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In the early stage of tumor colonization or growth, activated immune cells contribute to a tumor-suppressive inflammatory microenvironment that hinders tumor development, whereas long-term persistent antigenic stimulation, the activation of immunosuppressive cells and metabolic stress prompt the tumor to escape from the surveillance of the immune system and continue to grow, which is known as immune escape of the tumor (70,71)

Obesity, currently defined as a body mass index (BMI) of 30 kg/m 2 or greater, affects 800 million people worldwide [1]

FIGURE 2 2.1.1 Calcium channel modulation Recent research has shown that exendin-4, a GLP-1RA, suppresses L-type voltage-gated calcium channels (L-VGCC) activity through a cascade involving cAMP/PKA, ryanodine receptors, and calmodulin (CaM)

For the side effect phenotypes, we defined separate casecontrol phenotypes for each side effect recorded in the survey, contrasting those who self-rated their side effects as moderate or severe (cases) to those who self-rated their side effects as mild or non-existent (controls)