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Also, in the late phase of M1 macrophage polarization, lactate-derived lactylation of histone lysine residues as observed in conditions of hypoxia and bacterial challenges served as an epigenetic modification that directly stimulated the expression of homeostatic genes that have been traditionally associated with M2-like macrophages (Zhang et al., 2019)

lung diseases such as asthma, acute respiratory distress syndrome and chronic obstructive pulmonary disease

Subsequent studies, such as NCT03714555 in metastatic pancreatic cancer, have continued to explore this combination in specific GI tumor contexts

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