Similarly, hypoxia induced the upregulation of angiopoietin-like 4 (ANGPTL4), HIF-1α/COX-2 and miR-135b and miR-210 in the exosome cargo of A549 cells, exosome transfer of these factors to other A549 cells led to the enhanced proliferation, migration, angiogenesis, and tumor progression (80, 84). This evidence concerns the gene HIF1A and neoplasm.