What is inflammation ?
Inflammation acts as an effective defense mechanism against infection and injury. The immune system is quick to respond to any foreign substance and also to tissue injuries by attracting immune cells as well as mediators of inflammation to the targeted area. Therefore, inflammation is thought to be a cleansing process of the body, leading to the maintenance of equilibrium . Based on the pathological conditions of the tissues and the severity of triggers, the inflammation could be chronic or acute. Although acute inflammation can be an attempt to protect against infection or injury but failure to resolve it causes chronic inflammation.
The inflammatory disorders like bronchitis, sinusitis, arthritis and fibrocystic breast diseases as well as carpal tunnel syndrome and others. are common worldwide. Conventional nonsteroidal anti-inflammatory medicines (NSAIDs) as a stand-alone or when combined with other medications are prescribed to treat acute inflammation.
However, steroids are often combined with NSAIDs to combat chronic inflammation . The huge shortcomings of these medications have led to research on alternative options for treatment, including natural molecules. Thus, enzyme-based medications are becoming popular in a variety of fields of treatment, including inflammation.
Treatment of inflammation using Serratiopeptidase
Serine proteases are frequently utilized in various therapeutic areas, including inflammation. They were discovered to have an affinity that is high for the cyclooxygenases (COX-I and COX II) important enzymes that are involved in the production of various mediators of inflammation.
Serratiopeptidase was first utilized for its anti-inflammatory properties in Japan in the year 1957 . Furthermore, a number of researchers have examined the benefits of serratiopeptidase to combat inflammation in various therapeutic areas. It is also used in conjunction with other NSAIDs to create a synergistic effect.
While serratiopeptidase is proven to be a powerful anti-inflammatory molecule in numerous studies, it is necessary to maximize its dosage according to the use. Serratiopeptidase concentration in the plasma was observed to be dependent on the body's mass. Thus, validated cross over studies and optimization are essential steps to follow prior to prescribing and recommending serratiopeptidase
Pre-clinical and clinical studies using Serratiopeptidase
It was compared to the anti-inflammatory properties of serratiopeptidase against aspirin and the other proteolytic enzymes like chymotrypsin or trypsin in albino rats to fight carrageenan-induced paw edema. Serratiopeptidase demonstrated superior anti-inflammatory properties by itself, and also showed the synergistic effects with aspirin, both in acute and subacute forms of inflammation in rodents.
A further small preclinical study involving 16 Charles Foster albino rats evaluated serratiopeptidase's anti-inflammatory effects over diclofenac sodium. Serratiopeptidase in the range of (10-20 mg/kg body weight) produced comparable results to diclofenac (0.5 mg/kg) in the prevention of chronic as well as acute inflammation of the paws due to Edema. The amount of serratiopeptidase needed was greater than diclofenac. This could be due the insufficient bioavailability of Serratiopeptidase that can be increased with a suitable delivery method
Using Serratiopeptidase For Ulcerative Colitis
Ulcerative Colitis can be described as an intestinal disorder due to overstimulation or poor control of mucosal immunity which affects the colonic and rectal mucosa. The researchers conducted a significant study to examine the effects of serratiopeptidase to treat ulcerative colitis caused by acetic acid in mice.
Numerous inflammatory markers such as C-reactive protein, myeloperoxidase glutathione and nitric oxide were evaluated, as well as histopathological evaluation.
Serratiopeptidase decreased its disease activity index, and also stopped colonic shortening and enlargement of the spleen and glutathione depletion, inflammation due to lipid peroxidation and nitric oxygen production when compared with controls.
Additionally, there was a an important reduction in the C-reactive proteins in mice treated with serratiopeptidase as in comparison to the control. In addition, myeloperoxidase, which is an important marker of enzymes for inflammation, was lessened through serratiopeptidase treatment. These results prove the anti-inflammatory capabilities of serratiopeptidase.
Others studies on serratiopeptidase
Some studies on the other the other hand demonstrated a less effective effects of serratiopeptidase. In a research study, the safety and efficacy of serratiopeptidase and Seaprose S in treating inflammation of the venous system were evaluated.
Seaprose S had a higher efficiency when compared with serratiopeptidase (85 percent and 65 percent) without adverse side effects. Additionally, in this study, only one of 20 patients who received serratiopeptidase had a mild stomach disturbance. The study revealed a significantly lower analgesic as well as anti-inflammatory properties of serratiopeptidase compared to Betamethasone as well as Ibuprofen.
Additionally it was found that a combination of chymotrypsin and trypsin was more effective in the treatment of wounds as when compared with serratiopeptidase in an experiment with 75 patients . The opposite results were seen from two separate studies on a rat's model of edema in the paw.
In a study conducted by researchers who compared diclofenac with serratiopeptidase, the serratiopeptidase treatment (5.4 mg/kg body weight) did not show significant improvement in inflammation caused by the paw swelling. The results do not seem to be in line with other studies in which serratiopeptidase (10 mg/kg body weight) proved to have promising anti-inflammatory effects. The various dosages employed in both studies makes it difficult to draw conclusions.
