AKT1 and cancer: Exosomes, derived from esophageal squamous cell carcinoma cells in hypoxic conditions, contained hsa-circ-0048117 [22], which can mediate TLR4 activation, and miR-21-5p, which mediated downregulation of PTEN in cancer cells and co-cultured macrophages, resulting in activation of PI3K/AKT/STAT6 signaling pathway and polarization of macrophages towards M2.