A study published in 2018 by Miller George et al. found that bacterial ablation was linked to immunogenic reprogramming of the PDA tumor microenvironment, involving reduced myeloid-derived suppressor cells as well as increased differentiation of M1 macrophages, enhancing CD1+ T cell TH4 differentiation and the activation of CD8+ T cells, demonstrating that the apparent dysbiosis of bacterial ecology associated with PDA leads to innate and adaptive immune suppression (Pushalkar et al., 2020). This evidence concerns the gene CD8A and neoplasm.