Turk J Immunol. 2024; 12(2): 35-55 | DOI: 10.4274/tji.galenos.2024.26213

Toll-Like Receptors and Diabetic Nephropathy: A Review of Recent Advances

Mohammad Sadra Gholami Chahkand¹, Yasaman Tavakoli², Ava Aghakhani³, Monireh Askarzadeh⁴, Hosein Azimi⁵, Nogol Ghalamkarpour⁶, Alaleh Alizadeh⁷, Iman Archin⁸, Sajad Kermani⁷, Akram Ansari⁹, Mohadeseh Poudineh¹⁰, Zahra Mali¹¹, Elaheh Foroughi¹², Gisou Erabi¹³, Seyed Amirhossein Mazhari¹⁴, Mohammad Sadegh Fallahi³, Niloofar Deravi¹⁵, Parisa Alsadat Dadkhah^12
1Golestan University of Medical Sciences, School of Medicine, Student Research Committee, Gorgan, Iran
²Mazandaran University of Medical Science, Department of Medicine, Mazandaran, Iran
³Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
⁴Mazandaran University of Medical Sciences, School of Medicine, Student Research Committee, Sari, Iran
⁵Iran University of Medical Sciences, School of Medicine, Student Research Committee, Tehran, Iran
⁶Lorestan University of Medical Sciences, School of Allied Medicine, Department of Clinical Laboratory Sciences, Student Research Committee, Khorramabad, Iran
⁷Islamic Azad University Faculty of Medicine, Student Research Committee, Mashhad Branch, Mashhad, Iran
⁸Kazan (Volga Region) Federal University, Kazan, Russia
⁹Shantou University Medical College, Student Research Committee Shantou, Guangdong, China
¹⁰Zanjan University of Medical Sciences, School of Medicine, Zanjan, Iran
¹¹Urmia University of Medical Sciences, School of Medicine, Iran
¹²Isfahan University of Medical Sciences, School of Medicine, Student Research Committee, Isfahan, Iran
¹³Urmia University of Medical Sciences, Student Research Committee, Urmia, Iran
¹⁴Azerbaijan Medical University, Student Research Committee, Baku, Azerbaijan
¹⁵Shahid Beheshti University of Medical Sciences, School of Medicine, Student Research Committee, Arabi Ave, Iran

Diabetic nephropathy (DN) is one of the most common kidney diseases, but its exact pathophysiology remains unknown. Toll-like receptors (TLRs) are innate immune receptors that recognize pathogen- and danger-associated molecular patterns, which can result in an inflammatory response. TLR4, TLR2, TLR5, TLR7, TLR8, TLR9, and TLR11 are essential in the pathogenesis of DN, according to recent evidence collected from both in vivo and in vitro studies. Studies have shown that TLR2 and TLR4 expression is higher in patients with renal failure and nephrotic diabetes. They also play critical roles in podocyte injury and inflammation caused by high glucose. TLR2 and TLR4 may be helpful therapeutic targets to prevent or delay DN in patients with type 2 diabetes mellitus. Additionally, TLR7 may contribute to kidney damage in type 1 diabetes mellitus, whereas downregulation of TLR9 expression inhibits inflammation and apoptosis pathways associated with DN.

Keywords: Toll-like receptor, nephropathy, diabetic kidney disease, chronic kidney disease, TLRs

---

CITE