10.1038/nrc1478
10.1038/nrc1478-c1
We thank Ger Bongaerts and Theo Wagener for their comments. It appears that they have misunderstood some components of our article. We completely agree with the biochemical pathways of glucose metabolism that they outline. We also agree that in the absence of oxygen, tumour cells, like normal cells, will generate energy by metabolized glucose to lactic acid (a process they term 'fermentative'). The question we address is the observation that tumour cells, unlike normal cells, use fermentative processes even in the presence of oxygen. We describe this as 'aerobic glycolysis' — a term they appear to misconstrue as meaning the oxidative metabolism of glucose. In any case, our main point is that metabolism of glucose to lactic acid provides a proliferative advantage to tumour populations if they evolve resistance to the resulting extracellular acidosis. In other words, during carcinogenesis some tumour populations gain a competitive advantage by using fermentative processes to create an environment that is toxic (through creation of extracellular acidosis) to their competitors but harmless to themselves. We hypothesize that this advantage explains the observation that tumour cells use anaerobic metabolism of glucose even in the presence of oxygen.
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