Fig. 2.

Physical exercise regulates cancer metabolism. Physical exercise can increase ADP concentrations, resulting in a reduction in ATP/ADP and downregulation in the expression of GLUT4 and HK2. These are key factors in regulating anaerobic glycolysis, which inhibits cancer cell proliferation and induces apoptosis. Lactate is a critical fuel for metabolites during physical exercise. LDH, especially LDHA, can be inhibited by exercise, which reduces lactate production in anaerobic glycolysis. ADP = adenosine diphosphate; AMPK = AMP activated protein kinase; ATP = adenosine triphosphate; cAMP = cyclic adenosine monophosphate; GLUT4 = glucose transporter 4; G6P = glucose-6-phosphate; HDAC5 = histone deacetylase 5; HK2 = hexokinase 2; LDH = lactate dehydrogenase; LDHA = lactate dehydrogenase A; mTOR = mammalian target of rapamycin; PEP = phosphoenolpyruvate; Akt = protein kinase B; PPAPa = 5′-O-pyrophosphoryladenylyl-(3′-5′)-adenosine.