The mRNAs of other genes such as CREB1, FASN, LGALS4, PTGS1, SCAF11, TNFRSF10D, and USP5 were differentially downregulated in EVs from the three stages of PC patients compared to healthy subjects at an average of -20 to -90 fold (Figure 4-Group1). Here, CREB1 is linked to pachyonychia congenita.