Research progress on the impact on bone healing of the regulation of macrophage polarization by lactic acid and lactylation modification
Lu Chenyang
Sun Xiaoxian
Yu Yunfei
Zhang Yan
Wu Mao
Abstract：This paper explores the roles of lactic acid and its derived lactylation modification in macro-phage polarization and bone healing.It elaborates on how lactic acid regulates the transformation of macrophages from the M1 to M2 phenotype through metabolic reprogramming and signaling pathways,and further discusses the important significance of this process in the inflammatory,reparative and remodeling phases of fracture healing.In addition,the paper describes the special manifestations of macrophage polarization under pathological conditions such as hypoxia in the fracture microenvironment and osteoporosis.At the mechanistic level,it not only summarizes histone lactylation modification,but also reveals how non-histone lactylation modification(e.g.,pyruvate kinase M2)directly regulates the expression of bone healing-related genes,including the regulation of osteoclast resorption and osteoblast differentiation.This paper emphasizes the potential of lactic acid and lactylation modification as therapeutic targets for bone healing,and proposes future research directions for improving bone repair efficacy by regulating macrophage polarization,providing an innovative strategy for the treatment of non-union fractures.
Keywords：Bone healingLactic acidLactylation modificationMacrophage polarizationMetabolic reprogrammingInflammatory response
Publication Date：2026-02-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 310-315 )