In addition to nicotine inducing acinar cell de-differentiation in these models, it was shown that nicotine could enhance pancreatic progenitor cell activity through upregulation of the stem cell genes/markers Sox9 and ALDH, and could also enhance pancreatic cancer stem cell populations through the upregulation of Sox9, Oct3/4, and ALDH [45]. Here, LDHA is linked to familial pancreatic carcinoma.