Type 2 diabetes (T2DM) is characterized by hyperglycemia, dyslipidemia, and increased inflammation. Previously, we showed that high glucose (HG) induces Toll-like receptor (TLR) expression, activity, and inflammation via NF-B followed by cytokine release in vitro and in vivo. Here, we determined how HG-induced inflammation is affected by free fatty acids (FFA) in human monocytes. THP-1 monocytic cells, CD14 ϩ human monocytes, and transiently transfected HEK293 cells were exposed to various FFA (0 -500 M) and glucose (5-20 mM) for evaluation of TLR2, TLR4, NF-B, IL-1, monocyte chemoattractant protein-1 (MCP-1), and superoxide release. In THP-1 cells, palmitate increased cellular TLR2 and TLR4 expression, generated reactive oxygen species (ROS), and increased NF-B activity, IL-1, and MCP-1 release in a dose-and time-dependent manner. Similar data were observed with stearate and FFA mixture but not with oleate. Conversely, NADPH oxidase inhibitor treatment repressed glucoseand palmitate-stimulated ROS generation and NF-B activity and decreased IL-1 and MCP-1 expression. Silencing TLR2, TLR4, and p47phox with small inhibitory RNAs (siRNAs) significantly reduced superoxide release, NF-B activity, IL-1, and MCP-1 secretion in HG and palmitate-treated THP-1 cells. Moreover, data from transient transfection experiments suggest that TLR6 is required for TLR2 and MD2 for TLR4 to augment inflammation in FFA-and glucoseexposed cells. These findings were confirmed with human monocytes. We conclude that FFA exacerbates HG-induced TLR expression and activity in monocytic cells with excess superoxide release, enhanced NF-B activity, and induced proinflammatory factor release.palmitate; hyperglycemia; Toll-like receptor 2; Toll-like receptor 4 THE LEVELS OF PLASMA free fatty acids (FFA) and glucose are elevated in obesity and type 2 diabetes (T2DM) and are implicated in the excess cardiovascular disease (CVD) risk associated with diabetes (15). Cell culture and animal studies have established chronic inflammation in the development and progression of insulin resistance (IR) and T2DM (29). In parallel, epidemiologic studies showed elevated plasma levels of C-reactive protein (CRP), serum amyloid A, cytokines, and chemokines as potential mediators of inflammation and predictors of CVD in T2DM patients (28). Monocytes and macrophages are pivotal cells orchestrating the development of IR and CVD (4). They are closely linked to the chronic inflammatory processes that underline IR, T2DM, and atherosclerosis (27). Proinflammatory factors derived from them have deleterious effects in the development and progression of IR and diabetes (27). Thus the mechanisms by which these metabolic abnormalities (dyslipidemia and hyperglycemia) contribute to systemic inflammation are essential for understanding of the pathophysiology of IR, T2DM, and CVD.Activation of the innate immune system via Toll-like receptors (TLRs) is implicated in a plethora of inflammatory diseases (8,33,36,41). TLRs are evolutionarily conserved pattern recognition recep...