In situ lactate dehydrogenase patterns as markers of tumour oxygenation.

The histochemical patterns of lactate dehydrogenase, LDH, are here proposed as indicators of the local levels of oxygenation of malignant tissue. This parameter has outstanding importance in determining the tumour aggressiveness and response to treatment. The tetrazolium salt reaction previously proposed for the mapping of hypoxia has been improved by the use of polyvinyl alcohol as a tissue stabilizer. The intracellular coloured products of this reaction appear in two distinct forms, diffuse and granular, which we previously postulated to be indicative of LDH isoenzymes soluble and bound, respectively. Solubility is promoted by H-LDH subunits preferentially synthesized under good oxygenation; binding to membranes is favoured by the presence of M-LDH subunits preferentially active under poor oxygeneration. A reversible shift between the two forms apparently regulates the cells' metabolic adaptation to different stress situations. We assume that the anoxic shock protein LDHk exists exclusively in the bound form. In the Ehrlich carcinoma model previously employed, we verify a drift towards the exclusive presence of the granular form as the section's depth increases and/or when the cuff width decreases. This trend is ascribed to a progressive worsening of the local oxygenation levels. At the tumour interface, a chronic inflammatory tissue (notoriously highly hypoxic) is characterized by a granular LDH activity. New models of hypoxia are proposed and discussed for explaining the patterns here described and observed also in other studies, namely those derived from hyperviscosaemia, damaged endothelia, fibrosis, anaemia, poor ventilation and impaired cardio-vascular system.