Moreover, it has been shown that activation of TLR4 in MM cells can reduce the response to bortezomib (27, 28, 30) and the anthracycline adriamycin (29), while TLR7 and TLR9 activation has been shown to reduce the sensitivity to dexamethasone (25) in vitro. This evidence concerns the gene TLR9 and Miyoshi myopathy.