Enzyme therapy

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

Last updated on: 25.04.2024

Synonym(s)

Enzyme preparations

Definition
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Treatment method based on the supply of plant(bromelain, papain) or animal enzymes (trypsin, chymotrypsin, serrapeptase) or from fungi such as amylase and lipase. The intravenous administration of enzymes for the treatment of thromboses and embolisms, as well as topical application for cleaning chronic wounds, is scientifically recognized.

Effects
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Anti-inflammatory, anti-edematous, analgesic, improvement of the resorption of haematomas, in tumor patients an increase of the TNF was proven.

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Indication
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Inflammatory, degenerative and tumorous diseases. Trypsin-Bromelain: Inflammatory oedema, hematoma, polyarthritis, ankylosing spondylitis, AVK, surgery, viral infections.

Contraindication
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Pregnancy, haemophilia, Marcumar therapy, anticoagulants, liver dysfunction, creatinine > 1.8.

Tables
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Enzyme	Origin	Indication	Preparation	Side effects
Bromelain	Pineapple	Thromboembolism, inflammatory swellings	Traumanase forte	Occasional stomach complaints, diarrhea, allergic reactions
Bromelain	Pineapple	Thromboembolism, inflammatory swellings	Bromelain POS	Occasional stomach complaints, diarrhea, allergic reactions
Clostridiopeptidase	Clostridium histolyticum	Ulcer and wound treatment local	Iruxol N	Pain, burning or skin irritation
Papain	Juice of the unripe fruit of Carica papaya	For autoimmune diseases	Wobe-Mugos (combination with trypsin and chymotrypsin)	Stool changes in texture, color and odor; bloating, flatulence; occasional nausea; pruritus, urticaria, angioedema
Papain	Juice of the unripe fruit of Carica papaya	Disorders of the digestive function	Chol-Arbuz NF (combination with pancreatic powder)
Serrapeptase	silkworm	Rheumatoid arthritis, inflammatory autoimmune diseases such as ulcerative colitis, psoriasis, inflammatory swellings, suppurations (additional therapy to antibiotic or surgical therapy), postoperative inflammations, sinusitis, inflammation of the teeth, breast swelling and lactation complaints in the early postpartum period due to hormonally induced congestion, cystitis (additional medication to antibiotic therapy)	Aniflazym	rarely: nausea, vomiting, diarrhea; occasionally: exanthema, erythema, urticaria, itching, breathing difficulties, edema; in individual cases: Stevens-Johnson syndrome, Lyell syndrome, Löffler syndrome, pneumonitis, anaphylactic shock
Streptokinase/streptodornase	Streptococci	Ulcer and wound treatment local	Varidase	Burning and pain in the wound area, allergic reactions (approx. 2-5% of patients)
trypsin	Pancreas (pigs, cattle)	Systemic long-term treatment for tumors, additional treatment during radiotherapy, metastasis prophylaxis, support for inflammations (abscesses, fistulas, necroses and viral infections (e.g. herpes zoster).	Wobenzym (combination with pancreatin, chymotrypsin, bromelain, papain, rutoside)	Stool changes in texture, color and odor; bloating, flatulence
			Wobe-Mugos (combination with chymotrypsin and papain)
			Phlogenzym (combination with bromelain and rutoside)