Was your doctor incompetent in NOT DOING ANYTHING with this from 4+ years ago? So, your board of directors is so incompetent they don't know they are employing incompetence?
Extended preclinical investigation of lactate for neuroprotection after ischemic stroke July 2021
Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING? Your choice; let them be incompetent or demand action!
Lactate Is Answerable for Brain Function and Treating Brain Diseases: Energy Substrates and Signal Molecule
Abstract
Research to date has provided novel insights into lactate's positive role in multiple brain functions and several brain diseases. Although notable controversies and discrepancies remain, the neurobiological role and the metabolic mechanisms of brain lactate have now been described. A theoretical framework on the relevance between lactate and brain function and brain diseases is presented. This review begins with the source and route of lactate formation in the brain and food; goes on to uncover the regulatory effect of lactate on brain function; and progresses to gathering the application and concentration variation of lactate in several brain diseases (diabetic encephalopathy, Alzheimer's disease, stroke, traumatic brain injury, and epilepsy) treatment. Finally, the dual role of lactate in the brain is discussed. This review highlights the biological effect of lactate, especially L-lactate, in brain function and disease studies and amplifies our understanding of past research.
Keywords: lactate, brain function, brain diseases, energy substrates, signal molecule
Introduction
Brain lactate, as a well-known metabolite, primarily roots in astrocytic glycolysis from blood glucose, glycogen, and blood lactate. Recently, the role of the “good guy” has gradually superseded the traditional concept of metabolic waste in medical literature in neuroscience (1). The most interesting dimension of this is the physiological character of lactate's role in mediating brain function (2). These canonical function involves learning and memory (3), cerebral blood flow (4), neurogenesis (5, 6) and cerebral microangiogenesis (7), energy metabolism (8), neuronal activity (9–11), and neuroprotection (12–15). Therefore, lactate is competent to be a potential therapy for ameliorating the pathological process of some brain diseases associated with impaired brain function. In mammals, lactate exists as two enantiomers. The structure of asymmetrical C2 carbon leads to the two stereoisomers of lactate that are designated as L-lactate and D-lactate (16). L-lactate is the major enantiomer found in the brain and blood whereas D-lactate is normally present in very low concentrations under healthy physiological conditions (17). D-lactate is also considered as the rivalrous inhibitor of L-lactate since it competitively inhibits L-lactate transport (18). In different brain disease patterns, L- and D-lactate is reported to exert a similar or distinct effect on brain function. The involving mechanisms are far more complex than originally thought. For the most part, L-lactate can be utilized as a preferred energy substrate of neurons for meeting the energy demand (19, 20) or act as the novel hormone-like effect called lactormone (21, 22). But current research about D-lactate's role in brain function and brain-related disease is sparse and debatable. D-lactate-mediated mechanisms are also unclear.
In this narrative review, we aim to provide a comprehensive and profound summary of the role of lactate in brain function and related diseases. Consequently, we expound the food source of lactate intake, discuss the lactate enantiomers and their metabolism manner in the brain, compare the influence of L- and D-lactate on brain functions, expound on the effect of L- and D-lactate replenishment on several common brain diseases, and summarize the mechanisms of L-lactate.
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