Intratumoural microbiota reprograms the TME of PDA by modulating the PDA microbiome, which reduces MDSCs and increases M1 macrophage differentiation, resulting in increased Th1 differentiation of CD4 + T cells and CD8 + T cell activation, ultimately enhancing the efficacy of immunotherapy [22]. The gene discussed is CD4; the disease is Patent ductus arteriosus.