A further study by Al-Wadei et al. showed that propranolol prevents PC development in hamsters with ethanol-induced pancreatitis by nicotine-derived nitrosamine (NNK), a beta-adrenergic agonist, through a mechanism involving the block of cAMP-dependent release of EGF and VEGF, the down-regulation of the α7nicotinic acetylcholine receptor (α7nAChR), as well as the extracellular signal regulated protein kinases (ERK1/2) and p-CREB [77]. This evidence concerns the gene CREB1 and pachyonychia congenita.