TLR4

Chr 9

toll like receptor 4

Also known as: ARMD10, CD284, TLR-4, TOLL

The TLR4 protein functions as a transmembrane pattern recognition receptor that recognizes bacterial lipopolysaccharide and other pathogen-associated molecular patterns to activate innate immune responses and cytokine production. Mutations in TLR4 have been associated with altered lipopolysaccharide responsiveness and susceptibility to infectious diseases, though well-defined Mendelian disorders are not established. This gene shows very low constraint against loss-of-function variants, suggesting that complete loss of TLR4 function may be tolerated in humans.

OMIMResearchSummary from RefSeq, UniProt
MultiplemechanismLOEUF 0.99
Clinical SummaryTLR4
Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
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Clinical Trials
10 active or recruiting trials — potential therapeutic options may be available

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
0.99LOEUF
pLI 0.000
Z-score 1.59
OE 0.66 (0.450.99)
Tolerant

Typical tolerance to LoF variation

Missense Constraint
0.65Z-score
OE missense 0.91 (0.840.99)
379 obs / 416.1 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.66 (0.450.99)
00.351.4
Missense OE0.91 (0.840.99)
00.61.4
Synonymous OE0.96
01.21.6
LoF obs/exp: 17 / 25.7Missense obs/exp: 379 / 416.1Syn Z: 0.38
DN
0.78top 25%
GOF
0.78top 25%
LOF
0.1993th %ile

This gene has evidence for multiple mechanisms of pathogenicity (dominant-negative and gain-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to dominant-negative as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

DNprediction above median
GOFprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

TLR4 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Coronary Heart Disease

Adipose Tissue and Inflammation in Coronary Heart Disease

ACTIVE NOT RECRUITING
NCT02760914Oslo University HospitalStarted 2016-06
Alzheimer Disease (AD)

Tributyrin Treatment in Mild Alzheimer Disease: Assessment of Butyrate Effects Via the Gut-Brain

NOT YET RECRUITING
NCT06797817Phase PHASE3Universidad de AlmeriaStarted 2026-06-01
tributyrinPlacebo
PeriodontitisEnd-stage Renal Disease

The Role of Toll-like Receptor-4 in Periodontitis Patients With End-stage Renal Disease in a Sample of Egyptian Population

RECRUITING
NCT06755372Ain Shams UniversityStarted 2025-04-01
PeriodontitisGingivitisPeriodontal Diseases

Evaluation of the Effect of Smoking on Pyroptosis in Periodontal Pathogenesis

ACTIVE NOT RECRUITING
NCT07563192Suleyman Demirel UniversityStarted 2024-10-15
Chronic PainLiving Kidney DonorQuadratus Lumborum Block

The Effect of Quadratus Lumborum (QL) Block on the Incidence of Chronic Neuropathic Pain After Retroperitoneal Laparoscopic Donor Nephrectomy: A Study on Neuroinflammation and Neurophysiology

NOT YET RECRUITING
NCT07037992Phase NAIndonesia UniversityStarted 2025-07-01
injection of local anesthesia solutionInjection of normal saline
NASH - Nonalcoholic Steatohepatitis

A Randomized, Double-Blind, Placebo Controlled Study to Assess the Efficacy and Safety of SNP-610 for the Treatment of Patients With Non-alcoholic Steatohepatitis

NOT YET RECRUITING
NCT03468556Phase PHASE2Sinew Pharma Inc.Started 2026-04-01
SNP-610Placebo Oral Tablet
PreDiabetesDysbiosisEndotoxemia

Assessing Gut Microbiota Mediated Health Outcomes of Whole Wheat and Its Major Bioactive Components

ACTIVE NOT RECRUITING
NCT05318183Phase NAOhio State UniversityStarted 2022-01-27
Whole Wheat BreadWhite Bread (control)
AsthmaAtherosclerosisMetabolic Syndrome

Study of the Effect of Innate on the Inflammatory Response to Endotoxin

RECRUITING
NCT01143480National Institute of Environmental Health Sciences (NIEHS)Started 2012-07-30
Inflammatory Cytokine Expression

Effects of Propolis Flavonoids on TLR4 Signaling and Inflammation in Human PDLSCs In Vitro

NOT YET RECRUITING
NCT07367451Cairo UniversityStarted 2026-01-25
Flavonoid extract from propolisno medication added
Maternal ObesityObesity

The Developmental Origins of Obesity

RECRUITING
NCT06981676Phase NAPontificia Universidad Catolica de ChileStarted 2023-07-25
DHA and EPA
Clinical Literature
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