HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin ThomasThe role of toll-like receptors in diabetic kidney diseasePanchapakesan, Usha; Pollock, CarolAuthor Information Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, NSW, Australia Correspondence to A/Prof. Usha Panchapakesan, St. Leonards, Australia. Tel: +61 2 99264783; fax: +61 2 99265715; e-mail: firstname.lastname@example.org Current Opinion in Nephrology and Hypertension: January 2018 - Volume 27 - Issue 1 - p 30-34 doi: 10.1097/MNH.0000000000000377 Buy Metrics Abstract Purpose of review Involved in innate immunity, toll-like receptors (TLRs) recognize pathogenic and endogenous ligands. Ligand binding initiates an inflammatory cascade which if sustained leads to fibrosis. This review summarizes the role of TLRs in diabetic kidney disease (DKD) with particular emphasis on TLR2 and TLR4. Recent findings Collectively, preclinical evidence to date supports the causative role of TLR2 and TLR4 in both type I and type II DKD. The relative importance of each is still unclear. In experimental models, there are increased TLR2 and TLR4 ligands, expression and signalling. Functional studies using inhibitors or knockout animal models confirm causality. Clinical evidence also supports increased ligands and TLR2 and TLR4 expression in diabetes however there are no clinical studies examining whether interruption of these pathways confer renoprotection. Summary Preclinical evidence to date supports the role of TLR2 and TLR4 in DKD. It will be useful to examine the value of interrupting these signalling pathways in clinical trials. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.