'''D-Aminolevulinic acid''' (dALA or δ-ALA or 5-aminolevulinic acid) is the first compound in the [[porphyrin]] synthesis pathway, the pathway that leads to [[hemoglobin]] in mammals.
* The presence of δ-aminolevulinic acid in the urine is a key guideline for patients suspected of having [[Porphyria|porhyria]] use
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* Normal values: '''<7.5 mg/24h urine''' in a 20ml urine sample. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref>
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In non-photosynthetic [[eukaryotes]] such as animals, insects, fungi, and [[protozoa]] as well as the α-proteobacteria group of bacteria it is produced by the [[enzyme]] [[ALA synthase]], from [[glycine]] and [[succinyl CoA]]. This reaction is known as the [[Shemin pathway]].
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In [[plants]], [[algae]], [[bacteria]] (except for the α-proteobacteria group) and [[archaea]] it is produced from [[glutamic acid]] via glutamyl-tRNA and [[glutamate-1-semialdehyde]]. The enzymes involved in this pathway are [[glutamyl-tRNA synthetase]], [[glutamyl-tRNA reductase]] and [[glutamate-1-semialdehyde aminotransferase]]. This pathway is known as the C5 or Beale pathway.<ref>Beale, Samuel I. (1990) Biosynthesis of the tetrapyrrole pigment precursor, d-aminolevulinic acid, from glutamate. Plant Physiology, 93(4), 1273-1279</ref><ref>Willows R.D. (2004) Chlorophylls In: Encylopaedia of Plant and Crop Science. pp 258-262, Ed: Robert M. Goodman. Marcel Dekker Inc, ISBN 0-8247-4268-0</ref>
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==Test Indications ==
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* [[Acute intermittent porphyria]]
* Chronic hepatic [[porphyria]]
* Drug damage to the liver
* Hereditary coproporphyria
* Porphyria variegata
==Clinical significance==
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It elicits synthesis and accumulation of [[fluorescent]] [[porphyrin]]s (protoporphyrin IX) in [[epithelium|epithelia]] and [[neoplasm|neoplastic]] [[Biological tissue|tissue]]s, among them [[glioma|malignant glioma]]s. It is used to visualise tumorous tissue in [[neurosurgery|neurosurgical]] procedures. Studies <ref> {{cite journal |author=Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ |title=Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial |journal=Lancet Oncol. |volume=7 |issue=5 |pages=392-401 |year=2006 |pmid=16648043 |doi=10.1016/S1470-2045(06)70665-9}}</ref> have shown that the intraoperative use of this guiding method may reduce the tumour residual volume and prolong progression-free survival in patients suffering from this disease.
dALA is also a [[photosensitizer]] for [[photodynamic therapy]].
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==References==
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<references/>
==See also==
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* [[Porphyrin]]
{{Chemotherapeutic agents}}
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{{DEFAULTSORT:Aminolevulinic acid, D-}}
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[[Category:Biomolecules]]
[[Category:Amines]]
[[Category:Carboxylic acids]]
[[pl:ALA]]
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Overview
D-Aminolevulinic acid is a {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of {{{indication}}}. There is a Black Box Warning for this drug as shown here. Common adverse reactions include .
Adult Indications and Dosage
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Off-Label Use and Dosage (Adult)
Guideline-Supported Use
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Developed by:
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Strength of Evidence:
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Condition2
There is limited information regarding Off-Label Guideline-Supported Use of D-Aminolevulinic acid in adult patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of D-Aminolevulinic acid in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
Condition1
Dosing Information
Dosage
Condition2
There is limited information regarding FDA-Labeled Use of D-Aminolevulinic acid in pediatric patients.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
Condition1
Developed by:
Class of Recommendation:
Strength of Evidence:
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There is limited information regarding Off-Label Guideline-Supported Use of D-Aminolevulinic acid in pediatric patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of D-Aminolevulinic acid in pediatric patients.
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Description
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Description
Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of D-Aminolevulinic acid in the drug label.
Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous
Postmarketing Experience
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