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Following receptor binding, intracellular signaling begins within hypothalamic appetite-regulation centers that influence satiety-related neuropeptide activity

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For example, in tubular epithelial cells exposed to high glucose, Exendin-4 reduced TGF--induced fibronectin and COL1A1 expression and decreased secretion of the microRNA miR192, which is implicated in kidney fibrosis, pro-fibrotic microRNA-192, a mediator implicated in renal fibrosis [59]