This is the first study analyzing simultaneously the expression pattern of TLR4, TLR5 and TLR9 in human gastric biopsies from paired cases collected in two independent visits separated by 3 years, and correlating with the H. pylori status and histological assessment of atrophy and intestinal metaplasia by Operative Link for Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia (OLGIM) scoring. The gene discussed is TLR4; the disease is gastritis.