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First, GLP-1RA can activate the first messenger adenylate cyclase (AC) after binding to the receptor, which stimulates an increase in the secretion level of the intracellular second messenger cyclic adenosine phosphate (cAMP) and subsequently activates the intracellular secondary messenger protein kinase A (PKA) ( Figure 1 For example, after GLP-1RA stimulates the activation of AC (56)