TLR4 and scleroderma: DAMP activated TLR4 signaling has been linked to fibrosis and the regulation and production of ECM proteins in hepatic fibrosis, renal fibrosis, lesional skin and lung in scleroderma patients, and most important to the work presented here we have linked DAMP activated TLR4 to TM damage and ocular hypertension [13, 27–30].