Figure 9.

Model depicting changes in the energy metabolism of Schwann cells and axons after axotomy. The proposed metabolic changes in the distal nerve stump. In Schwann cells, the glycolytic system and MCT-induced monocarboxylate transport are activated. In axons, the glycolytic system is activated, whereas TCA cycle is inactivated because of mitochondrial degeneration. The glycolytic intermediate, pyruvate is transported from Schwann cells to axons through MCTs, and both in Schwann cells and axons, pyruvate is metabolized by LDHA to generate NAD⁺ and promote metabolic shifts toward the glycolytic system to produce ATP. The main metabolic source of ATP is mainly on glycolytic system both in Schwann cells and axons. The excess produced lactate in axons is transported to Schwann cells, subsequently released to extracellular space via MCTs.