Tumor derived lactate also significantly inhibits monocyte TNF-α secretion, impairs monocyte glycolytic flux, stimulates macrophage VEGF and TGFβ, up regulates monocyte IL-23 production, and inhibits the differentiation of monocytes to dendritic cells (Dietl et al., 2010; Goetze et al., 2011). The gene discussed is VEGFA; the disease is neoplasm.