Do alkaline phosphatases have great potential in the diagnosis, prognosis, and treatment of tumors?

Abstract

Alkaline phosphatase (ALP) is a group of enzymes that catalyze hydrolysis of phosphate esters at an alkaline pH, resulting in the generation of inorganic phosphate. These enzymes are widely distributed, and their activity is found in various tissues including bone, liver, intestine, and placenta. However, abnormalities in ALP expression and activity have been observed in certain types of cancer. In some cases, elevated serum levels of ALP are observed in patients with liver and bone metastasis. In other cases, increased levels of ALP have been observed in patients with pancreatic and lung cancer. On the other hand, low expression of ALP has also been associated with poor prognosis in patients with certain types of tumors, including colorectal cancer (CRC), breast cancer, and non-small cell lung cancer (NSCLC). In these cases, low ALP activity may be associated with decreased differentiation of cancer cells and increased cancer cell proliferation. Overall, the role of ALP in cancer is complex and context-dependent. This article reviews application progress of ALP in cancer, and we hypothesize that ALP might be a potential tumor biomarker, combined detection of aspartate aminotransferase (AST)/alanine aminotransferase (ALT), bone-specific alkaline phosphatase (BSAP), carbohydrate antigen 19-9 (CA 19-9), lactate dehydrogenase (LDH) and ALP isozymes levels can be used for more accurate diagnosis of a particular tumor. Further research is needed to better understand the mechanisms underlying ALP dysregulation in cancer and to identify potential therapeutic targets.

Elucidating the role of liver enzymes as markers and regulators in ovarian cancer: a synergistic approach using Mendelian randomization, single-cell analysis, and clinical evidence

“…Moreover, an inverse correlation was observed between the levels of ALP and the ovarian cancer biomarker CA125. In several cancer types, including colorectal cancer (CRC), breast cancer, and non-small cell lung cancer (NSCLC), low levels of alkaline phosphatase (ALP) have been associated with a worse prognosis for patients [ 28 ]. Some studies have observed a relationship between low ALPL expression and chemo-resistance of high-grade serous ovarian cancer (HGSOC) cells to paclitaxel.…”

Can blood-based markers predict RECIST progression in non-small cell lung cancer treated with immunotherapy?

“…Additionally, fast increases over time and overall elevated trajectories of CRP have also been found to be predictors of high risk of progression (Riedl et al 2020 ). While research on ALP has demonstrated their potential as biomarkers across different tumour types, its role in NSCLC remains uncertain (Jiang et al 2023 ), and literature concerning NSCLC patients receiving immunotherapy is limited. Yang et al ( 2023 ) found that higher levels of pre-treatment ALP are associated with lower overall response rate, and shorter median progression-free survival (mPFS) in patients with NSCLC treated with immune checkpoint inhibitors and that ALP is an independent prognostic indicator of mPFS.…”

Molecular Biomarkers of Canine Reproductive Functions

“…Its activity has been demonstrated in cytoplasmic droplets, which raises the hypothesis that ALPL catalyzes dephosphorylation and transport of phosphate groups between the epididymal sperm and epididymal fluid. ALPL might be a potential biomarker for prostate and testicular cancer [ 39 ]. This enzyme inhibitor can reduce the growth and invasion of cancer cells [ 39 ].…”

“…ALPL might be a potential biomarker for prostate and testicular cancer [ 39 ]. This enzyme inhibitor can reduce the growth and invasion of cancer cells [ 39 ]. Measurement of the enzymatic activity of ALPL in the canine seminal plasma has been used for the diagnosis of incomplete ejaculation or azoospermia in dogs [ 38 ], and a reduced concentration of ALPL in the seminal plasma suggests bilateral obstruction of the vas deferens or epididymis [ 40 ].…”