Fig. 5
From: Metabolic reprogramming: the emerging concept and associated therapeutic strategies
Metabolic symbiosis between oxidative/aerobic tumor cells and hypoxic/glycolytic cells. Tumor heterogeneity induces a lactate shuttle between hypoxic and oxidative cancer cells. While MCT4-positive hypoxic cells contribute to formation of an acidic microenvironment by aerobic glycolysis and secretion of lactate, MCT1-expressing oxidative cells utilize lactate as a substrate of the TCA cycle, and consequently exhibit stem-like characteristics. Notably, in contrast with MCT1-positive cancer cells, glucose uptake is robust in MCT4-expressing cells