Most studies have concerned intra-cellular TLRs, such as TLR-3, TLR-7 and TLR-9, but recent studies have also shown that cell-surface TLRs, especially TLR-2 and TLR-4, play an equally important role in the development of autoimmune diseases [16]; however, relevant studies have not been conducted so far in women with GD. Here, TLR4 is linked to autoimmune disease.