Tracing the lactate shuttle to the mitochondrial reticulum

Lactate-induced lactylation and cardiometabolic diseases: From epigenetic regulation to therapeutics

Cardiometabolic diseases (CMDs) denote a cadre of chronic and devastating cardiovascular anomalies routed from metabolic derangements including obesity, type 2 diabetes mellitus, and hypertension. Recent studies have demonstrated the association between histone lactylation, a unique form of post-translational modification, and pathogenesis of CMDs, apparently through epigenetic mechanisms. Lactylation has been indicated to regulate key aspects of metabolism, inflammation, and cardiovascular function in the realm of CMDs in a cellular and tissue-specific manner. A better understanding of the molecular, cellular and physiological domains of lactylation in the etiology of CMDs is expected to offer new insights into etiopathogenesis, hazardous factor control and therapeutic development for these challenging ailments.

PGC-1α/LDHA signaling facilitates glycolysis initiation to regulate mechanically induced bone remodeling under inflammatory microenvironment

The mechanosensitivity of inflammation can alter cellular mechanotransduction. However, the underlying mechanism remains unclear. This study aims to investigate the metabolic mechanism of inflammation under mechanical force to guide tissue remodeling better. Herein, we found that inflammation hindered bone remodeling under mechanical force, accompanied by a simultaneous enhancement of oxidative phosphorylation (OXPHOS) and glycolysis. The control of metabolism direction through GNE-140 and Visomitin revealed that enhanced glycolysis might act as a compensatory mechanism to resist OXPHOS-induced osteoclastogenesis by promoting osteogenesis. The inhibited osteogenesis induced by inflammatory mechanical stimuli was concomitant with a reduced expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). PGC-1α knockdown impeded osteogenesis under mechanical force and facilitated osteoclastogenesis by enhancing OXPHOS. Conversely, PGC-1α overexpression attenuated the impairment of bone remodeling by inflammatory mechanical signals through promoting glycolysis. This process benefited from the PGC-1α regulation on the transcriptional and translational activity of lactate dehydrogenase A (LDHA) and the tight control of the extracellular acidic environment. Additionally, the increased binding between PGC-1α and LDHA proteins might contribute to the glycolysis promotion within the inflammatory mechanical environment. Notably, LDHA suppression effectively eliminated the bone repair effect mediated by PGC-1α overexpression within inflammatory mechanical environments. In conclusion, this study demonstrated a novel molecular mechanism illustrating how inflammation orchestrated glucose metabolism through glycolysis and OXPHOS to affect mechanically induced bone remodeling.

Human cardiac metabolism

The heart is the most metabolically active organ in the human body, and cardiac metabolism has been studied for decades. However, the bulk of studies have focused on animal models. The objective of this review is to summarize specifically what is known about cardiac metabolism in humans. Techniques available to study human cardiac metabolism are first discussed, followed by a review of human cardiac metabolism in health and in heart failure. Mechanistic insights, where available, are reviewed, and the evidence for the contribution of metabolic insufficiency to heart failure, as well as past and current attempts at metabolism-based therapies, is also discussed.

Lactate transported by MCT1 plays an active role in promoting mitochondrial biogenesis and enhancing TCA flux in skeletal muscle

Once considered as a "metabolic waste," lactate is now recognized as a major fuel for tricarboxylic acid (TCA) cycle. Our metabolic flux analysis reveals that skeletal muscle mainly uses lactate to fuel TCA cycle. Lactate is transported through the cell membrane via monocarboxylate transporters (MCTs) in which MCT1 is highly expressed in the muscle. We analyzed how MCT1 affects muscle functions using mice with specific deletion of MCT1 in skeletal muscle. MCT1 deletion enhances running performance, increases oxidative fibers while decreasing glycolytic fibers, and enhances flux of glucose to TCA cycle. MCT1 deficiency increases the expression of mitochondrial proteins, augments cell respiration rate, and elevates mitochondrial activity in the muscle. Mechanistically, the protein level of PGC-1α, a master regulator of mitochondrial biogenesis, is elevated upon loss of MCT1 via increases in cellular NAD+ level and SIRT1 activity. Collectively, these results demonstrate that MCT1-mediated lactate shuttle plays a key role in regulating muscle functions by modulating mitochondrial biogenesis and TCA flux.

