Novel Pyruvate-Enriched Medical Solutions and Beverages

The objective of this review is to introduce novel uses of pyruvate-enriched fluids. Pyruvate has been extensively and intensively studied since a half century ago. An abundance of experimental research in both animals and humans, in vitro and in vivo, demonstrate that pyruvate is a 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/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 additionally 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 favorable in plateau tourism, diabetes care and anti-aging. This review cited most important animal experiments and human tests with applicated pyruvate dosages, demonstrating the clinical effectiveness and safety and revealing innovative Pyr-ORS-based beverages as both medical care fluids 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 in this century.