ADAM9 also stimulates the inflammatory process through polymorphonuclear leukocytes, macrophages, and epithelial cells in some inflammatory diseases, such as acute lung injury or chronic obstructive pulmonary disease.[29] Notably, toll-like receptors (TLRs), as key recognition receptors in the innate immune system, may play a significant role in immune regulation of pediatric sepsis. The gene discussed is ADAM9; the disease is chronic obstructive pulmonary disease.