Lactate and lactylation in cardiovascular diseases: current progress and future perspectives

Cardiovascular diseases (CVDs) are often linked to structural and functional impairments, such as heart defects and circulatory dysfunction, leading to compromised peripheral perfusion and heightened morbidity risks. Metabolic remodeling, particularly in the context of cardiac fibrosis and inflammation, is increasingly recognized as a pivotal factor in the pathogenesis of CVDs. Metabolic syndromes further predispose individuals to these conditions, underscoring the need to elucidate the metabolic underpinnings of CVDs. Lactate, a byproduct of glycolysis, is now recognized as a key molecule that connects cellular metabolism with the regulation of cellular activity. The transport of lactate between different cells is essential for metabolic homeostasis and signal transduction. Disruptions to lactate dynamics are implicated in various CVDs. Furthermore, lactylation, a novel post-translational modification, has been identified in cardiac cells, where it influences protein function and gene expression, thereby playing a significant role in CVD pathogenesis. In this review, we summarized recent advancements in understanding the role of lactate and lactylation in CVDs, offering fresh insights that could guide future research directions and therapeutic interventions. The potential of lactate metabolism and lactylation as innovative therapeutic targets for CVD is a promising avenue for exploration.

Bioenergetic myths of energy transduction in eukaryotic cells

The study of energy transduction in eukaryotic cells has been divided between Bioenergetics and Physiology, reflecting and contributing to a variety of Bioenergetic myths considered here: 1) ATP production = energy production, 2) energy transduction is confined to mitochondria (plus glycolysis and chloroplasts), 3) mitochondria only produce heat when required, 4) glycolysis is inefficient compared to mitochondria, and 5) mitochondria are the main source of reactive oxygen species (ROS) in cells. These myths constitute a 'mitocentric' view of the cell that is wrong or unbalanced. In reality, mitochondria are the main site of energy dissipation and heat production in cells, and this is an essential function of mitochondria in mammals. Energy transduction and ROS production occur throughout the cell, particularly the cytosol and plasma membrane, and all cell membranes act as two-dimensional energy conduits. Glycolysis is efficient, and produces less heat per ATP than mitochondria, which might explain its increased use in muscle and cancer cells.

The polymorphism T1470A of the SLC16A1 gene is associated with the lactate and ventilatory thresholds but not with fat oxidation capacity in young men

PURPOSE

To examine the association of the single nucleotide polymorphism A1470T in the SLC16A1 gene with blood lactate accumulation during a graded exercise test and its associated metaboreflex.

METHODS

Forty-six Latin-American men (Age: 27 ± 6 years; Body fat: 17.5 ± 4.7%) performed a graded exercise test on a treadmill for the assessment of maximal oxygen uptake (VO2max), lactate threshold (LT), ventilatory threshold (VT) and the exercise intensity corresponding to maximal fat oxidation rate (FATmax), via capillary blood samples and indirect calorimetry. Genomic DNA was extracted from a peripheral blood sample. Genotyping assay was carried out by real-time polymerase chain reaction to identify the A1470T polymorphism (rs1049434).

RESULTS

Genotypes distribution were in Hardy-Weinberg equilibrium (X2 = 5.6, p > 0.05), observing allele frequencies of 0.47 and 0.53 for the A and T alleles, respectively. No difference in VO2max, body composition nor FATmax were observed across genotypes, whereas carriers of the TT genotype showed a higher LT (24.5 ± 2.2 vs. 15.6 ± 1.7 mL kg-1 min-1, p < 0.01) and VT in comparison to carriers of the AA + AT genotypes (32.5 ± 3.3 vs. 21.7 ± 1.5 mL kg-1 min-1, p < 0.01). Both, VO2max and the A1470T polymorphism were positively associated to the LT (R2 = 0.50, p < 0.01) and VT (R2 = 0.55, p < 0.01). Only VO2max was associated to FATmax (R2 = 0.39, p < 0.01).

CONCLUSION

Independently of cardiorespiratory fitness, the A1470T polymorphism is associated to blood lactate accumulation and its associated ventilatory response during submaximal intensity exercise. However, the A1470 polymorphism does not influence fat oxidation capacity during exercise in young men.

