GLUT3, also known as solute carrier family 2 member 3 (SLC2A3), is a facilitative glucose transporter protein that mediates the passive diffusion of glucose across cell membranes in a concentration-dependent manner.[1] It belongs to the SLC2 family of glucose transporters and is distinguished by its high affinity for glucose (Km ≈ 1.4 mM) and high transport capacity (Vmax up to 6,500 molecules per second per transporter), making it particularly suited for environments with low extracellular glucose levels.[1] Originally cloned in 1988 as the third isoform in the family, GLUT3 was initially identified as the primary neuronal glucose transporter due to its abundant expression in brain tissue.[1]Structurally, GLUT3 is an integral membrane protein consisting of 12 transmembrane helices organized into two bundles (helices 1–6 and 7–12) with intracellular N- and C-termini and a first extracellular loop between helices 1 and 2.[2] Crystal structures of GLUT3 in outward-facing conformations bound to glucose or the inhibitormaltose have revealed a central hydrophilic cavity that alternates between inward- and outward-open states to facilitate substrate translocation via an alternating access mechanism.[2] This architecture, conserved across the SLC2 family, includes N-linked glycosylation sites in the first extracellular loop, which influence transport kinetics and protein stability.[1]In terms of tissue distribution, GLUT3 is predominantly expressed in neurons throughout the brain, where it ensures efficient glucose uptake for high metabolic demands.[3] It is also present at lower levels in the placenta (particularly in cytotrophoblasts and syncytiotrophoblasts), heart, liver, testes, sperm, preimplantation embryos, and white blood cells, but is absent or barely detectable in skeletal muscle and kidney.[3][4] Functionally, GLUT3 plays a critical role in neuronal energy homeostasis, fetal development, and transplacental glucose transfer, with dysregulation implicated in neurodevelopmental disorders such as autism, epilepsy, and intrauterine growth restriction.[4] Its expression is regulated by factors including hypoxia (via HIF-1α) and ATP depletion[2], as well as maternal diet[4], highlighting its adaptability to physiological stresses.
Gene and Expression
Gene Structure and Location
The SLC2A3 gene, which encodes the glucose transporter GLUT3, is classified as a member of the solute carrier family 2 (SLC2A), consisting of facilitative glucose transporters. It is located on the short arm of human chromosome 12 at cytogenetic band 12p13.3, with genomic coordinates spanning from 7,919,230 to 7,936,187 on the reverse strand in the GRCh38 assembly.[5][6] The gene encompasses approximately 17 kb of genomic DNA.[6]The genomic organization of SLC2A3 includes 10 exons interrupted by 9 introns, with the first exon (ENSE00003532473) being entirely non-coding and comprising the 5' untranslated region (UTR).[5][7] The coding sequence begins in exon 2 and extends through exon 10, which also contains the 3' UTR. Alternative splicing of the primary transcript yields multiple transcript variants, with the canonical protein-coding isoform being the predominant form (496 amino acids).[8][6]The promoter region upstream of exon 1 features regulatory elements, including binding sites for transcription factors Sp1 and hypoxia-inducible factor 1 (HIF-1), which mediate basal and hypoxia-responsive expression, respectively.[9][10]SLC2A3 exhibits a high degree of evolutionary conservation across mammalian species, reflecting its essential role in glucose transport; for instance, the human protein shares approximately 83% amino acid sequence identity with its mouse ortholog, Slc2a3.[5][11][12]
Tissue-Specific Expression
GLUT3, encoded by the SLC2A3 gene, displays distinct tissue-specific expression patterns characterized by high basal levels in select tissues with elevated glucose demands. In humans, the highest expression occurs in the brain, particularly within neurons, where it serves as the predominant facilitative glucose transporter.[1] Substantial expression is also observed in the placenta, testes, and leukocytes, including hematopoietic and lymphoid cells, while levels are notably lower in the kidney, heart, and liver.[1][13] Recent research as of 2025 has also identified elevated SLC2A3 expression in various cancers, including head and neck squamous cell carcinoma, correlating with tumor progression.[14]Within the brain, GLUT3 expression is primarily confined to neurons, with minimal basal presence in astrocytes or other glial cells, underscoring its specialized role in neuronal glucose handling. This neuronal predominance has been confirmed through techniques such as immunohistochemistry, which reveals strong membranous and cytoplasmic staining in neuronal populations across cortical and hippocampal regions. In contrast, expression in non-neuronal brain cells remains low under normal conditions.