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TLR-4 not only responds to exogenous microbial motifs but can also recognize molecules which are released by stressed and necrotic cells, as well as degraded products of endogenous macromolecules. Upregulation of TLR-4 is found in tubular epithelial cells, vascular endothelial cells, and infiltrating leukocytes during renal ischemia-reperfusion injury, which is induced by massive release of endogenous damage-associated molecular pattern molecules such as high-mobility group box chromosomal protein 1. Activation of TLR-4 promotes the release of proinflammatory mediators, facilitates leukocyte migration and infiltration, activates the innate and adaptive immune system, and potentiates renal fibrosis. TLR-4 inhibition serves as the target of pharmacological agents, which could attenuate ischemia-reperfusion injury and associated delayed graft function and allograft rejection. There is evidence in the literature showing that targeting TLR-4 could improve long-term transplantation outcomes. Given the pivotal role of TLR-4 in ischemia-reperfusion injury and associated delayed graft function and allograft rejection, inhibition of TLR-4 using pharmacological agents could be beneficial for long-term graft survival.<\/jats:p>","DOI":"10.1152\/ajprenal.00469.2013","type":"journal-article","created":{"date-parts":[[2014,2,13]],"date-time":"2014-02-13T02:30:01Z","timestamp":1392258601000},"page":"F801-F811","source":"Crossref","is-referenced-by-count":104,"title":["Role of Toll-like receptor-4 in renal graft ischemia-reperfusion injury"],"prefix":"10.1152","volume":"306","author":[{"given":"Hailin","family":"Zhao","sequence":"first","affiliation":[{"name":"Section of Anesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Santiv\u00e1\u00f1ez","family":"Perez","sequence":"additional","affiliation":[{"name":"Section of Anesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaizhi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Southwest Hospital, Third Military Medical University, Chongqing, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J. 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