TLR4 and spinal cord ischemia: In addition, some studies have reported that DEX preconditioning effectively reduces the inflammatory response of myocardial, renal and spinal cord ischemia by downregulation of high-mobility group protein B1 (HMGB1)/toll-like receptor 4 (TLR4) pathways (Gu et al., 2011; Rong et al., 2017; Yang et al., 2017).