For a long time after its discovery at the beginning of the 20th century, lactate was considered a waste product of cellular metabolism. Starting in the early '90s, however, lactate has begun to be recognized as an active molecule capable of modulating the immune response. Inflammatory sites, including in rheumatoid arthritis (RA) synovitis, are characterized by the accumulation of lactate, which is partly responsible for the establishment of an acidic environment. We have recently reported that T cells sense lactate via the expression of specific transporters, leading to inhibition of their motility. Importantly, this "stop migration signal" is dependent upon lactate's interference with intracellular metabolic pathways, specifically glycolysis. Furthermore, lactate promotes the switch of CD4 + T cells to an IL-17 + subset, and reduces the cytolytic capacity of CD8 + T cells. These phenomena might be responsible for the formation of ectopic lymphoid structures and autoantibody production in inflammatory sites such as in RA synovitis, Sjogren syndrome salivary glands, and multiple sclerosis plaques. Here, we review the roles of lactate in the modulation of the inflammatory immune response.Keywords: Arthritis r Inflammation r Lactate r Metabolism r T cells
Crosstalk between immunity and metabolismThe immune system is constituted of a heterogeneous population of immune cells, which are able to respond to inflammatory stimuli upon switching from a quiescent to an activated status. These responses are tightly regulated by a wide range of cell type specific receptors and transcription factors. In immune cells this determines changes in the expression of large numbers of genes and results in the acquisition of new functions, such as the production of cytokines, lipid mediators and metabolites as well as the ability to proliferate, differentiate into specialized subtypes and migrate to target tissues. All such functions require the supply of nutrients into different metabolic pathways. In the last few yearsCorrespondence: Dr. Claudio Mauro e-mail: c.mauro@qmul.ac.uk there has been an increasing appreciation of how such metabolic pathways integrate with and in fact determine specific immune cell responses [1].
T-cell metabolism, inflammation, and autoimmunityIn the past few years, metabolism has been in the spotlight because of its pivotal role in disorders such as cancer as well as inflammatory and autoimmune diseases. Many studies have highlighted how cancer cells rely upon bioenergetic pathways to support their growth. As for cancer cells, immune cells also adapt their metabolic status as a consequence to changes in the external microenvironment (i.e. inflammation). T cells are key players of adaptive immunity and have high metabolic demand for their activation, proliferation, differentiation in specific cell subsets, and migration to target organs, while quiescent T cells rely mainly Alterations of this fine tuning between metabolism and immunity might lead to an unbalance between pro-and anti-inflammatory responses ...