The Study Mechanism Of TLR4Signaling Pathway In The Process Of â…¡ Diabetes Mellitus Aggravating Destructive Process Of Periodontitis

Objective: Periodontitis is a chronic inflammation caused by bacterial infection,in our country the incidence of periodontitis is up to60%, it has become the leadingcause of adult tooth loss. The incidence of diabetes has also been increasing,it has beenup to9.7%by2008. The complications of diabetes is closely related to chronicinflammation, periodontal disease is considered to be the sixth complications ofdiabetes.The relation between II diabetes and periodontal disease has always been thefocus of various studies. The probability of type II diabetic patients with severeperiodontitis is higher2to3times than non-diabetic patients.This study is to detectTLR4(Toll like receptor4) in gingival tissue and to detect the expression of TLR4’sdownstream product of TRAF6(tumor necrosis factor receptor,-associated factor6), theexpression of NF-κB （nuclear transcription factor-κB) and the expression of cytokineIL-1β(interleukin-1beta).Meanwhile,to investigate the role and significance whichTLR4pathway and the cytokines IL-1βplay in type Ⅱ diabetes mellitus aggravating theperiodontal tissue inflammation and the process of alveolar bone resorption, to providea theoretical basis to explore the mechanism of type Ⅱ diabetes aggravating periodontaltissue destruction.Methods:10patients with periodontal health necessary to remove mandibularthird molar as control group,10patients with chronic periodontitis patients as chronicperiodontitis group,10patients with chronic periodontitis accompanied with type Ⅱdiabetic as type II diabetic patients withchronic periodontitis group.All patients weresigned informed consents. To take gingival tissue of patients during the operation andwere immediately placed in liquid nitrogen tank in the EP tube set-40℃and werequickly transferred to a-80℃refrigerator to save. Respectively, observing the following indicators:(1)To take the gums in the normal control group, the chronic periodontitis groupand patients with type II diabetic patients accompanied with chronic periodontitis group,then to extract protein from the cytoplasm and nucleus.Immunoblotting (westernblotting)was used to determine the protein of TLR4and TRAF6in the cytoplasm, theprotein of NF-κB in nucleus, and observe their changing patterns.(2)To take the gums in the normal control group, the chronic periodontitis groupand patients with type II diabetic patients accompanied with chronic periodontitis group,the cytokines IL-1β were measured by enzyme-linked immunosorbent assay (ELISA)and to bserve their changing patterns.Results:1Western blot results showed that the relative expression level of TLR4protein in the normal control group was0.059±0.03, the relative expression levels inchronic periodontitis group was0.097±0.05, the relative expression levels intypeⅡdiabetic patients accompanied with chronic periodontitis group was0.176±0.12,the three was statistically significant (p<0.05).2Western blot results showed that the relative expression level of TRAF6proteinin the normal control group was0.446±0.24, the relative expression level of which inchronic periodontitis group was0.637±0.33, the relative expression level of which intype Ⅱ diabetic patients accompanied with chronic periodontitis group was1.27±0.62,the three was statistically significant (p<0.05).3Western blot results showed that the relative expression level of NF-κB proteinin the normal control group was0.467±0.25,the relative expression levels of which inchronic periodontitis group was0.577±0.31, the relative expression levels of which intype Ⅱ diabetic patients accompanied with chronic periodontitis group was1.002±0.58, the three was statistically significant (p<0.05).4.ELISA results show that compared with healthy controls group, the expressionof IL-1βin gingival tissue in inflammatory group was increased, the difference wasstatistically significant (p<0.05); the expression of IL-1β in inflammatory periodontitisaccompanied with type Ⅱ diabetic patients is higher than the chronic periodontitisgroup, the difference was statistically significant (p<0.05).Conclusion:1. Signaling pathway constituted by TLR4and its downstream TRAF6, NF-kappaB plays an important role in the process of II diabetes aggravating periodontal tissueinflammation and in the process of alveolar bone destruction 2.IL-1β may stimulate bone resorption in the process of II diabetes aggravatingperiodontal tissue inflammation.