TLR4 and diabetes mellitus: Given that (1) dysbiosis and intestinal hyper-permeability have been associated with T1D22–25; and (2) modulation of the gut microbiota normalizes the endogenous innate state, lowers plasma TLR4 ligand levels, and delays/prevents diabetes in BB rats36, we reasoned that probiotic supplementation may lower systemic inflammation in unaffected siblings of T1D patients.