These were still significant, in multiple regression analysis including sex, age, tuberculosis history, smoking history and inhaled corticosteroid (ICS) usage within 3 months, which could affect pulmonary function and emphysema development[24-26]; β of TLR4 expression = 0.11 (95% confidence interval [CI] 0.007–0.22) for FEV1/FVC (P = 0.04) and −0.41 (95% CI = −13.1– -3.00) for emphysema score (P = 0.002). This evidence concerns the gene TLR4 and pulmonary emphysema.