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Aminolevulinic acid (ALA) or delta-aminolevulinic acid or 5--aminolevulinic acid is an amino acid synthesized by the liver. This the first compound in the porphyrin synthesis pathway that leads to heme biosynthesis. ALA test is to measure this substance excreted in the urine. Higher quantities of ALA are found in the urine in inherited acute porphyrias or due to inhibition of ALA dehydratase. Moreover, 5ALA being a precursor of protoporphyrin-IX which is a photosensitizer is used as an add-on agent for photodynamic therapy in diagnosis (fluorescence imaging) and treatment of cancers (photosensitizer molecules) by computer simulations can be able to penetrate tumor cell membranes. The principle behind it is that cancer cells lack or have reduced ferrochelatase activity and hence it results in the accumulation of protoporphyrin-IX (its metabolic pathway precursor), a fluorescent substance that can be visualized.
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