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Systemic Multi-Enzyme Therapy: The Power of Synergy Keeping
the Blood Flowing Many serious
chronic diseases, in addition to the aging process itself, are marked by a slowdown
in the flow of blood, especially in the smallest vessels. Various mechanisms
contribute to this circulatory deterioration. For example, aging and chronic
disease are commonly associated with increased levels of the protein
fibrinogen. Fibrinogen is transformed in the body into fibrin, the central
structural element in all blood clots. As fibrinogen levels rise, blood
begins to thicken, slowing its flow throughout the body and increasing the
risk of forming thrombi (blood clots that may block a blood vessel) and
consequent heart attack or stroke. Red blood
cells (erythrocytes) also tend to stiffen with age and chronic disease,
making it more difficult for them to fold and bend within the tight confines
of the capillary bed, where they must go to perform the oxygen-delivery
function. Those cells inflexible enough to get "stuck" may block
the way for others, failing to deliver oxygen and possibly initiating the
formation of a thrombus. Studies
confirm that proteolytic enzymes, including bromelain, papain, and especially
trypsin and chymotrypsin improve the flow characteristics of blood by at
least three different mechanisms: Numerous
animal studies have demonstrated the fibrinolytic activity of proteolytic
enzymes. For example, papain given intravenously to rabbits or dogs inhibits
the coagulation of the animals' blood for as long as two weeks. When given to
monkeys following abdominal surgery, papain prevented the development of
peritoneal adhesions; clots that formed were easily broken down. A similar
result was reported as far back as 1936 following abdominal surgery in human
patients. Rutin also
has important vascular protective actions. By inhibiting the enzyme
phosphodiesterase, for example, it reduces thrombocyte aggregation. In
addition, rutin is a potent free-radical scavenger, which helps prevent
oxidative damage within the vascular system, which is thought to be an early
stage in cardiovascular disease. Pain
Relief Proteolytic
enzymes produce a delayed analgesic effect that appears to arise from two
separate mechanisms. First, the enzymes neutralize inflammatory mediators,
such as the kinins and prostaglandins, which otherwise would directly
stimulate nerve pain receptors. Second, by promoting the breakdown of plasma
proteins and immune complexes and by stimulating phagocytosis, as described
earlier, they reduce edema which subsequently leads to a relief of pain due
to fluid pressure. Numerous
clinical studies in various types of pain have confirmed the analgesic
abilities of proteolytic enzymes. In a randomized, double-blind, placebo-controlled
crossover study in 25 people undergoing oral surgery, each subject underwent
two different comparable procedures (left and right) on two different
occasions. Without knowing which condition they were in at a given time, the
participants received papain for one procedure and placebo for the other.
Regression of edema and reduction in pain occurred significantly faster
following papain treatment compared with placebo. Papain treatment was also
associated with a shorter recovery time. In a randomized,
double-blind, placebo-controlled study of episiotomy pain, 160 women received
either bromelain or placebo following episiotomy. After 4 days of treatment,
the researchers found striking reductions in pain, edema, and inflammation in
the bromelain-treated women. As shown in Figure 3, 100% of the women in the
placebo group were still reporting pain on movement by day 4, compared with
only 3.75% of the bromelain-treated women. Systemic Multi-Enzyme Therapy:
The Power of Synergy Although
individual proteolytic enzymes can be exceptionally useful, the extraordinary
contribution of Wolf, Benitez, and their successors was the discovery that
combining these enzymes in just the right proportions yields a therapeutic
combination that can be greater than the sum of its parts. The reason for
this synergy is really quite simple, although the details of the mechanisms
involved could fill volumes. Inflammatory
processes, cardiovascular diseases, and immune modulation are all extremely
complex events. It makes intuitive sense that one or two individual
substances, whether individual enzymes or pharmaceutical drugs, could not
cover all the bases. Different enzymes have different actions as well as
different sites of action. For example, chymotrypsin is known to cleave
phenylalanine and tryptophan bonds, while trypsin cleaves the bonds in
arginine and lysine. In general,
systemic multi-enzyme therapy is advantageous because the combination of
enzymes has a broader spectrum of activity than the individual enzymes. For
example, the degradation of protein-rich intermediary and residual products
during an inflammatory reaction takes place through a number of physiological
enzymatic processes that occur sequentially. These molecules are catalyzed by
successive metabolic processes of the various proteolytic enzymes, which
attack them from different points. Some proteolytic enzymes attack the
molecule at its midpoint, while others attack it at the ends. Thrombocyte
aggregation is an important step in blood clot formation. Papain and
bromelain reduce ADP(adenosine diphosphate)- dependant aggregation while
trypsin activates plasminogen, which in turn degrades native fibrin. Table 1
summarizes some of the activities of several important proteolytic enzymes. Clinical
Effects of Systemic Multi-Enzyme Combinations Scores of
clinical studies of systemic multi-enzyme therapy (mostly various forms of
Wobenzym) have been conducted in a variety of conditions which are commonly
associated with inflammation, such as rheumatoid arthritis, surgery,
fractures, sports injuries, and other injuries of the knees and ankles.
