NAGK (N-acetylglucosamine kinase) is a metabolic sugar kinase with dual roles in innate immunity and hexosamine salvage metabolism (PMID:36002575, PMID:34844667). In immune sensing, NAGK directly phosphorylates the C6 hydroxyl of the N-acetylmuramic acid moiety of muramyl dipeptide (MDP), generating 6-O-phospho-MDP; this phosphorylated species, not unmodified MDP, is the agonist that activates NOD2, and NAGK-deficient macrophages are completely unable to sense MDP (PMID:36002575). In parallel, NAGK phosphorylates free GlcNAc to feed UDP-GlcNAc pools through a hexosamine salvage pathway that becomes critical when de novo synthesis is limited by glutamine restriction, a dependence exploited by pancreatic ductal adenocarcinoma cells for tumor growth (PMID:34844667). This salvage-derived UDP-GlcNAc supply specifically supports Wnt signaling during vertebrate development, conserved across Xenopus, zebrafish, and Drosophila and required for Wnt-dependent intestinal enteroid growth (PMID:30904594). In the hypothalamus, NAGK supports transcription of Gnrh and Kiss1 and GnRH secretion, and its knockdown delays puberty onset in female mice (PMID:39488153).