Second, long-term exercise-derived exosomal miR-342-5p not only targets the Caspase-9 and JNK2 pathways but also enhances survival signaling (p-Akt) by targeting the phosphatase gene Ppm1f to protect the heart from MI/R injury (Hou et al., 2019). Here, CASP9 is linked to myocardial infarction.