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=== Mechanism of action === The transcription factors serve as a short term trigger to an irreversible process. The transdifferentiation liver cells observed 8 months after one single injection of pdx1.<ref name="nature.com"/> The ectopic transcription factors turn off the host repertoire of gene expression in each of the cells. However, the alternate desired repertoire is being turned on only in a subpopulation of predisposed cells.<ref>{{Cite journal | last1 = Meivar-Levy | first1 = I. | last2 = Sapir | first2 = T. | last3 = Gefen-Halevi | first3 = S. | last4 = Aviv | first4 = V. | last5 = Barshack | first5 = I. | last6 = Onaca | first6 = N. | last7 = Mor | first7 = E. | last8 = Ferber | first8 = S. | doi = 10.1002/hep.21766 | title = Pancreatic and duodenal homeobox gene 1 induces hepatic dedifferentiation by suppressing the expression of CCAAT/enhancer-binding protein Ξ² | journal = Hepatology | volume = 46 | issue = 3 | pages = 898β905 | year = 2007 | pmid = 17705277 | doi-access = free }}</ref> Despite the massive dedifferentiation β lineage tracing approach indeed demonstrates that transdifferentiation originates in adult cells.<ref>{{Cite journal | last1 = Mauda-Havakuk | first1 = M. | last2 = Litichever | first2 = N. | last3 = Chernichovski | first3 = E. | last4 = Nakar | first4 = O. | last5 = Winkler | first5 = E. | last6 = Mazkereth | first6 = R. | last7 = Orenstein | first7 = A. | last8 = Bar-Meir | first8 = E. | last9 = Ravassard | first9 = P. | last10 = Meivar-Levy | first10 = I. | last11 = Ferber | first11 = S. | editor1-last = Linden | editor1-first = Rafael | title = Ectopic PDX-1 Expression Directly Reprograms Human Keratinocytes along Pancreatic Insulin-Producing Cells Fate | doi = 10.1371/journal.pone.0026298 | journal = PLOS ONE | volume = 6 | issue = 10 | pages = e26298 | year = 2011 | pmid = 22028850 | pmc =3196540 | bibcode = 2011PLoSO...626298M | doi-access = free }}</ref>
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