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Additionally, physical activity has been associated with modest enhancements in GLP-1 responses to meals in some studies, though the effects are variable

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Lactate further inhibits the antitumor activity of T cells by upregulating immune checkpoint molecules like PD-L1, providing an important metabolic basis for tumor immune escape through this multiple-action mechanism (86)

Further reciprocal mutagenesis studies will be required to identify key interactions responsible for the contrasting effects of exendin-phe1, exendin-asp3 and other analogs, facilitating future design of agonists with even greater selectivity

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