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  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>British Journal of Medical and Health Research</journal-title>
        <abbrev-journal-title abbrev-type="publisher">BJMHR</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="epub">2394-2967</issn>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.46624/bjmhr.2020.v7.i10.002</article-id>
      <article-id pub-id-type="publisher-id">BJMHR0710002</article-id>
      <title-group>
        <article-title>Isoform A of Lactate Dehydrogenase (LDH-A), a potential ultra-early, high sensitivity biomarker of tumorigenesis.</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>GratacÃ³s</surname>
            <given-names>Ernesto Prieto</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Gauto</surname>
            <given-names>Pablo Aguirre</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">Precision Metabolic Oncology UK</aff>
      <aff id="aff2">Metabolic Therapy Center of Buenos Aires</aff>
      <pub-date pub-type="epub" iso-8601-date="2020-10-01">
        <month>10</month>
        <day>01</day>
        <year>2020</year>
      </pub-date>
      <volume>7</volume>
      <issue>10</issue>
      <abstract>
        <p>A higher than normal percentual contribution of isoform A to the lactate dehydrogenase enzymatic cluster reveals a pathological shift towards fermentative metabolism somewhere within the organism of the host. The hypermetabolic phenotype expressed by tumour cells, a well-documented hallmark of cancer, is rooted on the catalytic action of several enzymes, amongst which hexokinase 2 and LDH-A are key players, supporting cell survival and neoangiogenesis as well as driving tumour growth. The physiological, intrinsic secretion of lactic dehydrogenase A in healthy humans has not been described formally and can be used as a functional frame of reference in the ultra-early detection of neoplastic transformation. In healthy subjects, even with total plasma LDH within the normal range, increases in the isoform A surpassing three or more standard deviations above its mean percentual contribution to the enzymatic cluster suggest a pathological reprogramming of energy metabolism. Herein, preliminary evidence is presented, supporting the notion of LDH-A as a screening tool for ultra-early, actionable detection of microtumours, during the initial or avascular phase of neoplastic progression.</p>
      </abstract>
      <kwd-group kwd-group-type="author">
        <kwd>isoenzyme A</kwd>
        <kwd>lactic dehydrogenase</kwd>
        <kwd>Warburg effect</kwd>
        <kwd>metabolic cancer therapy</kwd>
      </kwd-group>
    </article-meta>
  </front>
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