Toll-like receptor 4 (TLR4) antagonists as potential therapeutics for intestinal inflammation

Indian J Gastroenterol. 2021 Feb;40(1):5-21. doi: 10.1007/s12664-020-01114-y. Epub 2021 Mar 5.

Abstract

Gastrointestinal inflammation is a hallmark of highly prevalent disorders, including cancer treatment-induced mucositis and ulcerative colitis. These disorders cause debilitating symptoms, have a significant impact on quality of life, and are poorly managed. The activation of toll-like receptor 4 (TLR4) has been proposed to have a major influence on the inflammatory signalling pathways of the intestinal tract. Inhibition of TLR4 has been postulated as an effective way to treat intestinal inflammation. However, there are a limited number of studies looking into the potential of TLR4 antagonism as a therapeutic approach for intestinal inflammation. This review surveyed available literature and reported on the in vitro, ex vivo and in vivo effects of TLR4 antagonism on different models of intestinal inflammation. Of the studies reviewed, evidence suggests that there is indeed potential for TLR4 antagonists to treat inflammation, although only a limited number of studies have investigated treating intestinal inflammation with TLR4 antagonists directly. These results warrant further research into the effect of TLR4 antagonists in the intestinal tract.

Keywords: Acute inflammation; Chemotherapy; Chronic inflammation; Crohn’s disease; Inflammatory bowel disease; Intestinal mucositis; Lipopolysaccharide; Radiation; TLR4 antagonists; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology*
  • Gastrointestinal Agents / pharmacology*
  • Humans
  • Inflammation
  • Inflammatory Bowel Diseases / drug therapy*
  • Intestines / drug effects*
  • Signal Transduction / drug effects
  • Toll-Like Receptor 4 / antagonists & inhibitors*

Substances

  • Anti-Inflammatory Agents
  • Gastrointestinal Agents
  • Toll-Like Receptor 4