear to be altered in individuals with diabetes, are usually mediated by the recognition of pathogens through toll-like receptors (TLRs). The constitutive expression of some TLRs has been reported in healthy human gingival tissue. Interestingly, the expression of TLRs 2 and 4 is increased with the severity of periodontal disease. Considering that the inflammatory reaction is exacerbated in individuals with diabetes and periodontitis, we suspected that the expression of some TLRs might be increased in gingival tissue in these patients.
In this study, we analyzed, by immunofluorescence, the expression of TLRs 2, 3, 4 and 9 in gingival tissues from healthy individuals and from periodontal patients with or without type 2 diabetes.
We found that the expression levels of TLRs 2, 3, 4 and 9 were higher in all periodontal patients than in healthy individuals. The expression of some TLRs was increased in subjects with periodontitis and diabetes relative to subjects with periodontitis but without diabetes; this increase in expression was found particularly in TLR2 and TLR9 in the connective tissue and in TLR4 at the epithelial region.
These data suggest that the expression of these TLRs 2, 3, 4 and 9 in gingival tissue is higher in individuals with diabetes because its inflammatory reaction is exacerbated. Additionally, the expression of these TLRS is positively regulated with the severity of periodontal disease.
广泛的证据表明，糖尿病既增加了牙周病的风险，又加速了其进展。同样，慢性炎症或感染似乎会引发胰岛素抵抗，从而导致糖尿病及其并发症的发生。先天免疫反应在糖尿病患者中似乎发生了改变，通常是通过 Toll 样受体 (TLR) 识别病原体来介导的。一些 TLR 在健康人牙龈组织中的组成型表达已被报道。有趣的是，TLR2 和 TLR4 的表达随着牙周病的严重程度而增加。考虑到糖尿病和牙周炎患者的炎症反应加剧，我们怀疑这些患者的牙龈组织中某些 TLR 的表达可能会增加。
在这项研究中，我们通过免疫荧光分析了来自健康个体和患有 2 型糖尿病或无 2 型糖尿病的牙周病患者的牙龈组织中 TLR2、3、4 和 9 的表达。
我们发现所有牙周病患者的 TLR2、3、4 和 9 的表达水平均高于健康个体。与仅患有牙周病的患者相比，患有牙周病和糖尿病的患者中某些 TLR 的表达增加；在结缔组织中 TLR2 和 TLR9 以及在上皮区域中 TLR4 的表达增加尤为明显。
这些数据表明，糖尿病患者牙龈组织中这些 TLR2、3、4 和 9 的表达更高，因为其炎症反应加剧。此外，这些 TLR 的表达与牙周病的严重程度呈正相关。
