RNF43 and pancreatic ductal adenocarcinoma: However, several studies now also support an important immunomodulatory role for RNF43. For example, in a transgenic mouse model of early pancreatic ductal adenocarcinoma (PDAC), the loss of RNF43 accelerated the formation of high-grade cystic lesions and led to extensive immune remodeling in the form of decreased macrophage infiltration, increased T- and B-cell infiltration, and enhanced expression of immune checkpoints.