Lactate: A key metabolite in the intercellular metabolic interplay

Xavier M Leverve, Iqbal Mustafa, Xavier M Leverve, Iqbal Mustafa

Abstract

Most physicians involved in intensive care consider lactate solely as a deleterious metabolite, responsible for high morbidity and bad prognosis in severe patients. For the physiologist, however, lactate is a key metabolite, alternatively produced or consumed. Many studies in the literature have infused animals or humans with exogenous lactate, demonstrating its safety and usefulness, but the bad reputation of lactate is still widespread. The metabolic meaning of glucose–lactate cycling exceeds its initial role described by Cori and Cori. According to recent works concerning lactate, it can be predicted that a new role as a therapeutic agent will arise for this metabolite.

References

    1. Cano N. Bench-to-bedside review: Glucose production from the kidney. Critical Care. 2002;6:317–321.
    1. Bellomo R. Bench-to-bedside review: Lactate and the kidney. Critical Care. 2002;6:322–326.
    1. Iscra F, Gullo A, Biolo G. Bench-to-bedside review: Lactate and the lung. Crit Care. 2002;6:327–329.
    1. Schurr A. Bench-to-bedside review: A possible resolution of the glucose paradox of cerebral ischemia. Crit Care. 2002;6:330–334.
    1. Bakker J, Coffernils M, Leon M, Gris P, Vincent JL. Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest. 1991;99:956–962.
    1. Marecaux G, Pinsky M, Dupont E, Kahn R, Vincent J. Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock. Intensive Care Med. 1996;22:404–408.
    1. Bellomo R. Lactic acidosis, sepsis, and anaerobic glycolysis: a continuing controversy. Crit Care Shock. 1998;1:102–108.
    1. Chiolero R, Tappy L, Gillet M, Revelly JP, Roth H, Cayeux C, Schneiter P, Leverve X. Effect of major hepatectomy on glucose and lactate metabolism. Ann Surg. 1999;229:505–513. doi: 10.1097/00000658-199904000-00009.
    1. Chiolero RL, Revelly JP, Leverve X, Gersbach P, Cayeux MC, Berger MM, Tappy L. Effects of cardiogenic shock on lactate and glucose metabolism after heart surgery. Crit Care Med. 2000;28:3784–3791.
    1. King P, Kong MF, Parkin H, MacDonald IA, Barber C, Tattersall RB. Intravenous lactate prevents cerebral dysfunction during hypoglycaemia in insulin-dependent diabetes mellitus. Clin Sci (Colch) 1998;94:157–163.
    1. Levraut J, Ciebiera JP, Chave S, Rabary O, Jambou P, Carles M, Grimaud D. Mild hyperlactatemia in stable septic patients is due to impaired lactate clearance rather than overproduction. Am J Respir Crit Care Med. 1998;157(4 part 1):1021–1026.
    1. Mustafa I, Leverve X. Metabolic and hemodynamic effects of hypertonic solutions: sodium lactate versus sodium chloride infusion in postoperative patients. Shock. 2002.
    1. Veneman T, Mitrakou A, Mokan M, Cryer P, Gerich J. Effect of hyperketonemia and hyperlacticacidemia on symptoms, cognitive dysfunction, and counterregulatory hormone responses during hypoglycemia in normal humans. Diabetes. 1994;43:1311–1317.
    1. Miles MP, Clarkson PM. Exercise-induced muscle pain, soreness, and cramps. J Sports Med Phys Fitness. 1994;34:203–216.
    1. Spurway NC. Aerobic exercise, anaerobic exercise and the lactate threshold. Br Med Bull. 1992;48:569–591.
    1. Leverve X, Mustafa I, Péronnet F. Pivotal role of lactate in aerobic metabolism. In: Vincent J, editor. In Yearbook of Intensive Care and Emergency Medicine. Berlin: Springer-Verlag; 1998. pp. 588–596.
    1. Leverve XM. Energy metabolism in critically ill patients: lactate is a major oxidizable substrate. Curr Opin Clin Nutr Metab Care. 1999;2:165–169. doi: 10.1097/00075197-199903000-00013.
    1. Leverve X, Mustafa I. From cellular pathways to in vivo considerations (in healthy subject and critically ill patients). Crit Care Shock. 1998;1:89–95.
    1. Sekine N, Cirulli V, Regazzi R, Brown LJ, Gine E, Tamarit-Rodriguez J, Girotti M, Marie S, MacDonald MJ, Wollheim CB. Low lactate dehydrogenase and high mitochondrial glycerol phosphate dehydrogenase in pancreatic beta-cells. Potential role in nutrient sensing. J Biol Chem. 1994;269:4895–4902.
    1. Joseph SE, Heaton N, Potter D, Pernet A, Umpleby MA, Amiel SA. Renal glucose production compensates for the liver during the anhepatic phase of liver transplantation. Diabetes. 2000;49:450–456.
    1. Schurr A, Payne RS, Miller JJ, Rigor BM. Brain lactate is an obligatory aerobic energy substrate for functional recovery after hypoxia: further in vitro validation. J Neurochem. 1997;69:423–426.
    1. Schurr A, Payne RS, Miller JJ, Rigor BM. Brain lactate, not glucose, fuels the recovery of synaptic function from hypoxia upon reoxygenation: an in vitro study. Brain Res. 1997;744:105–111.
    1. Schurr A, Rigor BM. Brain anaerobic lactate production: a suicide note or a survival kit? Dev Neurosci. 1998;20:348–357.
    1. Magistretti PJ, Pellerin L. Metabolic coupling during activation. A cellular view. Adv Exp Med Biol. 1997;413:161–166.
    1. Tascopoulos M, Magistretti PJ. Metabolic coupling between glia and neurons. J Neurosci. 1996;16:877–885.
    1. Kline JA, Thornton LR, Lopaschuk GD, Barbee RW, Watts JA. Lactate improves cardiac efficiency after hemorrhagic shock. Shock. 2000;14:215–221.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera