L-lactate dehydrogenase

Overview

L-lactate dehydrogenase (LDH) is a key metabolic enzyme that catalyzes the reversible interconversion of pyruvate and L-lactate with concomitant interconversion of NADH and NAD(^+). This reaction is central to anaerobic glycolysis, redox balance, and cellular energy metabolism. In biomedical literature, LDH is often discussed both as a functional enzyme and as a clinical biomarker, because elevated circulating LDH can reflect tissue injury, hemolysis, inflammation, hypoxia, or high tumor burden.

In recent research, L-lactate dehydrogenase has been studied in several contexts: as a prognostic marker in malignancy and inflammatory disease, as a readout of cell damage or pyroptosis in experimental systems, and as a potential therapeutic target in metabolic inhibition strategies. Its relevance spans cancer immunotherapy, cardiovascular and renal injury, COVID-19-associated complications, and experimental models of diabetes, fibrosis, and oxidative stress.

Recent Publications Summary

Recent studies have used L-lactate dehydrogenase (LDH) as a clinical biomarker across obstetric, infectious, inflammatory, and oncologic settings. In pregnant women with hypertensive disorders of pregnancy, one study evaluated whether maternal serum LDH levels were associated with adverse pregnancy outcomes and whether metabolic risk factors modified this relationship. In post-COVID-19 syndrome research, participants with prior SARS-CoV-2 infection had higher levels of soluble thrombomodulin and L-lactate dehydrogenase than individuals without documented infection, supporting LDH as part of a biomarker profile linked to persistent post-infectious changes 42129413May. In critically ill COVID-19 patients, LDH was among the blood markers significantly associated with coagulopathy alongside leptin, IL-6, ferritin, neutrophil-lymphocyte ratio, CRP, fibrinogen, and erythrocyte sedimentation rate 42065184May.

LDH has also been examined as a readout of tissue injury and treatment response in regenerative medicine. In a rabbit model of cartilage defects treated with allogeneic mesenchymal stem cells, serum and synovial fluid LDH were measured before and 12 weeks after implantation; serum LDH increased significantly in all MSC-treated groups compared with controls, suggesting a systemic response to implantation or altered metabolism, although no additional adverse effects were observed 42299097Jun. In cancer-related studies, LDH was used both as a therapeutic target and as a prognostic marker. Stiripentol, described as a putative LDH inhibitor, was tested in glioblastoma cells and produced moderate LDH inhibition accompanied by increased reactive oxygen species, reduced mitochondrial membrane potential, and cellular senescence-associated cell death 42035940Apr. In a separate tumor immunotherapy study, zinc was reported to suppress glycolysis by directly restraining LDH activity, reducing lactate output and ATP generation as part of a broader metabolic disruption strategy 41941350Apr. Another clinical oncology analysis found that normal LDH was an independent factor associated with longer overall survival in the DDR-wild-type cohort of the MD Anderson IMPACT2 study 41963611Apr.

Beyond human disease, LDH has been targeted in diagnostic and antiparasitic assay development. A cellulose nanobead-based lateral flow immunoassay was developed for highly sensitive detection of Plasmodium vivax lactate dehydrogenase, achieving improved sensitivity over conventional gold nanoparticle-based rapid tests 42295386Jun. Computational drug design efforts also targeted Babesia microti lactate dehydrogenase, identifying sanguinarine derivatives with favorable docking and drug-likeness properties as candidate inhibitors 41932198Apr.

What Changes, What Holds

1. LDH is being extended as a cross-cutting biomarker in pregnancy, post-infectious syndromes, and critical COVID-19
NEW DIRECTION Recent work broadens LDH beyond the Overview’s general role as a marker of tissue injury and inflammation by placing it in obstetric risk stratification and post-acute infectious phenotyping. That does not displace the baseline account, but it suggests LDH may be useful in more specific clinical subgroups than previously emphasized. The findings remain associative and do not yet establish whether LDH adds independent predictive value or merely tracks severity42129413May.

2. LDH is being used as both a therapeutic vulnerability and a response marker in metabolic and oncologic interventions
REINFORCES These studies do not change what LDH is understood to do; they sharpen the existing view of LDH as a functional enzyme and biomarker in cancer and tissue injury. The stem-cell cartilage work mainly adds another context in which LDH can be monitored after intervention, while the glioblastoma, zinc, and survival findings fit the established theme that LDH-linked metabolism and prognosis matter in tumors. The therapeutic claims remain early and context-specific 42299097Jun42035940Apr.

3. LDH is becoming a target for parasite diagnostics and inhibitor design outside human disease
NEW DIRECTION The Overview covers LDH as a human metabolic enzyme and clinical marker, but not as a species-specific diagnostic or antiparasitic target. These studies therefore extend the entity into assay development for malaria and computational screening for Babesia, suggesting practical value in pathogen detection and drug discovery. That is a new use class rather than a revision of the baseline account, and it remains to be shown how well these approaches translate beyond experimental or in silico settings 42295386Jun41932198Apr.

Overview update candidates: LDH as a biomarker in post-COVID-19 syndrome and critical COVID-19 coagulopathy; LDH as a diagnostic/therapeutic target in parasitic disease.