Fig. 6.

A scheme of possible mechanisms for DPP4i-induced HCC prevention. DPP4i may downregulate the p62/Keap1/Nrf2 pathway in HCC, leading to suppression of the pentose phosphate pathway. Lower adenine and guanine levels, end products of the pentose phosphate pathway, may inhibit HCC progression through the suppression of nucleic acid production. DPP4i, dipeptidyl peptidase-4 inhibitor; HCC, hepatocellular carcinoma; Glu, glucose; P, phosphate; TCA, tricarboxylic acid cycle; AMP, adenosine monophosphate; GMP, guanosine monophosphate.