Mode of action: After administration of Gliolan® (5-ALA), malignant glioma cells selectively accumulate a fluorescent dye protoporphyrin IX (PPIX)1,2
Heme biosynthesis in mitochondrion
Mode of action: PPIX accumulation after 5-ALA exposure in malignant glioma cells probably due to increased uptake of 5-ALA or an altered enzyme profile1
Malignant glioma cells accumulate more 5-ALA-induced PPIX compared to non-malignant cells, resulting in higher sensitivity, specificity and accurancy for malignant cells.3
This accumulation can be explained by increased uptake of 5-ALA (e.g., impaired blood-brain barrier, overexpression of membrane transporters)1 and by an altered expression or activity of enzymes involved in hemoglobin biosynthesis (e.g., decrease in ferrochelatase) in malignant glioma cells.4
1. Traylor et al. 2021, Cancers; 13 (3): 580 2. www.ema.europa.eu/en/documents/product-information/gliolan-epar-product-information_en.pdf, Stand 15/06/2022 3. Stummer et al 1998. Neurosurgery: 42,518-26 4. Teng et al. 2011, Br J. Cancer: 104,798-807
