Lactate infusion as therapeutical intervention: a scoping review

Abstract

Traditionally, clinicians consider lactate as a waste product of anaerobic glycolysis. Interestingly, research has shown that lactate may serve as an alternative fuel for the brain to protect it against harm. The increasing scientific awareness of the potential beneficial side of lactate, however, is entering the clinic rather slowly. Following this, and realizing that the application of potential novel therapeutic strategies in pediatric populations often lags behind the development in adults, this review summarizes the key data on therapeutic use of intravenous infusion of sodium lactate in humans. PubMed and clinicaltrial.gov were searched up until November 2021 focusing on interventional studies in humans. Thirty-four articles were included in this review, with protocols of lactate infusion in adults with diabetes mellitus, traumatic brain injury, Alzheimer’s disease, and cardiac disease. One study on lactate infusion in children was also included. Results of our literature search show that sodium lactate can be safely administrated, without major side effects. Additionally, the present literature clearly shows the potential benefits of therapeutic lactate infusion under certain pathological circumstances, including rather common clinical conditions like traumatic brain injury.Conclusion: This review shows that lactate is a save, alternative energy source for the adult brain warranting studies on the potential therapeutic effects of sodium lactate infusion in children. What is Known:• Lactate is generally considered a waste product of anaerobic glycolysis. However, lactate also is an alternative fuel for different organs, including the brain.• Lactate infusion is not incorporated in standard care for any patient population. What is New:• Thirty-four studies investigated the therapeutic use of intravenous sodium lactate in different patient populations, all with different study protocols.• Literature shows that lactate infusion may have beneficial effects in case of hypoglycemia, traumatic brain injury, and cardiac failure without the risk of major side effects.

3-phenyllactic acid promotes healthspan through SKN-1/ATFS-1-mediated mitochondrial activation and stress resilience

“…Circulating lactate facilitates the decoupling of carbohydrate-derived mitochondrial energy metabolism from glycolysis, and the lactate/pyruvate ratio helps balance the NADH/NAD + ratio across cells and tissues 49 . This mechanism supports mitochondrial energy generation as a carbohydrate fuel source, shedding light on its positive influence on aging 24,44,50 .…”

Lactate Mediates the Bone Anabolic Effect of High-Intensity Interval Training by Inducing Osteoblast Differentiation

“…Thus, lactate clearance, instead of lactate supplementation, has been the main goal in the clinical setting 30,31 . Nonetheless, the benefit of lactate has emerged during the last 30 years, and clinical studies showed that sodium lactate can be safely administrated to patients with hypoglycemia, traumatic brain injury, Alzheimer disease, and heart failure 32 . Yet, it must be acknowledged that the clinical use of lactate is still experimental.…”

“…Its optimal dose, time of administration, and blood lactate concentration need to be further evaluated. Furthermore, possible adverse effects of lactate such as panic attacks should be recognized 32 .…”

Beyond Mechanical Tension: A Review of Resistance Exercise-Induced Lactate Responses & Muscle Hypertrophy

“…La − should be viewed as a valuable metabolic fuel source that functions as a signaling molecule and epigenetic modifier, with evidence that it may also influence skeletal muscle hypertrophy. A recent review by van Gemert et al (2022) [ 160 ] discussed a potential role for La − as a therapeutic intervention for traumatic brain injury and cardiac failure. Brooks et al (2021) [ 29 ] brilliantly termed La − “a phoenix risen” in the research.…”