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"Wherever the art of Medicine is loved, there is also a love of Humanity."
— Hippocrates

Inflamed tissues often experience hypoxia because of high oxygen consumption and poor perfusion. Consequently, cells undergo a shift known as metabolic reprogramming to meet rising bioenergetic demands. Glycolysis in inflammation serves as a fundamental pathway to sustain ATP production when oxygen availability is scarce. This ancient metabolic process enables both immune and non-immune cells to maintain homeostasis and execute specific functions during an inflammatory response.
Hypoxia reduces mitochondrial oxidative phosphorylation, which forces cells to rely on alternative energy sources. Specifically, cells increase their glycolytic flux through rapid allosteric regulation and transcriptional changes. Transcriptional upregulation of glucose transporters ensures a steady supply of fuel. Additionally, the formation of specialized glycolytic enzyme complexes accelerates energy production. Thus, the metabolic environment directly dictates the cellular response to injury.
In immune cells like macrophages and neutrophils, enhanced glycolysis determines critical effector functions. These functions include cytokine production, migration, and antimicrobial activity. Similarly, non-immune cells such as epithelial and stromal cells utilize this pathway. It influences barrier function and tissue remodeling significantly. Understanding these cell-type-specific responses helps researchers identify precise therapeutic targets for diverse pathologies.
Targeting glycolytic pathways offers a promising avenue for treating various inflammatory diseases. By modulating metabolic flux, clinicians might control excessive immune activation without broad immunosuppression. Furthermore, researchers examine how these interventions could restore tissue homeostasis. Consequently, metabolic therapy represents a frontier in modern clinical practice.
Glycolysis provides a rapid source of ATP and biosynthetic precursors. This allows immune cells to function in hypoxic environments where oxygen-dependent energy production is impaired.
Both immune cells, such as macrophages and neutrophils, and non-immune cells, including epithelial and stromal cells, undergo this reprogramming to support inflammatory and repair processes.
Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or replace professional consultation. Refer to the latest local and national guidelines for clinical practice.
References
Dehantschutter ET et al. The role of glycolysis in inflammation. Am J Physiol Cell Physiol. 2026 May 08. doi: 10.1152/ajpcell.00113.2026. PMID: 42102390.
Palsson-McDermott EM, O'Neill LA. The Warburg effect then and now: from cancer to inflammation. Bioessays. 2013 Nov;35(11):965-73. doi: 10.1002/bies.201300084.
Kierans SJ, Taylor CT. Understanding cellular adaptation to hypoxia through hypoxia-inducible factor-1 alpha. Frontiers in Cell and Developmental Biology. 2021;9:648004.

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