Included among these are 11 double-blind, placebo-controlled trials and three
trials comparing enzyme therapy with conventional pharmaceutical
anti-inflammatory drugs. All but one of these 14 trials showed the enzymes to
be superior to placebo or the comparative drug. The fourteenth was
inconclusive due to methodological problems in the study design. Figure 4
shows the results of one of these studies, a randomized, double-blind, placebo
controlled, crossover trial of patients with soft tissue injuries sustained
during karate. The participants, aged 13 to 21 years, took either a
multi-enzyme formulation (Wobenzym) or placebo prophylactically for 8 weeks,
beginning 2 weeks prior to the start of karate training. The superiority of
enzyme therapy in reducing symptoms of inflammation is obvious. Arthritis
Relief One of the
most important potential benefits of systemic multi-enzyme therapy is in the
treatment of rheumatoid arthritis. Conventional treatment of this devastating
disease involves powerful, dangerous drugs, like steroidal and nonsteroidal
anti-inflammatory drugs, as well as more exotic treatments, such as
methotrexate and D-penicillamine. About the best one can say about these
drugs is that they may provide a degree of short-term symptomatic relief. At
worst, they will kill you. Numerous
studies in animals and people with rheumatoid arthritis indicate that enzyme
therapy can manage symptoms of pain and inflammation at least as well as the
conventional drugs but with none of the adverse effects. In fact, side
effects with enzymes are virtually nonexistent. Physicians
who are experienced with systemic multi-enzyme therapy find that, in addition
to treatment of arthritis and related diseases, prophylactic treatment offers
a wide range of benefits following injury or surgery, including: References 1. Engel A
Erfahrungsbericht über das Präparat Wobenzym bei den Olympischen Spielen 1984
in Los Angeles. Report from the Allgemein Kranken-haus, Vienna, University
Orthopedic Clinic. 1985. 2.
Müller-Hepburn W. Anwendung von Enzymen in der Sportmedizin. Forum prakt
Allg.-Arzt. 1979; 18:7-10. 3. Netti C,
Bandi C, Pecile A. Anti-inflammatory action of proteolytic enzymes of animal,
vegetable or bacterial origin administered orally com-pared with that of
known antiphlogistic compounds. Il Farmaco. 1972;27:453-466. 4. Logan D,
King L. Proteolytic enzymes in urethral edema: A laboratory study. Invest
Urol. 1965;3:17-20. 5. Moss J,
Frazier C, Martin G. Bromelains. The pharmacology of the enzymes. Arch Int
Pharmacodyn. 1963;145:166-189. 6. Monkhouse F.
An investigation of the coagulation defect brought about in rabbits and dogs
by the intravenous injection of papain. Can J Biochem Physiol.
1954;33:112.121. 7. Kapur B.
Talwar J, Gulati S. Use of papase in prevention of experimental peritoneal
adhesions. Surgery, 1969;65:629-632. 8. Ochsner A,
Storck A. The prevention of peritoneal adhesions by papain. Ann Surg.
1936;104:736-747. 9. Zatuchni
G, Colombi D. Bromelain therapy for the prevention of episiotomy pain. Obst
Gynecol. 1967;29:275-278. 10. Metro P,
Horton R. Plant enzymes in oral surgery. Oral Surg. 1965;19:309-316. |