Vertical Strength Transfer Phenomenon Between Upper Body and Lower Body Exercise: Systematic Scoping Review

BACKGROUND

There are a myriad of exercise variations in which upper body (UB) and lower body (LB) exercises have been intermittently used. However, it is still unclear how training of one body region (e.g. LB) affects adaptations in distant body areas (e.g. UB), and how different UB and LB exercise configurations could help facilitate physiological adaptations of either region; both referred to in this review as vertical strength transfer.

OBJECTIVE

We aimed to investigate the existence of the vertical strength transfer phenomenon as a response to various UB and LB exercise configurations and to identify potential mechanisms underpinning its occurrence.

METHODS

A systematic search using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for Scoping Reviews protocol was conducted in February 2024 using four databases (Web of Science, MEDLINE, Scopus and CINAHL) to identify peer-reviewed articles that investigated the vertical strength transfer phenomenon.

RESULTS

Of the 5242 identified articles, 24 studies met the inclusion criteria. Findings suggest that the addition of UB strength training to LB endurance exercise may help preserve power-generating capacity for the leg muscle fibres. Furthermore, systemic endocrine responses to high-volume resistance exercise may beneficially modulate adaptations in precedingly or subsequently trained muscles from a different body region, augmenting their strength gains. Last, strength training for LB could result in improved strength of untrained UB, likely due to the increased central neural drive.

CONCLUSIONS

Vertical strength transfer existence is enabled by neurophysiological mechanisms. Future research should involve athletic populations, examining the potential of vertical strength transfer to facilitate athletic performance and preserve strength in injured extremities.

Evidence of 13 C-lactate oxidation in the human brain from hyperpolarized 13 C-MRI

PURPOSE

To test the hypothesis that lactate oxidation contributes to the  13 $$ {}^{13} $$ C-bicarbonate signal observed in the awake human brain using hyperpolarized  13 $$ {}^{13} $$ C MRI.

METHODS

Healthy human volunteers (N = 6) were scanned twice using hyperpolarized  13 $$ {}^{13} $$ C-MRI, with increased radiofrequency saturation of  13 $$ {}^{13} $$ C-lactate on one set of scans.  13 $$ {}^{13} $$ C-lactate,  13 $$ {}^{13} $$ C-bicarbonate, and  13 $$ {}^{13} $$ C-pyruvate signals for 132 brain regions across each set of scans were compared using a clustered Wilcoxon signed-rank test.

RESULTS

Increased  13 $$ {}^{13} $$ C-lactate radiofrequency saturation resulted in a significantly lower  13 $$ {}^{13} $$ C-bicarbonate signal (p = 0.04). These changes were observed across the majority of brain regions.

CONCLUSION

Radiofrequency saturation of  13 $$ {}^{13} $$ C-lactate leads to a decrease in  13 $$ {}^{13} $$ C-bicarbonate signal, demonstrating that the  13 $$ {}^{13} $$ C-lactate generated from the injected  13 $$ {}^{13} $$ C-pyruvate is being converted back to  13 $$ {}^{13} $$ C-pyruvate and oxidized throughout the human brain.

Wearable device for continuous sweat lactate monitoring in sports: a narrative review

