乳酸穿梭在心肌缺血／再灌注损伤中保护作用研究进展

Research advances on protective effect of lactate shuttle against myocardial ischemia/reperfusion injury

背景在传统观念上，乳酸是葡萄糖无氧代谢的废弃物，然而最近研究表明乳酸可作为能源物质，在体内能量代谢中有重要意义。在组织和细胞间存在大量乳酸穿梭现象，此种现象为机体代谢提供了保障。目的结合国内外相关研究，就乳酸穿梭机制在心肌保护中的作用进行阐述。内容乳酸是葡萄糖酵解的产物。乳酸穿梭是指机体不同组织和细胞间存在乳酸互相穿梭供能的现象。细胞间的乳酸转运主要由单羧酸转运蛋白（monocarboxylate transporter，MCT）、黏附分子（CDl47）、乳酸脱氢酶组成。在心肌缺血／再灌注损伤（ischemia／reperfusion injury，I／RI）中乳酸穿梭主要是通过优化能量代谢及对Ca^2＋浓度的影响来发挥对心肌的保护作用。趋向目前研究发现乳酸在能量代谢中有重要意义，乳酸穿梭是机体I／RI时重要的能量代谢调节途径。但关于乳酸穿梭具体的调控机制研究尚少。

Background In the classical concept, lactic acid is regarded as the waste of glucose in anaerobic metabolism. However, it has been shown that lactic acid can be used as an energy material in the body. The existence of a large number of lactate shuttle phenomenon between tissues and cells can guarantee the body metabolism. Objective Based on the available domestic with foreign related literatures, this review describes role of the lactate shuttle mechanism in the myocardial protection. Content Lactic acid is the product of glycolysis of glucose. The phenomenon of lactate shuttle is that lactate shuttle can supply energy for each other in different tissues and cells of the body. The inter-cell lactate transportion is consisted of monocarboxylate transporter （MCT）, adhesion molecule CD147 and lactate hydrogenase. Themyocardial protection of lactate shuttle against isehemia/reperfusion injury （I/RI） is achieved by optimizing energy metabolism and influencing the concentration of calcium ions. Trend The available literature shows that lactic acid has important significance in energy metabolism and the lactate shuttle can supply the energy metabofic pathways for the body. However, there is few studies regarding the regulation mechanism of lactate shuttle.