Thus, we propose a mechanism that, in the early stage of diabetes, a leakage of albumin into the renal tubules upregulates TLR2 and TLR4 and induces HSP70 release and TLR4 activation, leading to a more severe injury and a stronger inflammatory response in the tubule and interstitium (summarized in Fig. 5D). This evidence concerns the gene ALB and diabetes mellitus.