Couple of interesting articles with some scientific references.
(I do not agree with the bit on safety though. Overdosing with some enzymes as serrapeptase can have side effects).
Preclinical and Clinical Studies
Innumerable studies, controlled or otherwise, randomized or not, have been conducted to prove efficacy and safety of systemic enzymes in infections. Enzymes have been found useful in following conditions-
1. Airway infections and inflammations-Serrapeptase has been found to be effective in alleviating thick infected respiratory secretions. Ninety-seven percent of those taking serrapeptase reported good or excellent results compared to 22% in the control subjects. In a multi-center, double-blind, randomized study involving 193 participants, serratiapeptidase acted rapidly to reduce local inflammation and ease symptoms in people suffering from ear, nose and throat disorders[87]. Serrapeptase also is beneficial in patients with bronchitis and other chronic lower airway diseases[88, 89]. Combination of trypsin and chymotrypsin with antibiotics is effective for management of acute or chronic non-tubercular bronchopneumonias[90]. Bromelain is effective and safe in acute sinusitis. It decreases sinus pain and throat pain. It changes the consistency of nasal mucus favourably[47, 70, 91-97].
2. Sepsis and septic shock-Enzymes when used in conjunction with appropriate antibiotics can lead to early recovery from sepsis in pediatric patients[71]. Papain has also been found to enhance the chemotherapeutic efficacy of antibiotics on an average by 50% in mice with septicemia[67]. Ishikawa et al has also shown that bromelain has a protective effect when used with antibiotics in experimental infection in mice produced by Streptococcus hemolyticus, Streptococcus pneumoniae and Pseudomonas aeruginosa[98].
3. Oro-dental infections- Since 1960s, proteolytic enzymes have been used in stomatology. Varney-Burch used peroral trypsin and chymotrypsin in postdental surgery and found that these enzymes reduced the healing time by 50%[99, 100]. Proteolytic enzymes are also found to be useful in dental infections. Used as a mouthwash, the enzymes help in combating gingivitis and reducing plaque formation in children and young adults[101, 102].
4. Skin and soft tissue infections- Adequate debridement of wound and burn areas is essential for prevention and management of infections. Experimental runs of enzymes as wound debridement agents have given positive results. Papain-urea, papain-urea-chlorophyllin, bromelain, ficin and bacterial collagenase has been extensively investigated for use in wound bed preparation[103-111]. A novel streaming technique has been tried in order to improve efficiency of enzyme solutions to cause early wound debridement and healing[112]. Bromelain scores over collagenase in efficacy and safety as a wound debridement agent[113].
5. Genito-urinary infections-Enzymes have been studied in urinary tract infections and found to play a favourable role. They can also help eradicate chlamydial infections of prostate[114].
6. Joint infections- Intraarticular serratiopeptidase enzyme has also been found useful in eradication of infection caused by biofilm-forming bacteria in experimental animal model. The serratiopeptidase group had significantly less persistence of infection as compared to the control group (5.6% s 37.5% respectively)[65].
7. Viral hepatitis- Oral enzymes have been found to be useful in hepatitis B infection. When administered, they tended to lead to faster recovery, with early normalization of spleen and liver size, and restoration of liver function[115-117]. Enzymes are also superior to ribavarin and ?-interferon in hepatitis C patients[118, 119].
8. Varicella-zoster infection- Various studies have shown that enzyme therapy is beneficial in herpes infections. Oral enzymes decreased significantly ‘segmental pain’ on day 7 and 14 of the herpes zoster illness, as compared to the virostatic drug, acyclovir. Global judgement of the drug by physicians was in favour of the enzymes with similar tolerability in both groups. Hyperaesthesia and postzosteric neuralgia was also less in enzyme group[120-122]. Billigmann et al in their study found no difference in segmental pain in enzyme or acyclovir group, but adverse events were significantly less in enzyme group[123]. Mikazans used enzymes per os as well as locally in herpes-zoster infection and observed that as compared to oral acyclovir, enzyme therapy reduced clinical symptoms and signs faster and also was free of any side-effects. Postherpetic neuralgia was also less in the enzyme group[124].
9. Recurrent laryngeal papillomatosis- In an uncontrolled study, Mudrak et al found that after the surgical extirpation of the laryngeal papillomatosis, subsequent application of peroral proteases caused a significant improvement in clinical and laboratory results in these patients. Also they were disease-free for 10-18 months[125]. But this result has not been confirmed by means of a randomized controlled study.
10. Human immunodeficiency virus (HIV)- Auto-antibodies and circulating immune complexes characterize HIV. Jaeger used hydrolytic enzymes in HIV infections and found that they improved functional ability and weight of patients and are also well-tolerated[126].
11. Fungal infections- Bromelain has been found to enhance the killing actity of human white cells against candida albicans[60]. But no clinical studies of use of enzymes in fungal infections could be found.
12. Parasitic infections-There are very few studies on role of enzymes in parasitic infections. Enzymes are found to have a limited role in treatment of intestinal helminthiasis[127-129]. More clinical studies are needed to evaluate the role and safety of enzymes as adjuvant therapy in intestinal worms.
http://www.webmedcentral.com/article_view/2495
http://j.b5z.net/i/u/2100778/f/Serrapeptase Clinicals/Serrapeptase_Clinical_Abstracts.pdf
(I do not agree with the bit on safety though. Overdosing with some enzymes as serrapeptase can have side effects).
