In acute pancreatitis, Metastasis-associated lung adenocarcinoma transcript-1 (MALAT1) embedded in EVs competitively binds to miR-181a-5p and induces M1 macrophages, further regulating high mobility group box protein-1 (HMGB1)-TLR4 signaling pathway, thereby upregulating TNF-α and IL-6 levels [42]. This evidence concerns the gene MALAT1 and acute pancreatitis.