Lactate transport in canine red blood cells

Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement

OBJECTIVE

To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate.

DATA SOURCES

Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection.

HUMAN AND VETERINARY DATA SYNTHESIS

Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na⁺ -K⁺ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics.

CONCLUSION

The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.

Monocarboxylate transporters in the brain and in cancer

Monocarboxylate transporters (MCTs) constitute a family of 14 members among which MCT1-4 facilitate the passive transport of monocarboxylates such as lactate, pyruvate and ketone bodies together with protons across cell membranes. Their anchorage and activity at the plasma membrane requires interaction with chaperon protein such as basigin/CD147 and embigin/gp70. MCT1-4 are expressed in different tissues where they play important roles in physiological and pathological processes. This review focuses on the brain and on cancer. In the brain, MCTs control the delivery of lactate, produced by astrocytes, to neurons, where it is used as an oxidative fuel. Consequently, MCT dysfunctions are associated with pathologies of the central nervous system encompassing neurodegeneration and cognitive defects, epilepsy and metabolic disorders. In tumors, MCTs control the exchange of lactate and other monocarboxylates between glycolytic and oxidative cancer cells, between stromal and cancer cells and between glycolytic cells and endothelial cells. Lactate is not only a metabolic waste for glycolytic cells and a metabolic fuel for oxidative cells, but it also behaves as a signaling agent that promotes angiogenesis and as an immunosuppressive metabolite. Because MCTs gate the activities of lactate, drugs targeting these transporters have been developed that could constitute new anticancer treatments. This article is part of a Special Issue entitled: Mitochondrial Channels edited by Pierre Sonveaux, Pierre Maechler and Jean-Claude Martinou.

Agreement between i-STAT and YSI 2300 devices to determine lactate concentrations in dogs undergoing exercise

Little information is available comparing the i-STAT and the YSI 2300 Stat Plus devices to determine the lactate concentration [Lac] in dogs undergoing intense exercise. The reproducibility of the YSI 2300 for quantifying the [Lac] in canine blood [Lac]b and plasma [Lac]p samples has been observed. In addition, the i-STAT handheld device was used to quantify [Lac] in dogs subjected to exercise, and the results were compared with that of YSI 2300. Venous blood samples of Beagle and American Pit Bull Terrier dogs were obtained during an intense exercise training on a treadmill. [Lac]p and [Lac]b were quantified using the YSI 2300 instrument to determine the reproducibility of the results. A total of 52 specimens were compared for both plasma and whole blood. For comparing the devices (YSI 2300 vs i-STAT), 96 samples were used. Ordinary least products regression, the correlation coefficient, and Bland-Altman plots were used to assess the agreement of using the i-STAT device. The relationship between duplicate measurements of both [Lac]b and [Lac]p by YSI 2300 was strong (r=0.99). A correlation between the data obtained using the i-STAT and YSI 2300 instruments was observed for both the [Lac]p (r=0.97) and [Lac]b (r=0.88). The i-STAT exhibited a small constant bias (-0.25 mmol/l) compared to YSI 2300 ([Lac]b). There were proportional biases of 0.89 mmol/l for [Lac]p and 1.22 mmol/l for [Lac]b when using YSI 2300 vs i-STAT. We confirmed the reproducibility of the YSI 2300 for canine lactate blood/plasma samples. The results obtained by the i-STAT and YSI 2300 analyser were highly correlated, but a small constant bias was observed between them. The i-STAT device can be used in clinical evaluations, and it is also adequate for designing and monitoring fitness programmes.