[15][16]Developmentally, GLUT3 mRNA and protein levels undergo upregulation during neuronal differentiation and synaptogenesis in the embryonic and postnatal brain, aligning with periods of heightened metabolic needs for neural maturation. This temporal increase has been documented in rodent models, where protein expression peaks in correspondence with synaptic development. Quantitative assessments via RT-PCR and immunohistochemistry indicate that GLUT3 mediates approximately 50-70% of total glucose uptake in mature neurons, highlighting its quantitative dominance in neuronal energy supply.[17][18][19]Expression patterns of GLUT3 are largely conserved across species, with similar high levels in brain and testes observed in both humans and rodents. However, placental expression is more pronounced in humans, particularly during early gestation, where it supports fetal nutrient transfer more robustly than in rodents.[20][17]
Protein Structure and Properties
Topology and Folding
GLUT3, encoded by the SLC2A3 gene, is a 496-amino-acid protein with a calculated molecular weight of approximately 54 kDa.[21] Both the N- and C-termini are located intracellularly, consistent with its role as an integral membrane protein.[22]The protein adopts a typical Major Facilitator Superfamily (MFS) topology, featuring 12 transmembrane α-helices that bundle into an hourglass-shaped structure with a central hydrophilic cavity for substrate binding.[23] These helices are organized into two pseudosymmetric bundles of six, connected by a large intracellular loop between helices 6 and 7.[24] Key structural elements include transmembrane helices 7 and 10, which play critical roles in substrate occlusion by facilitating conformational changes that alternately seal the binding site from extracellular or intracellular environments.[25] Additionally, GLUT3 contains N-linked glycosylation sites at asparagine (Asn) residues in extracellular loops, particularly in the first loop between transmembrane helices 1 and 2, which contribute to its maturation and stability.[1]Recent crystal structures of GLUT3 reveal distinct inward-open and outward-open conformations that underpin its facilitative transport mechanism, with comparative analyses alongside structures of related transporters like GLUT1 providing further insights.[26][27] These structures highlight conserved features across the SLC2A family, where GLUT3 shares the core MFS topology with other isoforms.
Kinetic Parameters
GLUT3 functions as a facilitative uniport transporter, enabling the passive diffusion of D-glucose and D-galactose across plasma membranes without coupling to ions or other substrates.[1] This mechanism is inhibited by cytochalasin B, which acts as a competitive inhibitor binding to the inward-facing conformation of the transporter.[1][26]The transporter displays high affinity for glucose, with reported K_m values ranging from 1.4 mM to 2.9 mM depending on the substrate analog and assay conditions, compared to GLUT1's higher K_m of 6-10 mM.[28][1][26] Its maximum velocity (V_{max}) or turnover number (k_{cat}) is approximately 5-10 times greater than that of GLUT1 in neuronal preparations, reaching up to 6,500 s^{-1} at physiological temperatures, which supports efficient glucose uptake under low-concentration conditions.[1] Transport kinetics follow the Michaelis-Menten equation:v = \frac{V_{max} [S]}{K_m + [S]}where v is the initial transport rate and [S] is the substrate concentration.[28]GLUT3 exhibits selectivity for hexoses, transporting 2-deoxy-D-glucose with a K_m of about 1.4 mM but excluding D-fructose.[1][28] The process is voltage-independent and shows minimal pH dependence within physiological ranges, ensuring consistent activity across cellular environments.[1] Optimal transport occurs at 37°C, with activity measured at lower temperatures in experimental settings yielding lower V_{max} values, such as 853 s^{-1} at 25°C.[1][28] The glucose-binding site shares structural homology with that of GLUT1, contributing to similar substrate recognition patterns.[26]
Discovery and Characterization
Historical Discovery
