The structural conditions relevant for metabolite exchange in anaerobic and aerobic work conditions in muscle tissue are reviewed. High-intensity non-steady-state exercise is supported by the phosphocreatine pool, which serves as a shuttle for high-energy phosphates produced by glycolysis and by aerobic metabolism. This is achieved through the intermediary of a topologically organized creatine kinase isozyme system. The muscle capillary network supplies substrate and environmental oxygen to the mitochondria. The network is quantitatively matched to the muscle oxidative capacity, determined structurally by mitochondrial volume. Capillary hematocrit, erythrocyte spacing and oxygen saturation of myoglobin are critical variables for oxygen release from microvessels. Myoglobin greatly helps intracellular oxygen transfer as, under aerobic work conditions, it keeps intracellular oxygen tension low and uniform in the muscle fibers. During sustained submaximal work, muscle cells are fueled by both endogenous (triglycerides and glycogen) and circulatory (lactate, glucose and fatty acids) substrates. A lactate shuttle in which lactate may move through the circulation, as well as directly from fiber to fiber, provides many of the carbohydrate-derived carbon skeletons for terminal oxidation. Glucose is taken up from the interstitial space by facilitated diffusion, mostly mediated by a glucose transporter (GLUT4) that is translocated from an intracellular location to the sarcolemma by activity and insulin. Extramyocellular transport of fatty acids is mediated by albumin, while fatty-acid-binding proteins are held responsible for intracellular fatty acid transport.

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