In sports science, the use of wearable technology has facilitated the development of new approaches for tracking and assessing athletes' performance. This narrative review rigorously explores the evolution and contemporary state of wearable devices specifically engineered for continuously monitoring lactate levels in sweat, an essential biomarker for appraising endurance performance. Lactate threshold tests have traditionally been integral in tailoring training intensity for athletes, but these tests have relied on invasive blood tests that are impractical outside a laboratory setting. The transition to noninvasive, real-time monitoring through wearable technology introduces an innovative approach, facilitating continuous assessment without the constraints inherent in traditional methodologies. We selected 34 products from a pool of 246 articles found through a meticulous search of articles published up to January 2024 in renowned databases: PubMed, Web of Science, and ScienceDirect. We used keywords such as "sweat lactate monitoring," "continuous lactate monitoring," and "wearable devices." The findings underscore the capabilities of noninvasive sweat lactate monitoring technologies to conduct long-term assessments over a broad range of 0-100 mM, providing a safer alternative with minimal infection risks. By enabling real-time evaluations of the lactate threshold (LT) and maximal lactate steady state (MLSS), these technologies offer athletes various device options tailored to their specific sports and preferences. This review explores the mechanisms of currently available lactate monitoring technologies, focusing on electrochemical sensors that have undergone extensive research and show promise for commercialization. These sensors employ amperometric reactions to quantify lactate levels and detect changes resulting from enzymatic activities. In contrast, colorimetric sensors offer a more straightforward and user-friendly approach by displaying lactate concentrations through color alterations. Despite significant advancements, the relationship between sweat lactate and blood lactate levels remains intricate owing to various factors such as environmental conditions and the lag between exercise initiation and sweating. Furthermore, there is a marked gap in research on sweat lactate compared to blood lactate across various sports disciplines. This review highlights the need for further research to address these shortcomings and substantiate the performance of lactate sweat monitoring technologies in a broader spectrum of sports environments. The tremendous potential of these technologies to supplant invasive blood lactate tests and pioneer new avenues for athlete management and performance optimization in real-world settings heralds a promising future for integrating sports science and wearable technology.

Exploring the relationship between hyperlactatemia and anemia

Hyperlactatemia and anemia commonly coexist and their crosstalk is a longstanding mystery with elusive mechanisms involved in physical activities, infections, cancers, and genetic disorders. For instance, hyperlactatemia leads to iron restriction by upregulating hepatic hepcidin expression. Increasing evidence also points to lactate as a crucial signaling molecule rather than merely a metabolic byproduct. Here, we discuss the mutual influence between anemia and hyperlactatemia. This opinion calls for a reconsideration of the multifaceted roles of lactate and lactylation in anemia and emphasizes the need to fill knowledge gaps, including the dose dependence of lactate's effects, its sources, and its subcellular localization.

Intelligent Delivery Systems in Tumor Metabolism Regulation: Exploring the Path Ahead

Cancer metabolism plays multifaceted roles in the initiation and progression of tumors, and interventions in metabolism are considered fundamental approaches for cancer control. Within the vast metabolic networks of tumors, there exist numerous potential therapeutic targets, intricately interconnected with each other and with signaling networks related to immunity, metastasis, drug resistance, and more. Based on the characteristics of the tumor microenvironment, constructing drug delivery systems for multi-level modulation of the tumor microenvironment is proven as an effective strategy for achieving multidimensional control of cancer. Consequently, this article summarizes several features of tumor metabolism to provide insights into recent advancements in intelligent drug delivery systems for achieving multi-level regulation of the metabolic microenvironment in cancer, with the aim of offering a novel paradigm for cancer treatment.

Empowering mitochondrial metabolism: Exploring L-lactate supplementation as a promising therapeutic approach for metabolic syndrome

Mitochondrial dysfunction plays a critical role in the pathogenesis of metabolic syndrome (MetS), affecting various cell types and organs. In MetS animal models, mitochondria exhibit decreased quality control, characterized by abnormal morphological structure, impaired metabolic activity, reduced energy production, disrupted signaling cascades, and oxidative stress. The aberrant changes in mitochondrial function exacerbate the progression of metabolic syndrome, setting in motion a pernicious cycle. From this perspective, reversing mitochondrial dysfunction is likely to become a novel and powerful approach for treating MetS. Unfortunately, there are currently no effective drugs available in clinical practice to improve mitochondrial function. Recently, L-lactate has garnered significant attention as a valuable metabolite due to its ability to regulate mitochondrial metabolic processes and function. It is highly likely that treating MetS and its related complications can be achieved by correcting mitochondrial homeostasis disorders. In this review, we comprehensively discuss the complex relationship between mitochondrial function and MetS and the involvement of L-lactate in regulating mitochondrial metabolism and associated signaling pathways. Furthermore, it highlights recent findings on the involvement of L-lactate in common pathologies of MetS and explores its potential clinical application and further prospects, thus providing new insights into treatment possibilities for MetS.