Prior to the molecular identification of specific glucose transporter isoforms, kinetic studies in brain tissue during the 1970s and early 1980s provided evidence for multiple facilitative glucose transport systems. These investigations, using techniques such as the single-pass indicator dilution method, revealed distinct kinetic profiles, including a high-affinity, low-capacity system (Km ≈ 1-3 mM) predominant in neuronal uptake and a low-affinity, high-capacity system (Km ≈ 10-15 mM) associated with endothelial cells of the blood-brain barrier.[29] Such findings suggested the existence of specialized transporters adapted to the brain's high glucose demand under varying physiological conditions.[30]The molecular era began with the cloning of GLUT1 in 1985 from human erythrocytes, establishing the facilitative glucose transporter family. This was followed by GLUT2 in 1988 from rat liver, expanding the family to include tissue-specific isoforms. In the same year, Asano et al. cloned a high-affinity glucose transporter cDNA from rabbitbrain, demonstrating its expression during neural development and providing a probe for homologous sequences in other species.[31]Kayano et al. then isolated the human ortholog in 1988 from a fetal skeletal muscle cDNA library, using a human GLUT1 cDNA probe for low-stringency hybridization; the resulting 496-amino-acid protein, designated GLUT3 as the third isoform, shared 64% sequence identity with GLUT1 and exhibited properties consistent with a brain-enriched transporter. These efforts highlighted the emerging SLC2A gene family, unifying diverse glucose transport mechanisms. The cloning demonstrated high mRNA levels in human brain tissue and lower levels elsewhere. Subsequent studies in the early 1990s confirmed GLUT3's neuronal specificity through in situ hybridization and immunohistochemical analyses.[32]
Initial Functional Studies
Following the cloning of the GLUT3 gene in the late 1980s, initial functional studies utilized Xenopus oocyte expression systems to characterize its glucose transport properties. Injection of synthetic GLUT3 cRNA into defolliculated Xenopus laevis oocytes resulted in significant uptake of the non-metabolizable glucose analog 2-deoxy-D-glucose, confirming GLUT3's role as a facilitative glucose transporter with a high affinity for glucose, evidenced by a Michaelis constant (Km) of approximately 1.4 mM. These assays demonstrated that GLUT3-mediated transport was saturable and stereospecific, distinguishing it from passive diffusion and aligning with its predicted facilitative mechanism.[33]Early immunological studies further elucidated GLUT3's localization in neural tissues, employing polyclonal antibodies raised against synthetic peptides corresponding to the GLUT3 C-terminus. In rat brain sections, immunofluorescence revealed prominent GLUT3 expression in neurons, with particular enrichment in axonal and dendritic processes of pyramidal cells in the cerebral cortex and hippocampal formation, suggesting a role in localized glucose delivery to synaptic regions. This neuronal predominance contrasted with lower expression in microvessels, underscoring GLUT3's specialization for high-demand neural environments.Comparative kinetic analyses highlighted GLUT3's superior efficiency in low-glucose settings, such as the brain interstitium where extracellular glucose concentrations range from 0.5 to 2 mM. Unlike the lower-affinity GLUT1 (Km ~7 mM), GLUT3's Km value enabled robust transport rates even at subsaturating glucose levels, positioning it as ideal for maintaining neuronal energy supply under fluctuating conditions.Insights into GLUT3's substrate range emerged from oocyte uptake experiments with glucose analogs and related hexoses. GLUT3 facilitated the transport of 3-O-methyl-D-glucose and D-galactose, with competitive inhibition by D-glucose and maltose indicating a shared binding site, while it showed no activity toward L-glucose, reinforcing its facilitative and D-stereospecific nature. These findings established GLUT3 as a high-affinity, broad-specificity transporter tailored for neuronal glucose homeostasis.[33]
Physiological Function
Role in the Brain
GLUT3 serves as the principal facilitative glucose transporter in neurons, where it ensures a steady supply of glucose to meet the brain's substantial energy requirements, particularly during periods of heightened synaptic activity and neurotransmission. Neurons rely heavily on glucose as their primary fuel source, and GLUT3's localization in neuronal membranes, including axons and dendrites, positions it to support ATP production essential for maintaining membrane potentials and neurotransmitter release. This transporter's abundance in brain tissue underscores its dominance in neuronal glucose uptake, enabling efficient energy homeostasis in the central nervous system.[18][15]In the context of the blood-brain barrier (BBB), GLUT3 contributes to glucose transport by being expressed in endothelial cells of brain microvessels, facilitating the passage of glucose from the bloodstream into the brain parenchyma. Although GLUT1 is the predominant isoform at the BBB, GLUT3's presence in these endothelial cells, along with minor expression in perivascular astrocytes, aids in the overall delivery of glucose to support neuronal functions. This involvement helps maintain the barrier's role in regulating nutrient entry while accommodating the brain's metabolic demands.