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In our model, depletion of Hypoxia-Inducible Factor 1 alpha (HIF-1) impaired the effects of Exendin-4 on glucose metabolism, while pharmacological inhibition of Phosphoinositide 3-kinase (PI3K) or mTOR completely abolished such effects
doi: 10.1128/EC.00007-09 49 YurimotoH.OkuM.SakaiY
Functional studies have demonstrated that lncRNA PVT1 could reduce GEM-reduced apoptosis and attenuate GEM-induced tumor growth inhibition in vitro and in vivo
That also explains why the effect is dose-related and why it concentrates around increases
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