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Updated: Jul 9, 2026

In Vitro Assay to Study Tumor-macrophage Interaction
Published on: August 1, 2019
Immunotherapy of metastatic colorectal cancer with vitamin D-binding protein-derived macrophage-activating factor,
Nobuto Yamamoto1, Hirofumi Suyama, Hiroaki Nakazato
1Division of Cancer Immunology and Molecular Immunology, Socrates Institute for Therapeutic Immunology, 1040, 66th Ave, Philadelphia, PA 19126-3305, USA. nobutoyama@verizon.net
Abstract:
Serum vitamin D binding protein (Gc protein) is the precursor for the principal macrophage-activating factor (MAF). The MAF precursor activity of serum Gc protein of colorectal cancer patients was lost or reduced because Gc protein is deglycosylated by serum alpha-N-acetylgalactosaminidase (Nagalase) secreted from cancerous cells. Deglycosylated Gc protein cannot be converted to MAF, leading to immunosuppression. Stepwise treatment of purified Gc protein with immobilized beta-galactosidase and sialidase generated the most potent macrophage-activating factor (GcMAF) ever discovered, but it produces no side effect in humans. Macrophages treated with GcMAF (100 microg/ml) develop an enormous variation of receptors and are highly tumoricidal to a variety of cancers indiscriminately. Administration of 100 nanogram (ng)/ human maximally activates systemic macrophages that can kill cancerous cells. Since the half-life of the activated macrophages is approximately 6 days, 100 ng GcMAF was administered weekly to eight nonanemic colorectal cancer patients who had previously received tumor-resection but still carried significant amounts of metastatic tumor cells. As GcMAF therapy progressed, the MAF precursor activities of all patients increased and conversely their serum Nagalase activities decreased. Since serum Nagalase is proportional to tumor burden, serum Nagalase activity was used as a prognostic index for time course analysis of GcMAF therapy. After 32-50 weekly administrations of 100 ng GcMAF, all colorectal cancer patients exhibited healthy control levels of the serum Nagalase activity, indicating eradication of metastatic tumor cells. During 7 years after the completion of GcMAF therapy, their serum Nagalase activity did not increase, indicating no recurrence of cancer, which was also supported by the annual CT scans of these patients.
Insights
Serum vitamin D binding protein (Gc protein) is a precursor to macrophage-activating factor (MAF). Gc protein deglycosylation by Nagalase in cancer patients reduces MAF, causing immunosuppression. Gc-protein derived macrophage-activating factor (GcMAF) therapy eradicated cancer in patients by activating macrophages.
Area of Science:
- Immunology
- Biochemistry
- Oncology
Background:
- Serum vitamin D binding protein (Gc protein) is a precursor for macrophage-activating factor (MAF).
- Cancer cells secrete Nagalase, an enzyme that deglycosylated Gc protein, reducing MAF activity and causing immunosuppression.
- Deglycosylated Gc protein cannot be converted to MAF, leading to a compromised immune response against cancer.
Purpose of the Study:
- To investigate the efficacy of Gc-protein derived macrophage-activating factor (GcMAF) therapy in colorectal cancer patients.
- To assess the impact of GcMAF on serum Nagalase activity as a marker of tumor burden.
- To evaluate the long-term effects of GcMAF therapy on cancer recurrence.
Main Methods:
- Purified Gc protein was treated with beta-galactosidase and sialidase to generate GcMAF.
- Weekly administration of 100 ng GcMAF to eight colorectal cancer patients with metastatic cells.
- Monitoring of serum MAF precursor activity and Nagalase activity as prognostic indicators.
Main Results:
- GcMAF therapy increased MAF precursor activity and decreased Nagalase activity in all patients.
- Serum Nagalase activity returned to healthy control levels after 32-50 weekly GcMAF administrations, indicating tumor eradication.
- No cancer recurrence was observed in patients for 7 years post-therapy, confirmed by CT scans.
Conclusions:
- GcMAF therapy is a potent treatment for colorectal cancer, effectively activating macrophages to eliminate cancer cells.
- Serum Nagalase activity serves as a reliable biomarker for monitoring GcMAF therapy effectiveness and predicting cancer recurrence.
- GcMAF therapy demonstrates long-term efficacy and safety in patients with metastatic colorectal cancer.
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