Liu et al. also found that ERS-induced exosomes derived from HCC cells contain high levels of miR-23a-3p, which upregulates the expression of PD-L1 in macrophages by activating the PTEN/AKT pathway, thus reducing the ratio of CD8+ T cells and promoting T cell apoptosis (38). Here, AKT1 is linked to hepatocellular carcinoma.