In systemic sclerosis, tissue damage has been shown to amplify fibrosis through the TLR4/myeloid differentiation factor 2 (MD2) complex and its endogenous DAMP ligands, as demonstrated by augmented MD2 and TLR4 expression in skin biopsies from patients and by reduction of fibrosis upon MD2/TLR4 blockade in the animal model.7 Here, TLR4 is linked to systemic sclerosis.