Preclinical and Clinical Studies
Innumerable studies, controlled or otherwise, randomized or not, have been conducted to prove efficacy and safety of systemic enzymes in infections. Enzymes have been found useful in following conditions-
1. Airway infections and inflammations-Serrapeptase has been found to be effective in alleviating thick infected respiratory secretions. Ninety-seven percent of those taking serrapeptase reported good or excellent results compared to 22% in the control subjects. In a multi-center, double-blind, randomized study involving 193 participants, serratiapeptidase acted rapidly to reduce local inflammation and ease symptoms in people suffering from ear, nose and throat disorders[87]. Serrapeptase also is beneficial in patients with bronchitis and other chronic lower airway diseases[88, 89]. Combination of trypsin and chymotrypsin with antibiotics is effective for management of acute or chronic non-tubercular bronchopneumonias[90]. Bromelain is effective and safe in acute sinusitis. It decreases sinus pain and throat pain. It changes the consistency of nasal mucus favourably[47, 70, 91-97].
2. Sepsis and septic shock-Enzymes when used in conjunction with appropriate antibiotics can lead to early recovery from sepsis in pediatric patients[71]. Papain has also been found to enhance the chemotherapeutic efficacy of antibiotics on an average by 50% in mice with septicemia[67]. Ishikawa et al has also shown that bromelain has a protective effect when used with antibiotics in experimental infection in mice produced by Streptococcus hemolyticus, Streptococcus pneumoniae and Pseudomonas aeruginosa[98].
3. Oro-dental infections- Since 1960s, proteolytic enzymes have been used in stomatology. Varney-Burch used peroral trypsin and chymotrypsin in postdental surgery and found that these enzymes reduced the healing time by 50%[99, 100]. Proteolytic enzymes are also found to be useful in dental infections. Used as a mouthwash, the enzymes help in combating gingivitis and reducing plaque formation in children and young adults[101, 102].
4. Skin and soft tissue infections- Adequate debridement of wound and burn areas is essential for prevention and management of infections. Experimental runs of enzymes as wound debridement agents have given positive results. Papain-urea, papain-urea-chlorophyllin, bromelain, ficin and bacterial collagenase has been extensively investigated for use in wound bed preparation[103-111]. A novel streaming technique has been tried in order to improve efficiency of enzyme solutions to cause early wound debridement and healing[112]. Bromelain scores over collagenase in efficacy and safety as a wound debridement agent[113].
5. Genito-urinary infections-Enzymes have been studied in urinary tract infections and found to play a favourable role. They can also help eradicate chlamydial infections of prostate[114].
6. Joint infections- Intraarticular serratiopeptidase enzyme has also been found useful in eradication of infection caused by biofilm-forming bacteria in experimental animal model. The serratiopeptidase group had significantly less persistence of infection as compared to the control group (5.6% s 37.5% respectively)[65].
7. Viral hepatitis- Oral enzymes have been found to be useful in hepatitis B infection. When administered, they tended to lead to faster recovery, with early normalization of spleen and liver size, and restoration of liver function[115-117]. Enzymes are also superior to ribavarin and ?-interferon in hepatitis C patients[118, 119].
8. Varicella-zoster infection- Various studies have shown that enzyme therapy is beneficial in herpes infections. Oral enzymes decreased significantly ‘segmental pain’ on day 7 and 14 of the herpes zoster illness, as compared to the virostatic drug, acyclovir. Global judgement of the drug by physicians was in favour of the enzymes with similar tolerability in both groups. Hyperaesthesia and postzosteric neuralgia was also less in enzyme group[120-122]. Billigmann et al in their study found no difference in segmental pain in enzyme or acyclovir group, but adverse events were significantly less in enzyme group[123]. Mikazans used enzymes per os as well as locally in herpes-zoster infection and observed that as compared to oral acyclovir, enzyme therapy reduced clinical symptoms and signs faster and also was free of any side-effects. Postherpetic neuralgia was also less in the enzyme group[124].
9. Recurrent laryngeal papillomatosis- In an uncontrolled study, Mudrak et al found that after the surgical extirpation of the laryngeal papillomatosis, subsequent application of peroral proteases caused a significant improvement in clinical and laboratory results in these patients. Also they were disease-free for 10-18 months[125]. But this result has not been confirmed by means of a randomized controlled study.
10. Human immunodeficiency virus (HIV)- Auto-antibodies and circulating immune complexes characterize HIV. Jaeger used hydrolytic enzymes in HIV infections and found that they improved functional ability and weight of patients and are also well-tolerated[126].
11. Fungal infections- Bromelain has been found to enhance the killing actity of human white cells against candida albicans[60]. But no clinical studies of use of enzymes in fungal infections could be found.
12. Parasitic infections-There are very few studies on role of enzymes in parasitic infections. Enzymes are found to have a limited role in treatment of intestinal helminthiasis[127-129]. More clinical studies are needed to evaluate the role and safety of enzymes as adjuvant therapy in intestinal worms.
http://www.webmedcentral.com/article_view/2495
http://j.b5z.net/i/u/2100778/f/Serrapeptase Clinicals/Serrapeptase_Clinical_Abstracts.pdf
