LDHA and neoplasm: Given reports that high LA levels were associated with tumor progression, metastases, recurrence, and reduced patient survival12,31, we used immunohistochemistry (IHC) to measure the expression of representative proliferation marker Ki67, LA production indicator lactate dehydrogenase A (LDHA), and LA efflux indicator monocarboxylate transporter 4 (MCT4) in glioma samples from patients (Fig. 2a).