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Of note, neuronal-derived exosomes from patients who participated in this phase II trial had higher levels of insulin receptor substrate 1 (IRS-1) phosphorylation at tyrosine sites and higher levels of phosphorylated mTOR and phosphoinositide-3-kinase/Akt (PI3K/AKT) expression in PD patients treated with exenatide compared to the placebo group [75]