This activation of TLR8 triggers NF-κB expression, which leads to pro-metastatic inflammatory responses, LC progression, and metastasis.154 Studies have demonstrated that LCEVS, under hypoxic conditions, contains miR-619-5p, which promotes angiogenesis by suppressing RCAN1.4.155 TDEVs have been shown to establish an immune-suppressive environment by polarizing macrophages in LC. Here, RCAN1 is linked to laryngotracheoesophageal cleft.