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VEGF, in addition to acting as a mitogenic signal for vascular endothelial cells, protects tumor vasculature from apoptosis by inducing anti-apoptotic factors, mediates the activation of extracellular matrix degrading enzymes, and promotes tumor-immune evasion by recruiting immunosuppressive cells such as Tregs, TAMs, and MDSCs
Instead, it appears to work indirectly by stimulating release of met-enkephalin, one of the body's natural opioid peptides
