“…The resulting alpha ketoglutarate (αKG) formed by deamination of glutamate can be converted to malate and, if malate exits the mitochondria and is converted to pyruvate in the cytosol, this keto acid can reenter the cycle contributing to pool homeostasis [7]. However, if pyruvate's entrance into the cycle is blocked as may occur in tumor cells [5,8], then lowered cycle alpha ketoglutarate effectively "pulls" glutamate via GDH supplying net keto acid just as occurs in glucose withdrawal. However, in contrast to glucose withdrawal, pyruvate formed from malate in the cytosol would be unable to reenter the mitochondria, and, as a default pathway, glycolysis and lactate accumulation could occur (the Warburg effect, Fig.…”