Fig. 2
From: The emerging role of glycolysis and immune evasion in gastric cancer
Impact of lactate accumulation on immune cells within the TME. Within the TME, tumor cells predominantly consume nutrients while concurrently releasing excessive lactate, which leads to acidosis and immune suppression. Lactate further influences the metabolic activities of both innate and adaptive immune cells, impeding the functions of T cells, NK cells, and macrophages. Conversely, lactate promotes the sustenance of Treg cells, allowing them to maintain their immunosuppressive functions in the acidic milieu. Combining immunotherapy with medications targeting lactate production and lactate transporters can enhance the therapeutic efficacy of immune checkpoint inhibitors