Chronic lactate exposure promotes cardiomyocyte cytoskeleton remodelling

We investigated the effect of growing on lactate instead of glucose in human cardiomyocyte assessing their viability, cell cycle activity, oxidative stress and metabolism by a proteomic and metabolomic approach. In previous studies performed on elite players, we found that adaptation to exercise is characterized by a chronic high plasma level of lactate. Lactate is considered not only an energy source but also a signalling molecule and is referred as "lactormone"; heart is one of the major recipients of exogenous lactate. With this in mind, we used a cardiac cell line AC16 to characterize the lactate metabolic profile and investigate the metabolic flexibility of the heart. Interestingly, our data indicated that cardiomyocytes grown on lactate (72 h) show change in several proteins and metabolites linked to cell hypertrophy and cytoskeleton remodelling. The obtained results could help to understand the effect of this metabolite on heart of high-performance athletes.

How the 'Aerobic/Anaerobic Glycolysis' Meme Formed a 'Habit of Mind' Which Impedes Progress in the Field of Brain Energy Metabolism

The division of glycolysis into two separate pathways, aerobic and anaerobic, depending on the presence or absence of oxygen, respectively, was formulated over eight decades ago. The former ends with pyruvate, while the latter ends with lactate. Today, this division is confusing and misleading as research over the past 35 years clearly has demonstrated that glycolysis ends with lactate not only in cancerous cells but also in healthy tissues and cells. The present essay offers a review of the history of said division and the more recent knowledge that has been gained about glycolysis and its end-product, lactate. Then, it presents arguments in an attempt to explain why separating glycolysis into aerobic and anaerobic pathways persists among scientists, clinicians and teachers alike, despite convincing evidence that such division is not only wrong scientifically but also hinders progress in the field of energy metabolism.

Lactate metabolism in neurodegenerative diseases

Lactate, a byproduct of glycolysis, was thought to be a metabolic waste until the discovery of the Warburg effect. Lactate not only functions as a metabolic substrate to provide energy but can also function as a signaling molecule to modulate cellular functions under pathophysiological conditions. The Astrocyte-Neuron Lactate Shuttle has clarified that lactate plays a pivotal role in the central nervous system. Moreover, protein lactylation highlights the novel role of lactate in regulating transcription, cellular functions, and disease development. This review summarizes the recent advances in lactate metabolism and its role in neurodegenerative diseases, thus providing optimal perspectives for future research.

Effects of hyperthermia and acidosis on mitochondrial production of reactive oxygen species

Exercise is associated with the development of oxidative stress, but the specific source and mechanism of production of pro-oxidant chemicals during exercise has not been confirmed. We used equine skeletal muscle mitochondria to test the hypothesis that hyperthermia and acidosis affect mitochondrial oxygen consumption and production of reactive oxygen species (ROS). Skeletal muscle biopsies were obtained at rest, after an acute episode of fatiguing exercise, and after a 9-wk conditioning program to increase aerobic fitness. Mitochondrial oxygen consumption and ROS production were measured simultaneously using high-resolution respirometry. Both hyperthermia and acidosis increased nonphosphorylating (LEAK) respiration (5.8× and 3.0×, respectively, P < 0.001) and decreased efficiency of oxidative phosphorylation. The combined effects of hyperthermia and acidosis resulted in large decreases in phosphorylating respiration, further decreasing oxidative phosphorylation efficiency from 97% to 86% (P < 0.01). Increased aerobic fitness reduced the effects of acidosis on LEAK respiration. Hyperthermia increased and acidosis decreased ROS production (2× and 0.23×, respectively, P < 0.001). There was no effect of acute exercise, but an aerobic conditioning program was associated with increased ROS production during both nonphosphorylating and phosphorylating respiration. Hyperthermia increased the ratio of ROS production to O2 consumption during phosphorylating respiration, suggesting that high-temperature impaired transfer of energy through the electron transfer system despite relatively low mitochondrial membrane potential. These data support the role of skeletal muscle mitochondria in the development of exercise-induced oxidative stress, particularly during forms of exercise that result in prolonged hyperthermia without acidosis.NEW & NOTEWORTHY The results of this study provide evidence for the role of mitochondria-derived ROS in the development of systemic oxidative stress during exercise as well as skeletal muscle diseases such as exertional rhabdomyolysis.

