Brooks · Cell metabolism 2018 · narrative review · n=?

The Science and Translation of Lactate Shuttle Theory.

Cited 1443 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and conceptual framework synthesis

PubMed 29617642 · doi:10.1016/j.cmet.2018.03.008 · record verified 2026-08-29

What was done

This is a narrative review synthesizing historical and recent literature on the lactate shuttle theory. The author reviews mechanisms of lactate production under aerobic conditions, intercellular and intracellular shuttling, and translational applications in critical illness and sports medicine.

What was found

The abstract reports no numerical data, effect sizes, or statistical findings. It outlines three primary roles for lactate shuttling: acting as a major energy source, serving as the primary gluconeogenic precursor, and functioning as a cell-signaling molecule. It also describes a conceptual shift in medicine viewing elevated blood lactate as a strain biomarker rather than simply an indicator of hypoxia or anaerobic stress.

Why it matters

The paper synthesizes the paradigm shift from viewing lactate as a toxic metabolic waste product to recognizing it as a key metabolic intermediary and signaling molecule with potential therapeutic uses.

Limits

The abstract describes a non-systematic narrative review containing mechanism-based reasoning rather than a systematic synthesis or original experimental data. No sample sizes, quantitative results, or specific clinical trial metrics are provided in the abstract.

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