On the other hand, Sobrino and coworkers [37] have recently proved overexpression of Toll-like receptors 2 (TLR2) and 4 (TLR4) in monocytes and neutrophils of KC patients and higher serum levels of interleukin-1B (IL-1B), IL-6, tumour necrosis factor-α, MMP-9, the main inflammatory mediators found at corneal epithelium and tear film. This evidence concerns the gene MMP9 and keratoconus.