A research team from China investigated the expression of toll-like receptor (TLR) 4, nuclear factor-kB (NF-kB) p65 and hypoxiainducible transcription factor 1a (HIF-1a) in pancreatic ductal adenocarcinoma (PDAC) and their clinical significance. Their results demonstrated that TLR4, NF-kB p65 and HIF-1a are overexpressed in PDAC, TLR4 may be partly involved in up-regulating HIF-1a, and both synergestically promote development of PDAC.