TLR4 and ventilator-associated pneumonia: This reduction was even more obvious when individuals were assessed for combined double mutations with TIRAP. Unlike Kumpf et al. who showed that combination of TLR4 and TIRAP SNPs was associated with low circulating levels of IL-6 in adult patients with ventilator-associated pneumonia (36), we observed instead significantly reduced IL-6 levels in TLR1 or TLR6 and TIRAP double-mutant children following Pam3CSK4 stimulation.