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It accumulates at high concentrations under hypoxic conditions, inducing A2AR to impair the function and proliferation of T and NK cells, while also stimulating the expression of Foxp3 in Treg cells, leading to immune evasion in cancer and resulting in adverse clinical outcomes (187)

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Specifically, EGFR activation triggers ERK-mediated phosphorylation and nuclear translocation of ACSS2, which binds to KAT2A, functioning as a lactyltransferase to promote H3K14/18la and facilitating Wnt/b-catenin, NF-kB, and PD-L1 expression

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