Use of enzymes in controlling fibrin can be applied in several other disease models. One interesting aspect of fibrin control is the use of fibrinolytic enzymes in multiple sclerosis (MS). Researchers at the University of California, San Diego, School of Medicine found that, when fibrin was removed from the body (in animal models of MS), tissue damage resulting from MS was decreased and the life spans of animals were lengthened. These animals had decreased inflammatory measures and expression of major histocompatibility complex class I antigens, and reduced demyelination.9 Fibrin is, however, better known for its role in blood clotting.
Fibrinolysis via proteolytic enzymes may also affect some conditions that have historically been resistant to treatment. Conditions, such as Peyronie's disease, Dupuytren's contracture,
Carpal tunnel syndrome—10 mg of serrapeptase, twice daily for six weeks, led to significant clinical improvement in 65% of patients treated. Improvements were confirmed using electrophysiologic measurements (nerve-conduction studies), and no side effects were noted during or following the treatment period.3 Breast engorgement—70 patients with breast engorgement were treated with an unspecified dose of serrapeptase, resulting in an 85% reduction in symptoms. Serrapeptase in this study was superior to a placebo for resolving symptoms of breast pain, breast swelling, and induration. As in previous studies, no side effects were noted in the study period.b
Inflammatory venous disease—A comparison study between two different forms of serrapeptase was conducted on patients with venous inflammatory disease. Efficacy of the two forms of enzyme therapy was determined to be 65% and 85%, with only one case of adverse reaction (diarrhea). This side effect was halted by a temporary reduction in dosage. Patients in this study were shown to benefit from serrapeptase enzyme therapy.c aMalshe PC. A preliminary trial of serratiopeptidase in patients with carpal tunnel syndrome. J Assoc Physicians India. 1999;47:1170-1172. bKee WH, Tan SL, Lee V, Salmon YM. The treatment of breast engorgement with serrapeptase (Danzen): A randomised double-blind controlled trial. Singapore Med J. 1989;30:48-54. cBracale G, Selvetella L. Clinical study of the efficacy of and tolerance to seaprose S in inflammatory venous disease. Controlled study versus serratio-peptidase. Minerva Cardioangiol. 1996;44:515-524.
and Ledderhose's disease, are all marked by loss of elasticity and possible tearing of tissue, leading to bleeding and clot formation. This formation of localized clots is marked by fibrin deposition as well. Over time, continuous treatment with fibrinolytic enzymes may lead to resolution of scar tissue that has formed at sites of repeated trauma and bleeding. Several disease processes in humans are marked by their inflammatory components and scarring; one classic example of this is asthma. Over time, the continual inflammatory state of asthma can lead to scarring of the alveoli. Prophylactic therapy with enzymes is a therapeutic option for treating such conditions. Well-known for their role in the digestive process, enzymes can be used effectively in maintaining health by breaking up circulating immune complexes and controlling the amount of fibrin deposited in wounds, fractures, and joints. Enzymes digest necrotic debris and excess fibrin in the bloodstream as well. Neoplastic (cancerous) cells are often found surrounded by a coating of fibrin.10 This has been speculated to be a protective element devised by cancer cells, allowing them to escape destruction by the cells of the immune system. Appropriate dosing with proteolytic enzymes has been utilized as an adjunctive cancer treatment.
Enzyme therapy for musculoskeletal trauma is an excellent first-line therapy. Proteolysis can block the production of pain-inducing chemicals from inflamed tissue. In patients with osteoarthritis (OA), treatment with a combination enzyme product (Phlogenzym,™ MUCOS Pharma GmbH & Co., Geretsreid, Germany) produced similar results for relieving pain and improving knee function compared to a popular OA drug, diclofenac.11 Early and aggressive use of enzymes following musculoskeletal trauma can promote inflammation control and enhanced recovery. In a study examining the use of enzymes in wound healing, topical ap plication of enzymes helped to clean the wound area of necrotic tissue and sped the tissue recovery process.12
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