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. 2019 Nov 1;9:1143. doi: 10.3389/fonc.2019.01143

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Copyright © 2019 de la Cruz-López, Castro-Muñoz, Reyes-Hernández, García-Carrancá and Manzo-Merino.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Metabolic symbiosis. Solid tumors are characterized by metabolic heterogeneity. Glycolytic tumor cancers are sustained by a favorable location with high nutritional availability. This phenotype is regulated by a differential expression of MCTs, where glycolytic cells preferentially express MCT4 favoring lactate export. Meanwhile, oxidative cells express MCT1 transporter which preferentially promotes lactate import. Then, lactate is used by these cells as an energetic source due to its conversion to pyruvate which enters the TCA cycle in the mitochondria. The presence of lactate allows a metabolic symbiosis between hypoxic cancer cells (glycolytic) and with normoxic cancer cells (oxidative).