The Role of Toll-like Receptor-4 in Periodontitis Patients With End-stage Renal Disease in a Sample of Egyptian Population

This study examines the role of a protein called Toll-like receptor 4 (TLR-4) — part of the immune system's early warning response — in gum disease (periodontitis) in two groups: otherwise healthy people with periodontitis, and people with end-stage kidney disease (ESRD) on dialysis who also have periodontitis and type 2 diabetes. **You may be eligible if...** - You are 30–60 years old with diagnosed stage II or III periodontitis (moderate to severe gum disease) - You are either systemically healthy (Group 1) OR you have end-stage kidney disease on regular hemodialysis and type 2 diabetes (Group 2) **You may NOT be eligible if...** - You are a smoker - You have systemic diseases other than diabetes (Group 2 participants) - You have a history of cancer - You have had a kidney transplant (Group 2) - You are on long-term medications that could confound results (Group 1) Talk to your doctor to see if this trial is right for you.