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In summary, the role of lactate in macrophages cannot be oversimplified as merely promoting M2. It functions more like a double-edged sword, with its ultimate effect, whether it favors pro-inflammatory (M1) or anti-inflammatory (M2) phenotypes, being tightly regulated by factors such as concentration, duration, cell origin, and the overall tissue microenvironment [108]

Pandolfi F, Franza L, Mandolini C, Conti P

Gholami F, Antonio J, Evans C, et al

Larsson A, Mattsson B, Wauters EA, van Gool JD, Duran M, Wadman SK: 5-oxoprolinuria due to hereditary 5-oxoprolinase deficiency in two brothers--a new inborn error of the gamma-glutamyl cycle