Lactate: Beyond a mere fuel in the epileptic brain

Area of Science:

• Neuroscience
• Neurology
• Metabolism

Background:

• Epilepsy is a neurological disorder characterized by recurrent seizures.
• Metabolic factors, especially lactate, are increasingly implicated in epilepsy.
• The astrocyte-neuron lactate shuttle (ANLS) model is relevant to understanding lactate's role.

Purpose of the Study:

• To discuss the ANLS model's applicability during seizures.
• To examine lactate's metabolic adaptation in epilepsy progression.
• To explore lactate metabolism in microglia and oligodendrocytes, extending the ANLS model.

Main Methods:

• Review of existing literature on lactate metabolism in epilepsy.
• Discussion of neuro-glial metabolic interactions.
• Examination of lactate's modulatory effects on neuronal excitability.

Main Results:

• Lactate's role in epilepsy extends beyond energy supply.
• Lactate metabolism is adapted during epilepsy progression.
• Lactate influences neuronal excitability via HCAR1, ASICs, and KATP channels.

Conclusions:

• Lactate is a key player in the epileptic brain.
• Understanding lactate metabolism offers potential therapeutic targets for seizure control.
• Neuro-glial metabolic interactions involving lactate are crucial in epilepsy.