TLR4 as a risk factor for periodontal disease: a reappraisal.
OBJECTIVE
To determine whether genetic variants of the TLR4 gene are associated with either chronic or aggressive periodontitis.


METHODS
A systematic electronic search of literature was conducted to identify all published studies without any language restriction on the association between TLR4 and periodontal diseases, including chronic periodontitis and aggressive periodontitis. All case-control studies evaluating the TLR4 Asp299Gly and Thr399Ile polymorphisms in chronic or aggressive periodontitis were identified. A meta-analysis of the studies that fulfilled the inclusion criteria was performed.


RESULTS
Seven studies comprising 744 chronic periodontitis cases and 855 controls and four studies consisting of a total of 295 aggressive periodontitis cases and 456 controls were included in the meta-analysis. In the pooled analysis, the TLR4 299Gly allele (TLR4+896 A>G) appeared to be a genetic risk factor for susceptibility to chronic periodontitis with a random effects and fixed effects odds ratio (OR) of 1.43 [95% confidence interval (CI):1.04-1.97; p=0.03]. On the other hand, the TLR4 399Ile polymorphism (TLR4+1196 C>T) showed a protective effect against aggressive periodontitis with a random effects OR of 0.29 (95% CI: 0.13-0.61; p=0.001).


CONCLUSIONS
Our results suggest that the alleles 299Gly and 399Ile in TLR4 can be a potential genetic marker for periodontal disease.
Ozturk
Ayla
A
Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Vieira
Alexandre R
AR
D010520:Aggressive Periodontitis / Q000235:genetics* / Q000276:immunology; D000483:Alleles; D001224:Aspartic Acid; D055113:Chronic Periodontitis / Q000235:genetics* / Q000276:immunology; D005787:Gene Frequency; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D005998:Glycine; D006801:Humans; D007532:Isoleucine; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors; D013912:Threonine; D051197:Toll-Like Receptor 4 / Q000235:genetics*
D005819:Genetic Markers; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D007532:Isoleucine; D013912:Threonine; D001224:Aspartic Acid; D005998:Glycine