Links between CD39 and purinergic mediators with metabolism have been reported before in the context of hepatocellular carcinoma, where Cd39 deficiency was associated with increased production of lactate38; and in liver inflammation, where low CD39 and CD73 levels were noted in combination with upregulated hexokinase 2, pyruvate kinase M2 (PKM2) and lactate dehydrogenase39. Here, PKM is linked to hepatocellular carcinoma.