Lactate levels predict outcomes for motor neurone disease

New research suggests higher levels of blood lactate may be the key to a longer life for people with the neurodegenerative condition ALS, the most common form of motor neurone disease (MND).

A study at AIBN and Japan’s Shiga University of Medical Science has revealed that blood lactate is a key biomarker that can predict physical outcomes and prognosis in patients with ALS.

Lactate aids survival of motor neurons

ALS – or Amyotrophic Lateral Sclerosis – gradually and inevitably erodes a person’s ability to control voluntary muscle and movement, and to breathe on their own.

Shiga University neurologist Dr Ryutaro Nakamura said the findings could inform treatment and care to help ALS patients retain weight and survive for longer.

“Lactate is an essential metabolic fuel and has long been known to influence motor neuron survival,” Dr Nakamura said.

High lactate equals better prognosis

“This includes supporting the metabolic demands associated with ALS.

“Simply put, the more lactate an ALS patient has in their blood, the more likely they are to maintain weight and have a better prognosis.”

Dr Nakamura’s initial research at Shiga University alongside Professor Makoto Urushitani focused on a Japanese patient cohort.

Strengthened by collaboration

It was expanded when Dr Nakamura was seconded to the MND-focused lab led by AIBN’s Associate Professor Shyuan Ngo.

In collaboration with UQ Associate Professor Frederik Steyn, the researchers monitored 146 ALS patients in Japan and Australia to demonstrate those with low blood lactate levels began losing weight progressively after 3 months.

“Our findings support the hypothesis that lower lactate levels are associated with an increased likelihood of weight loss in ALS patients, faster disease progression and earlier death,” Dr Ngo said.

Dr Nakamura said the inclusion of an Australian ALS cohort and input from Dr Ngo and Dr Steyn strengthened the work and had provided critical international validation.

“Including both Australian and Japanese patients shows that the correlation between blood lactate levels, weight loss, and ALS prognosis transcends race and environment,” Dr Nakamura said.

Nutritional support for patients

Dr Nakamura hoped the research would inform proactive nutritional support for ALS patients with low blood lactate levels and contribute to the development of new treatments.

“Because weight loss strongly predicts survival in ALS, patients with low lactate levels may benefit from early and intensive nutritional support to improve outcomes,” Dr Nakamura said.

The research was published in the Annals of Neurology.

Associate Professor Shyuan Ngo has a joint appointment at UQ School of Biomedical Sciences.