The result was consistent with a previous study by Miyahara et al, who demonstrated that the mechanism of jaundice in leptospirosis is invasion of Disse’s space by the Leptospira, causing detachment of intercellular junctions between hepatocytes and destruction of bile canaliculi.51 In this study, there was markedly elevated expression of the cytokines TNF-α, IL-1β and IL-6 at the early stage of infection in the liver of WT mice compared with TLR4−/− mice. Here, TLR4 is linked to infection.