[15][34]The high affinity of GLUT3 for glucose, characterized by a low Km value of approximately 1-2 mM, enables sustained neuronal glucose uptake during hypoglycemia, when blood glucose levels fall below 4 mM. This property is crucial for protecting brain function under low-glucose conditions, as it allows neurons to continue extracting glucose from the interstitial fluid even when extracellular concentrations are reduced. Such adaptability prevents energy deficits that could impair cognitive processes.[35][1]During embryonic development, GLUT3 plays a vital role in post-implantation brain growth and neuronal migration, supporting the rapid proliferation and organization of neural tissues. Disruption of GLUT3 expression leads to impaired brainorganogenesis, including growth restriction and apoptosis in neural structures, highlighting its necessity for proper embryonic brain development and survival. This transporter's activity ensures adequate glucose availability for the energy-intensive processes of neuronal differentiation and migration.[36][4]
Functions in Other Tissues
In the placenta, GLUT3 exhibits high expression in trophoblast cells, facilitating the transplacental transport of glucose to support fetal growth and development. This transporter is particularly important throughout gestation, with expression decreasing over time but contributing to basal glucose uptake and responding to gestational changes to maintain fetal nutrition. Studies have shown that GLUT3 protein is localized in the syncytial microvillous membrane of the placenta.[37][38][39]In the testis, GLUT3 plays a supportive role in spermatogenesis by enabling glucose uptake in Sertoli cells and germ cells, which rely on glucose-derived metabolites for energy and maturation. Expressed intensely in germ cells within the seminiferous tubules, including spermatocytes and spermatids, GLUT3 helps provide the necessary substrates for lactate production by Sertoli cells, a key energy source for developing spermatozoa. Reduced GLUT3 levels have been associated with impaired spermatogenesis, highlighting its importance in maintaining testicular metabolic homeostasis.[40][41][42]GLUT3 contributes to immune function in leukocytes, where it aids in glucose uptake during cellactivation and migration, processes that are upregulated in response to inflammation. In T helper 17 (Th17) cells, GLUT3-mediated glucose influx supports glycolytic reprogramming and the production of inflammatory cytokines, enhancing immune responses in autoimmune contexts. Similarly, in macrophages and CD8+ T cells, enforced GLUT3 expression improves metabolic fitness, promoting signaling pathways and effector functions during inflammatory challenges.[43][44][45][46]Beyond these primary sites, GLUT3 provides minor contributions to glucose handling in other tissues. In the heart, GLUT3 is present at low levels and may assist in glucose metabolism during stress, such as ischemia, when cardiac reliance on glycolysis increases, though it plays a secondary role compared to dominant transporters like GLUT1 and GLUT4.[47][48][49]
Regulation and Interactions
Regulatory Mechanisms
The transcription of the SLC2A3 gene, which encodes GLUT3, is primarily regulated by hypoxia-inducible factor 1 (HIF-1), a transcription factor that binds to a hypoxia-responsive element (HRE) in the GLUT3 promoter under low-oxygen conditions, thereby upregulating expression to enhance glucose uptake in hypoxic environments.[50] Unlike some other glucose transporters such as GLUT4, GLUT3 operates in an insulin-independent manner, though its expression increases in response to glucose deprivation through pathways involving AMP-activated protein kinase (AMPK) and cAMP response element-binding protein 1 (CREB1), which promote transcriptional activation to support cellular energy needs during nutrient stress.[51] These regulatory elements in the promoter region serve as key targets for such hypoxia- and deprivation-induced controls.[52]At the post-transcriptional level, microRNAs (miRNAs) play a significant role in modulating GLUT3 expression; for instance, miR-155 targets SLC2A3 mRNA, leading to its downregulation, particularly in contexts like cancer where miR-155 deficiency combined with hypoxia can result in elevated GLUT3 levels and altered metabolism.[53] While alternative splicing variants have been noted in related glucose transporter family members, specific impacts on GLUT3 mRNA stability remain less characterized, with miRNA-mediated repression emerging as a dominant mechanism for fine-tuning transcript abundance.Post-translational modifications influence GLUT3 activity and localization, including NMDAR/Akt-dependent signaling that modulates its trafficking to the plasma membrane, enhancing surface expression in response to neuronal depolarization.