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. 2016 Dec 30;38(2):119–133. doi: 10.1093/carcin/bgw127

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© The Author 2016. Published by Oxford University Press.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 4. — Proposed mechanisms by which lactagenesis can be halted. Oxamate decreases activity of LDHA and aerobic exercise increases expression of LDHB which oxidizes lactate to pyruvate and may counteract deleterious action of LDHA. Dichloroacetate (DCA) increases the activity of pyruvate dehydrogenase (PDH) which directs glycolytic carbon flux to oxidation and away from lactate production and accumulation. Different inhibitors of MCT1-4 and CD147 are currently being evaluated which would inhibit lactate shuttling between, within and among cancer cells and susceptable candidate cells.