From receptor to response: dissecting the TLR4 pathway in diabetic neuropathy.

Diabetic neuropathy (DNP) is a common complication of diabetes that has a significant impact on the patient's quality of life. The primary objectives of clinical treatment for DNP these days are symptomatic pain management and glycemic control. Since there is currently no cure for nerve damage, the only objective is to alleviate discomfort and slow its progression. Pre-clinical research over the last decade has increasingly linked toll-like receptor 4 (TLR4)-mediated neuroinflammation as a major contributor to DNP development. The role of TLR4-mediated neuroinflammation in the pathophysiology of DNP is covered in this review, along with different therapeutic approaches that target TLR4-mediated neuroinflammation in DNP in pre-clinical research. Despite promising pre-clinical results, translating these findings into clinical practice remains a challenge, which we also discuss how to address and overcome in this review.