Nagalase Blood Test

The Nagalase blood test measures the activity of the enzyme α-N-acetylgalactosaminidase (Nagalase). (For information on the ordering procedure for this test, please scroll to the bottom of this description.)

Nagalase is an extracellular matrix-degrading enzyme that is secreted by cancerous cells in the process of tumor invasion. It is also an intrinsic component of the envelope protein of various virions, such as HIV and the influenza virus. Thus, it is also secreted from virus-infected cells (1,3,4).

Nagalase deglycosylates the vitamin D3-binding protein DBP (also known as Gc-protein). Gc-protein, which contains three sugars, is the precursor for the major macrophage-activating factor (MAF). By complete deglycosylation, Gc-protein can no longer be converted to MAF.

Normally, MAF is produced from the Gc-protein by sequential removal of the galactose and sialic acid without touching the remaining sugar N-acetylgalactosamine.

Macrophage activation for phagocytosis and antigen presentation is the first step in the immune development cascade. Lost precursor activity, therefore, leads to immune suppression.

Increased nagalase activity has been detected in the blood of patients with a wide variety of cancers such as cancer of the prostate, breast, colon, lung, esophagus, stomach, liver, pancreas, kidney, bladder, testis, uterus, and ovary, mesothelioma, melanoma, fibrosarcoma, glioblastoma, neuroblastoma, and various leukemias (1,3,4). For various types of tumors, various levels of nagalase activity were found (7). It appears that the secretory capacity of individual tumor tissue varies among tumor types depending upon tumor size, staging, and the degree of malignancy or invasiveness (7). Increased nagalase activity has not been detected in the blood of healthy individuals (1.)

Nagalase activity is directly proportional to viable tumor burden (1,2). Studies correlating nagalase levels with tumor burden suggest that the measurement of this enzyme can diagnose the presence of cancerous lesions below levels detectable by other diagnostic means (1). In research studies, nagalase activity decreased to near tumor-free control levels one day after surgical removal of primary tumors from cancer patients, suggesting that the half-life of nagalase is less than 24 hours (1,6). The short half-life of nagalase is valuable for prognosis of the disease during various therapies (1 ,5).

Test Indications

Nagalase in blood is a sensitive test for monitoring the efficacy of therapy in cancer and certain viral infections, including HIV and recently HSV-1/2. Because of the short half-life of nagalase, the method is suitable for monitoring various types of therapy. The great sensitivity of the test may help the physician / oncologist in obtaining a better understanding of the therapy and to fine-tune the treatment.

Note: The values may be affected by certain drugs used in the five days preceding blood draw. Drug use must be indicated on the Questionnaire submitted with the Requisition Form.

References

Korbelik M, VR Naraparaju, N Yamamoto. The value of serum alpha-N-acetylgalactosaminidase measurement for the assessment of tumour response to radio- and photodynamic therapy. Br J Cancer, 77:1009-1014, 1998.
Reddi AL et al. Serum alpha-N-acetylgalactosaminidase is associated with diagnosis/prognosis of patients with squamous cell carcinoma of the uterine cervix. Cancer Lett, 158:61-64, 2000.
Yamamoto N and M Urade. Pathogenic significance of alpha-N-acetylgalactosaminidase activity found in the hemagglutinin of influenza virus. Microbes Infect, 7:674-681, 2005.
Yamamoto N. Pathogenic significance of alpha-N-acetylgalactosaminidase activity found in the envelope glycoprotein gp160 of human immunodeficiency virus Type I. AIDS Res Hum Retroviruses, 22:262-271, 2006.
Yamamoto N, H Suyama, N Yamamoto. Immunotherapy for prostate cancer with Gc protein-derived macrophage activating factor (GcMAF). Transl Oncol, 1:65-72, 2008.
Yamamoto N et al. Therapeutic efficacy of vitamin D3-binding protein-derived macrophage activating factor for prostate, breast and colon cancers. Cancer Res Proc, 38:31, 1997.
Yamamoto et al. Deglycosylation of serum vitamin D3-binding protein leads to immunosuppression in cancer patients. Cancer Res, 56:2827-2831, 1996.
Procedure for Orders
When you order this test, we send a test kit directly to the shipping address you provide (typically your own). You then take that kit to an appointment at a local clinic or blood draw station to have a blood sample drawn, and you will need to pay them directly for that service. This kit includes a prepaid FedEx label for shipping the sample to the lab in New Jersey. The test results will be emailed to you.

Status of Your Immune System

This important test assesses the status of your patient’s immune system. The laboratory in New Jersey requires that prescriptions with a diagnostic code accompanies the samples to the lab. Dr. Lee must have a brief teleconference with the patient or their caregiver, to render the appropriate diagnosis and code. So after or during the purchase of the kit, ask for the schedule for Dr. Lee’s time and a brief teleconference will be scheduled to establish a case and a working diagnosis.

This 20 minute teleconference with an upfront $50 minimum charge. The proper requisition form accompanies the blood samples to the laboratory in New Jersey. In 7-10 days the full report of the Nagalase enzyme level will be sent via email to Dr Lee and the customer. Yours and your team’s use of this information is up to you and it is hoped it will be a valuable assessment tool.