TLR4 and Chédiak-Higashi syndrome: The presence of LYST (Lysosomal Trafficking Regulator) protein was noted in the PPI of P group, which is associated with cognitive impairment and Chediak–Higashi Syndrome (CHS), a condition that historically exhibits aggressive P. LYST mutations in CHS patients may affect TLR-2 and TLR-4 expression and function, leading to dysregulated immunoinflammatory response, which in turn may influence the periodontal phenotype [55].