To date, only one study has highlighted the effects of PDA tumor cells derived-EVs on MCs, resulting in their activation via EV-cell membrane receptor-mediated activation of ERK-1,2 signaling, leading to the upregulation of tissue-remodeling genes and the secretion of IL-6, IL-8, and VEGF [137]. Here, MAPK3 is linked to Patent ductus arteriosus.