Lactate as a myokine and exerkine: drivers and signals of physiology and metabolism.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing physiological mechanisms without primary empirical data or systematic search methodology
PubMed 36633863 · doi:10.1152/japplphysiol.00497.2022
What was done
This is a narrative review detailing the conceptual shift regarding lactate from a metabolic waste product to an active signaling molecule, myokine, and exerkine. The authors synthesize biological mechanisms—including mass action, redox modulation, allosteric regulation, and lactylation—and discuss its autocrine, paracrine, and endocrine actions across various physiological states such as rest, exercise, feeding, injury, and disease.
What was found
The abstract reports no numerical trial findings or pooled effect sizes. It notes that lactate exists in millimolar concentrations in muscle, blood, and other tissues and can increase by more than an order of magnitude. The review summarizes lactate's involvement in fueling the heart, supporting muscle adaptation, modulating brain executive function, participating in cardiopulmonary regulation, and influencing processes like mitochondrial biogenesis, pancreatic beta-cell insulin secretion, and carcinogenesis.
Why it matters
This paper synthesizes evidence reframing lactate as a dynamic metabolic driver and endocrine-like signal rather than a fatigue-inducing waste product, highlighting translational implications for metabolic health and exercise physiology.
Limits
As a narrative review, it does not employ a systematic literature search, standardized study selection criteria, or quality assessment of included evidence. The abstract contains no original empirical data, sample sizes, or quantitative outcome measures.
Cited by
- supports Lactate produced during exercise is used by the heart and brain as a preferred source of energy.