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This is due to its ability to regulate the expression of many molecular targets such as VEGF-A/VEGFR2 pathway, p38MAPK/ERK-1/2/PI3K/protein kinase B (AKT), HIF-1, IL-1, IL-2, IL-6, IL-8, IL-10, IL-17A, IL-18, IL-33, TNF-, NF-kB, IFN-, IGF-1-induced activation of IGF-1R, ER-, and ER- receptors, miR-95, miR-103, miRNA-138, miRNA-155, miR-183, miR-223, MMP-1, MMP-2, MMP-3, MMP-9, lncRNA-MEG3, lncRNA-H19, Ang-1 mRNA, Ang-2 mRNA, mRNA of urokinase plasminogen activator, mRNA expression and secretion of leptin, CD31, Tie-2, MCP-1 mRNA and protein, HGF, Nrf2, HO1, Keap1, COX-2, PGE-2, MKNK1, and human DNA TOP3A

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However, sustained ERS may also promote immune escape through exosomal miR-27a-mediated PD-L1 upregulation [110], underscoring the importance of temporally controlled therapeutic strategies

Some studies indicate that l-carnitine could have a positive effect on weight loss through fat oxidation and energy expenditure