TLR4 and neoplasm: The identification of elastase in NS cHL is particularly significant given its proinflammatory and pleiotropic effects in tumor growth.22 Accordingly, elastase remodels the matrix and activates dormant tumor cells,36 or engages the TLR4-p38-PGC-1α axis resulting in increased proliferation and survival of cancer cells.37 Furthermore, elastase proteolytically processes IL-1 family members into active forms and acts as a PAR-2 agonist, with generation of IL-6, IL-8, and IL-1β with upregulation of adhesion/integrin receptors.