[18]Protein kinase C (PKC)-mediated signaling modulates trafficking in non-neuronal cells, such as through phosphorylation of Akt.[1] Additionally, GLUT3 undergoes clathrin-mediated endocytosis, facilitating its recycling and internalization, which helps regulate glucose transport capacity under varying extracellular glucose levels.[54]Environmental stressors further drive GLUT3 regulation, with chronic hypoxia inducing sustained upregulation via HIF-1 to maintain neuronal glucose supply during oxygen limitation.[55] In neurons, oxidative stress also promotes GLUT3 expression through pathways involving Akt and HIF-1α, counteracting reactive oxygen species-induced damage by bolstering glucose availability for antioxidant defenses.[56]
Protein Interactions
GLUT3 interacts with Rab GTPases to facilitate its trafficking and localization in neurons. Specifically, GLUT3 co-localizes with Rab11 in endosomal compartments within neuronal somata and neurites, where Rab11 regulates the transport of GLUT3 to the cell surface. Dominant-active Rab11 enhances surface expression of GLUT3, while dominant-negative forms reduce it, indicating Rab11's role in vesicular trafficking that supports efficient glucose uptake in high-demand neuronal environments. This interaction is crucial for maintaining GLUT3 at synaptic and axonal sites, though direct axonal transport mechanisms involving Rab11 remain under investigation. Additionally, Rab11a-dependent recycling of GLUT3 has been shown to inhibit seizure-induced neuronal disulfidptosis by alleviating glucose deficiency.[57][58]In metabolic contexts, GLUT3 associates with glycolytic enzymes to form functional complexes that optimize glucose flux. GLUT3 colocalizes with hexokinase I in caveolae-like microdomains of spermatogenic cells, suggesting a similar organization in other tissues where proximity to hexokinase facilitates rapid phosphorylation of imported glucose, preventing efflux and enhancing glycolytic efficiency. Although primarily studied in non-neuronal cells, this spatial association likely contributes to metabolons in neurons, linking GLUT3-mediated uptake directly to downstream glycolysis. Evidence for direct binding with hexokinase II is limited, but the overall pattern supports GLUT3's integration into glycolytic assemblies.[59]GLUT3's activity is modulated by inhibitory ligands that bind at sites overlapping the glucose substrate pocket. Cytochalasin B, a fungal metabolite, inhibits GLUT3 by binding to the inward-facing conformation of the transporter, directly competing with glucose at the central binding cavity formed by transmembrane helices. Structural analyses confirm this overlap, with key residues like those in the QLS motif coordinating both substrate and inhibitor, leading to non-competitive inhibition kinetics in functional assays. This binding mechanism underscores GLUT3's vulnerability to pharmacological blockade, informing inhibitor design for glucose transport studies.[60]In pathological conditions, such as Alzheimer's disease models, GLUT3 engages in interactions that disrupt its membrane localization. Amyloid-β oligomers reduce GLUT3 expression and plasma membrane presence in neuronal cell lines, mediated through activation of the integrated stress response pathway rather than direct binding. This leads to diminished surface GLUT3 levels, impairing neuronal glucose uptake and contributing to hypometabolism observed in affected brain regions. Restoration of GLUT3 localization via stress response inhibition ameliorates these deficits, highlighting the interaction's role in disease progression.[61]
Clinical Relevance
Neurological Diseases
In Alzheimer's disease (AD), reduced expression of GLUT3 has been consistently observed in the hippocampus and cortex, regions critical for memory and cognition. Post-mortem analyses of AD brains reveal significant decreases in GLUT3 levels, which correlate with the severity of amyloid-β plaques and neurofibrillary tangles, contributing to impaired neuronal glucose uptake and energy deficits that precede clinical cognitive decline.[62] These reductions appear early in disease progression, as evidenced by longitudinal studies in rodent models where GLUT3 downregulation follows amyloid-β accumulation and is linked to hypometabolism in the hippocampus, a predictor of memory impairment in mild cognitive impairment patients.[63] Furthermore, amyloid-β oligomers interfere with GLUT3 function by promoting membrane lipid peroxidation in hippocampal neurons, exacerbating glucose transport deficits and tau hyperphosphorylation, which are hallmarks of AD pathology.