The Science and Translation of Lactate Shuttle Theory

Publication date: 3 April 2018
Source:Cell Metabolism, Volume 27, Issue 4
Author(s): George A. Brooks
Once thought to be a waste product of anaerobic metabolism, lactate is now known to form continuously under aerobic conditions. Shuttling between producer and consumer cells fulfills at least three purposes for lactate: (1) a major energy source, (2) the major gluconeogenic precursor, and (3) a signaling molecule. "Lactate shuttle" (LS) concepts describe the roles of lactate in delivery of oxidative and gluconeogenic substrates as well as in cell signaling. In medicine, it has long been recognized that the elevation of blood lactate correlates with illness or injury severity. However, with lactate shuttle theory in mind, some clinicians are now appreciating lactatemia as a "strain" and not a "stress" biomarker. In fact, clinical studies are utilizing lactate to treat pro-inflammatory conditions and to deliver optimal fuel for working muscles in sports medicine. The above, as well as historic and recent studies of lactate metabolism and shuttling, are discussed in the following review.

Teaser

Though originally thought of as a metabolic waste product and fatigue agent, lactate can now be regarded as the link between glycolytic and aerobic pathways. From its discovery to more recent clinical applications, Brooks provides a comprehensive look at lactate metabolism and shuttling in both basic physiology and medicine.


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