This suggests that macrophages have the ability to activate fibroblasts and improve the range of data showing macrophages as an important mediator of PDA progression and gemcitabine resistance.33 An in-depth analysis of the activation mode of those macrophages could be carried out to determine whether in our model IL-6 secretion is also responsible for macrophage changes and also to determine the phenotypic changes of these macrophages together with clinical correlation and patient's survival/status. Here, IL6 is linked to Patent ductus arteriosus.