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Hypoxic lung cancer-derived exosomes increased M2-type macrophage polarization via miR-103a transfer. Exosomal miR-103a decreases the level of PTEN in CD14+ monocytes, allowing the activation of the Pi3K/AKT and STAT3 signaling pathways (denoted by the red ++) and the polarization of macrophages towards the pro-tumoral M2 phenotype with IL-10, CCL18, and VEGF-A secretion, thus promoting cancer migration, invasion, and angiogenesis.
