Potential mediators may be inflammatory cytokines that are known to be increased in the serum of PaCa patients, and are also released from PaCa cells such as interleukin (IL)-1β, IL-6, IL-8, tumour necrosis factor-alpha (TNF-α), and transforming growth factor-β (TGF-β) [41]. This evidence concerns the gene TNF and permanent neonatal diabetes mellitus-pancreatic and cerebellar agenesis syndrome.