Lactate modulates iron metabolism by binding soluble adenylyl cyclase

Overproduction of lactate (LA) can occur during exercise and in many diseases such as cancers. Individuals with hyperlactatemia often display anemia, decreased serum iron, and elevated hepcidin, a key regulator of iron metabolism. However, it is unknown whether and how LA regulates hepcidin expression. Here, we show LA binds to soluble adenylyl cyclase (sAC) in normal hepatocytes and affects systemic iron homeostasis in mice by increasing hepcidin expression. Comprehensive in vitro, in vivo, and in silico experiments show that the LA-sAC interaction raises cyclic adenosine monophosphate (cAMP) levels, which activates the PKA-Smad1/5/8 signaling pathway to increase hepcidin transcription. We verified this regulatory axis in wild-type mice and in mice with disordered iron homeostasis. LA also regulates hepcidin in humans at rest and subjected to extensive exercise that produce elevated LA. Our study links hyperlactatemia to iron deficiency, offering a mechanistic explanation for anemias seen in athletes and patients with lactic acidosis.

Lactate shuttling as an allostatic means of thermoregulation in the brain

Lactate, the redox-balanced end product of glycolysis, travels within and between cells to fulfill an array of physiologic functions. While evidence for the centrality of this lactate shuttling in mammalian metabolism continues to mount, its application to physical bioenergetics remains underexplored. Lactate represents a metabolic "cul-de-sac," as it can only re-enter metabolism by first being converted back to pyruvate by lactate dehydrogenase (LDH). Given the differential distribution of lactate producing/consuming tissues during metabolic stresses (e.g., exercise), we hypothesize that lactate shuttling vis-à-vis the exchange of extracellular lactate between tissues serves a thermoregulatory function, i.e., an allostatic strategy to mitigate the consequences of elevated metabolic heat. To explore this idea, the rates of heat and respiratory oxygen consumption in saponin-permeabilized rat cortical brain samples fed lactate or pyruvate were measured. Heat and respiratory oxygen consumption rates, and calorespirometric ratios were lower during lactate vs. pyruvate-linked respiration. These results support the hypothesis of allostatic thermoregulation in the brain with lactate.

What the Lactate Shuttle Means for Sports Nutrition

The discovery of the lactate shuttle (LS) mechanism may have two opposite perceptions, It may mean very little, because the body normally and inexorably uses the LS mechanism. On the contrary, one may support the viewpoint that understanding the LS mechanism offers immense opportunities for understanding nutrition and metabolism in general, as well as in a sports nutrition supplementation setting. In fact, regardless of the specific form of the carbohydrate (CHO) nutrient taken, the bodily CHO energy flux is from a hexose sugar glucose or glucose polymer (glycogen and starches) to lactate with subsequent somatic tissue oxidation or storage as liver glycogen. In fact, because oxygen and lactate flow together through the circulation to sites of utilization, the bodily carbon energy flow is essentially the lactate disposal rate. Consequently, one can consume glucose or glucose polymers in various forms (glycogen, maltodextrin, potato, corn starch, and fructose or high-fructose corn syrup), and the intestinal wall, liver, integument, and active and inactive muscles make lactate which is the chief energy fuel for red skeletal muscle, heart, brain, erythrocytes, and kidneys. Therefore, if one wants to hasten the delivery of CHO energy delivery, instead of providing CHO foods, supplementation with lactate nutrient compounds can augment body energy flow.

Mitochondria: It is all about energy

Mitochondria play a key role in both health and disease. Their function is not limited to energy production but serves multiple mechanisms varying from iron and calcium homeostasis to the production of hormones and neurotransmitters, such as melatonin. They enable and influence communication at all physical levels through interaction with other organelles, the nucleus, and the outside environment. The literature suggests crosstalk mechanisms between mitochondria and circadian clocks, the gut microbiota, and the immune system. They might even be the hub supporting and integrating activity across all these domains. Hence, they might be the (missing) link in both health and disease. Mitochondrial dysfunction is related to metabolic syndrome, neuronal diseases, cancer, cardiovascular and infectious diseases, and inflammatory disorders. In this regard, diseases such as cancer, Alzheimer's, Parkinson's, amyotrophic lateral sclerosis (ALS), chronic fatigue syndrome (CFS), and chronic pain are discussed. This review focuses on understanding the mitochondrial mechanisms of action that allow for the maintenance of mitochondrial health and the pathways toward dysregulated mechanisms. Although mitochondria have allowed us to adapt to changes over the course of evolution, in turn, evolution has shaped mitochondria. Each evolution-based intervention influences mitochondria in its own way. The use of physiological stress triggers tolerance to the stressor, achieving adaptability and resistance. This review describes strategies that could recover mitochondrial functioning in multiple diseases, providing a comprehensive, root-cause-focused, integrative approach to recovering health and treating people suffering from chronic diseases.

