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Acid–base balance at exercise in normoxia and in chronic hypoxia. Revisiting the "lactate paradox"

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Abstract

Transitions between rest and work, in either direction, and heavy exercise loads are characterized by changes of muscle pH depending on the buffer power and capacity of the tissues and on the metabolic processes involved. Among the latter, in chronological sequence: (1) aerobic glycolysis generates sizeable amounts of lactate and H+ by way of the recently described, extremely fast (20–100 ms) "glycogen shunt" and of the excess of glycolytic pyruvate supply; (2) hydrolysis of phosphocreatine, tightly coupled with that of ATP in the Lohmann reaction, is known to consume protons, a process undergoing reversal during recovery; (3) anaerobic glycolysis sustaining ATP production in supramaximal exercise as well as in conditions of hypoxia and ischemia, is responsible for the accumulation of large amounts of lactic acid (up to 1 mol for the whole body). The handling of metabolic acids, i.e., acid-base regulation, occurs both in blood and in tissues, mainly in muscles which are the main producers and consumers of lactic acid. The role of both blood and muscle bicarbonate and non-bicarbonate buffers as well as that of lactate/H+ cotransport mechanisms is analyzed in relation to acid-base homeostasis in the course of exercise. A section of the review deals with the analysis of the acid-base state of humans exposed to chronic hypoxia. Particular emphasis is put on anaerobic glycolysis. In this context, the so-called lactate paradox is revisited and interpreted on the basis of the most recent findings on exercise at altitude.

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Notes

  1. It should be pointed out that changes of tissue lactate and proton concentrations in the ratio 1 to 1 lead to progressive drifts of the calculated β value because of the logarithmic nature of the latter parameter.

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  1. Department of Sciences and Biomedical Technologies, L.I.T.A., University of Milan, Via F.lli Cervi 93, 20090, SEGRATE, Milano, Italy

    Paolo Cerretelli

  2. Department of Medicine, Surgery and Dentistry, San Paolo Hospital, University of Milan, Via Di Rudini, 8, 20142, MILANO, Italy

    Michele Samaja

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Cerretelli, P., Samaja, M. Acid–base balance at exercise in normoxia and in chronic hypoxia. Revisiting the "lactate paradox". Eur J Appl Physiol 90, 431–448 (2003). https://doi.org/10.1007/s00421-003-0928-x

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