Abstract
Pyruvate has been extensively and intensively studied since a half century ago. An abundance of experimental researches, in vitro and in vivo, in both animals and humans demonstrate that pyruvate is an unique anion, which is more beneficial in protection of multiple cell/organ metabolism and function than anions in commercial medical fluids and health beverages. The robust advantages of pyruvate action are mainly enhancement of anoxia/hypoxia tolerance, correction of hypoxic lactic acidosis and improvement of glucometabolic disorders in addition to anti-oxidative stress and anti-inflammation and protection of mitochondria, leading to reversal of the Warburg effect in various pathogenic attacks, including severe hypoxia/ ischemia, hypo/hyperglycemia, trauma/burn and sepsis. Many investigations in animals and humans, in vivo, reveal pyruvate protections with absence of clinical adverse effects. Innovative pyruvate-enriched fluids, both crystalloids and colloids, would be more favorable than current fluids in clinical resuscitation due to therapeutic effects in addition as a volume expander. Pyruvate-enriched oral rehydration salt (Pyr-ORS, equimolar pyruvate replacement of alkalizers in WHO-ORS) also would be more beneficial than WHO-ORS in oral rehydration, peri-operative fluid management and prehospital rescue. Alternatively, oral Pyr-ORS-based beverages may be helpful in plateau tourism, diabetes care and anti-aging. This review cited most important animal experiments and human tests with pyruvate dosages applicated, suggesting the effectiveness and clinical safety and recommending innovative Pyr-ORS-based beverages as both medical care when short of medical supply and functional drinks in endurance exercises. Pyruvate, as a novel nutritional componence, applications in clinical scenarios would be another most important medical advance this century.
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