AKT1 and myocardial infarction: Additionally, previous studies have shown that MIF is an upstream regulator of AMPK and cardioprotection (51, 52); sustained exogenous administration of recombinant MIF efficiently activates AMPK phosphorylation and prevents hearts from ischemic injury (37, 53); MIF-engineered mesenchymal stem cells derived exosomes significantly activated the AKT signaling pathway, one of AMPK downstream pathways, and ameliorated cardiomyocyte apoptosis and cardiac dysfunction in rats with myocardial infarction (54).