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During fibrosis of renal proximal tubules, increased expression of HIF-1 leads to cellular metabolic reprogramming from FAO to glycolysis along with lipid accumulation [64, 65]

Notably, omniligase-1, a broad-specificity ligase engineered from subtilisin BPN, was successfully used to synthesize exenatide, and peptiligase has been applied for gram-scale quantities of therapeutic peptides such as thymosin-1, exenatide, and the kalata B1 variant T20K

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