Interestingly, according to the reverse Warburg effect, these immune cells of recruited TAMs may also up-regulate MCT4 in an HIF-1α/NF-κB dependent manner, resulting in increased synthesis and export of lactate that may exacerbate the acidity of the tumor microenvironment and further enhance the glycolytic capacity of GBM cells [111, 147, 165]. Here, HIF1A is linked to glioblastoma.