TLR4 and gestational diabetes: TLR4 and the downstream MyD88 always lead to activation of NF-κB and the transcription of many genes involved in the inflammatory response.[20] The expression levels of TLR4 mRNA and MyD88 mRNA were significantly increased in GDM placentas compared with the normal group (TLR4: normal = 0.74 ± 0.10, GDM = 2.62 ± 0.20, P < .01; MyD88: normal = 0.79 ± 0.10, GDM = 1.38 ± 0.20; n = 3 in each group.