[62]GLUT3 dysregulation also plays a role in epilepsy and hypoglycemia, where mutations or downregulation impair neuronal glucose transport, leading to energy shortages that heighten seizure susceptibility. In epileptic conditions, such as those modeled by pentylenetetrazol-induced seizures, decreased GLUT3 expression reduces glucose availability in neurons, promoting dysregulated uptake and glucose deficiency-induced neuronal damage, including disulfidptosis.[57] Similarly, zinc-α2-glycoprotein (ZAG) downregulation during seizures suppresses GLUT3 expression and membrane distribution, further limiting neuronal energy supply and exacerbating seizure-induced glucose hypometabolism.[64] In hypoglycemia, recurrent moderate episodes impair GLUT3-mediated glucose uptake, particularly in vulnerable brain regions, resulting in mitochondrial dysfunction and neuronal deficits that mimic features of glucose transport disorders like GLUT1 deficiency syndrome, where analogous energy crises trigger seizures.[65] Neuronal GLUT3-deficient mouse models demonstrate these effects, showing behavioral impairments and increased seizure risk due to chronic energy deficits.[66]In Parkinson's disease (PD), GLUT3 deficiency contributes to metabolic dysfunction, with oxidative stress playing a key role in diminishing its expression and overall glucose handling in dopaminergic neurons. Studies indicate reduced GLUT3 levels in PD brains, leading to impaired ATP production and heightened reactive oxygen species accumulation, which amplifies neuronal vulnerability and disease progression.[67]Oxidative stress from mitochondrial impairments further exacerbates this by disrupting glucose metabolism pathways involving GLUT3, promoting energy failure in the substantia nigra.[68]Potential therapeutics targeting GLUT3 hold promise for mitigating neurodegeneration, as demonstrated in animal models where its overexpression restores glucose uptake and alleviates symptoms. In a Drosophila model of Huntington's disease, neuronal GLUT3 overexpression extended lifespan by 71%, improved locomotor function, and rescued eye neurodegeneration by enhancing energy metabolism and counteracting oxidative stress via the pentose-phosphate pathway.[69] These findings suggest that strategies to upregulate or stabilize GLUT3 could similarly benefit AD and PD by addressing early hypometabolism, though clinical translation requires further validation in mammalian models.[65]
Cancer and Other Pathologies
GLUT3 is frequently upregulated in various cancers, contributing to enhanced glucose uptake that supports the Warburg effect and tumor proliferation. In glioblastoma, GLUT3 overexpression promotes metabolic reprogramming and is associated with aggressive tumor behavior, as it facilitates glucose transport under hypoxic conditions prevalent in the tumor microenvironment.[70] Similarly, in breast cancer cells, GLUT3 is essential for survival and metabolic adaptation, with elevated levels observed in malignant tissues compared to normal ones.[71] In lymphomas, such as diffuse large B-cell lymphoma, GLUT3 expression is increased and correlates with disease progression.[72]Efforts to target GLUT3 in cancer therapy have focused on developing specific inhibitors to disrupt tumor glucose metabolism. In silico ligand screening has identified potential GLUT3 blockers that selectively inhibit its activity, offering a strategy to starve cancer cells dependent on high-affinity glucose transport.[60] Structural studies have further elucidated the molecular basis for designing inhibitors that target GLUT3 alongside other transporters like GLUT1, aiming to overcome resistance in hyperproliferative tumors.[27] These approaches highlight GLUT3's vulnerability in cancers reliant on aerobic glycolysis.Beyond oncology, GLUT3 dysregulation contributes to diabetic complications, particularly through altered expression in placental tissue. In gestational diabetes mellitus, GLUT3 translocation and expression in trophoblasts are modulated by pathways like AMPK, influencing fetal glucose supply and potentially exacerbating maternal hyperglycemia-related risks.[73] In inflammatory conditions such as rheumatoid arthritis, GLUT3 drives glycolytic reprogramming in T helper 17 cells and platelets, promoting cytokine production and autoimmune responses that sustain joint inflammation.[43][74]High GLUT3 expression serves as a prognostic biomarker indicating poor survival in solid tumors. Meta-analyses have shown that elevated GLUT3 levels are linked to reduced overall survival across various malignancies, including gliomas and breast cancers, independent of other clinicopathological factors.[75] In glioblastoma specifically, patients with high GLUT3 exhibit significantly lower survival rates, underscoring its utility in risk stratification.[76]