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Monocarboxylate transporters 1, 2, and 4 (MCT1, MCT2, MCT4) are proton-linked plasma membrane transporters belonging to the SLC16 family (Halestrap, 2013). They facilitate the bidirectional transport of essential metabolites such as L-lactate, pyruvate, and ketone bodies, playing a critical role in cellular energy metabolism and pH homeostasis (Halestrap & Wilson, 2012). In many cancers, these transporters are upregulated to support the Warburg effect, enabling the efflux of glycolytic lactate via MCT4 and its uptake by oxidative cells via MCT1 (Doherty & Cleveland, 2013). This metabolic cooperation, known as metabolic symbiosis, promotes tumor growth, survival, and resistance to therapy (Sonveaux et al., 2008). Targeting these transporters, particularly MCT1 and MCT4, has emerged as a promising strategy in oncology to disrupt tumor metabolism and induce intracellular acidification (Beloueche-Babari et al., 2017). However, therapeutic development faces challenges such as on-target toxicities in the retina and heart, where MCT1 is physiologically expressed, and the potential for compensatory resistance mechanisms (Halford et al., 2017).
Inhibition of proton-coupled monocarboxylate transport, leading to intracellular acidification and disruption of metabolic symbiosis.
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