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Mechanism involves NO system modulation (homeostatic regulationupregulating when deficient, moderating when excessive), VEGF/VEGFR2 upregulation for angiogenesis, FAK-paxillin pathway activation for cell migration (40% increase per Chang et al.), and EGR-1 transcription factor upregulation for growth factor sensitivity

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Furthermore, GPR81 modulates the expression of lactate-handling genes such as MCT1/4, indicating its feedback control over both lactate signaling and transport [204]

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