A modified formula using energy system contributions to calculate pure maximal rate of lactate accumulation during a maximal sprint cycling test

Purpose: This study aimed at comparing previous calculating formulas of maximal lactate accumulation rate ( ν La.max) and a modified formula of pure ν La.max (P ν La.max) during a 15-s all-out sprint cycling test (ASCT) to analyze their relationships. Methods: Thirty male national-level track cyclists participated in this study (n = 30) and performed a 15-s ASCT. The anaerobic power output (Wpeak and Wmean), oxygen uptake, and blood lactate concentrations (La-) were measured. These parameters were used for different calculations of ν La.max and three energy contributions (phosphagen, W PCr; glycolytic, W Gly; and oxidative, W Oxi). The P ν La.max calculation considered delta La-, time until Wpeak (tPCr-peak), and the time contributed by the oxidative system (tOxi). Other ν La.max levels without tOxi were calculated using decreasing time by 3.5% from Wpeak (tPCr -3.5%) and tPCr-peak. Results: The absolute and relative W PCr were higher than W Gly and W Oxi (p < 0.0001, respectively), and the absolute and relative W Gly were significantly higher than W Oxi (p < 0.0001, respectively); ν La.max (tPCr -3.5%) was significantly higher than P ν La.max and ν La.max (tPCr-peak), while ν La.max (tPCr-peak) was lower than P ν La.max (p < 0.0001, respectively). P ν La.max and ν La.max (tPCr-peak) were highly correlated (r = 0.99; R 2 = 0.98). This correlation was higher than the relationship between P ν La.max and ν La.max (tPCr -3.5%) (r = 0.87; R 2 = 0.77). ν La.max (tPCr-peak), P ν La.max, and ν La.max (tPCr -3.5%) were found to correlate with absolute Wmean and W Gly. Conclusion: P ν La.max as a modified calculation of ν La.max provides more detailed insights into the inter-individual differences in energy and glycolytic metabolism than ν La.max (tPCr-peak) and ν La.max (tPCr -3.5%). Because W Oxi and W PCr can differ remarkably between athletes, implementing their values in P ν La.max can establish more optimized individual profiling for elite track cyclists.

The Association of the Oral Microbiota with the Effects of Acid Stress Induced by an Increase of Brain Lactate in Schizophrenia Patients

The altered cerebral energy metabolism central to schizophrenia can be linked to lactate accumulation. Lactic acid is produced by gastrointestinal bacteria, among others, and readily crosses the blood-brain barrier, leading to the brain acidity. This study aimed to examine the association of the oral microbiota with the effects of acid stress induced by an increase of brain lactate in schizophrenia patients. The study included patients with a diagnosis of acute polyphasic psychotic disorder meeting criteria for schizophrenia at 3-month follow-up. Results: Individuals with a significantly higher total score on the Positive and Negative Syndrome Scale had statistically significantly lower lactate concentrations compared to those with a lower total score and higher brain lactate. We observed a positive correlation between Actinomyces and lactate levels in the anterior cingulate cap and a negative correlation between bacteria associated with lactate metabolism and some clinical assessment scales. Conclusions: Shifts in the oral microbiota in favour of lactate-utilising bacterial genera may represent a compensatory mechanism in response to increased lactate production in the brain. Assessment of neuronal function mediated by ALA-LAC-dependent NMDA regulatory mechanisms may, thus, support new therapies for schizophrenia, for which acidosis has become a differentiating feature of individuals with schizophrenia endophenotypes.