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Friday, July 5, 2019

Serratiopeptidase: a Promising Enzyme

Dr. James Manos (MD)

July 5, 2019


                         Serratiopeptidase: a promising enzyme



Image (public domain): Plate I of Maria Sibylla Merian's Der Raupen wunderbare Verwandelung und sonderbare Blumennahrung. Plate title: "Maulbeerbaum samt Frucht" depicting the fruit and leaves of a mulberry tree and the eggs and larvae of the silkworm moth. Source for the image: Original publication: published 1679 in Nuremberg. Immediate source: https://ub.fau.de/2017/01/03/9-1-15-1-maria-sibylla-merian-1647-1717/ Retrieved from Wikipedia. Link: https://en.wikipedia.org/wiki/File:Maria_Sibylla_Merian_Maulbeerbaum_samt_Frucht_plate_1.png




Dietary supplement description


Serratiopeptidase (Serratia E-15 protease, also known as serralysin, serrapeptase, serratiapeptase, Serratia peptidase, serratio peptidase, or serrapeptidase) is a proteolytic enzyme (1). The silkworm (1) produces it, (4). It is present in the silkworm intestine, allowing the emerging moth to dissolve its cocoon. Serratiopeptidase is produced by purification from a culture of Serratia E-15 bacteria (1), (6).



Uses in Medicine


Serratiopeptidase is an anti-inflammatory agent (6). This enzyme may help patients with arthritis and tooth swelling. It is a painkiller and has anti-inflammatory properties without causing stomach ulcers as the rest of NSAIDs (nonsteroidal anti-inflammatory drugs).

According to a review, serratiopeptidase is a proteolytic enzyme prescribed in various specialties like surgery, orthopedics, otorhinolaryngology (ENT), gynecology, and dentistry for its anti-inflammatory, anti-swelling, and analgesic (painkilling) effects. Some anecdotal reports also suggest anti-atherosclerotic effects (that fight the building up of plaque that causes cardiovascular disease) due to its fibrinolytic and caseinolytic properties (2).


This enzyme has been used for the following conditions (although more evidence is needed to rate the effectiveness of serrapeptase for these uses):


Chronic bronchitis. It may significantly reduce coughing and thin secretions in people with chronic bronchitis after about 4 weeks of treatment.

Sinus pain (sinusitis). People with sinusitis who take serrapeptase have significantly reduced pain, nasal secretions, and nasal obstruction after 3-4 days of treatment.

Hoarseness (laryngitis). It can reduce pain, secretions, difficulty swallowing, and fever in people with laryngitis after 3-4 days of treatment.

Sore throat (pharyngitis). It can significantly reduce pain, secretions, difficulty swallowing, and fever in people with sore throats after 3-4 days of treatment.

Back pain.

Osteoarthritis.

Rheumatoid arthritis.

Osteoporosis.

Carpel tunnel syndrome.

Diabetes.

Leg ulcers.

Migraine headache.

Tension headache.

Asthma.

Pus accumulation (empyema).

Thrombophlebitis.

Fibromyalgia.

Fibrocystic breast disease.

Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease.

Breast engorgement.

Heart disease.

Ear infections (5).


A study concluded that serratiopeptidase is orally (taken by mouth) effective and possesses anti-inflammatory activity, which is nearly equivalent to diclofenac sodium in both acute and chronic phases of inflammation (3).


Serratiopeptidase has been studied in several conditions, including chronic airway lung disease, ear, nose, and throat disorders, carpal tunnel syndrome, jaw pain, osteoarthritis, and edema. Although these early studies show clinical potential, the full effectiveness and side effects require more research (5).



Adverse effects


Rare side effects of this enzyme include pneumonitis, allergic reactions, and minor aches and pains (5). There were reported rare cases of acute eosinophilic pneumonia (7), (8), and interstitial pneumonia (9). A case of Stevens-Johnson syndrome was also reported in a patient who combined it with diclofenac (10).



Contraindications


It is contraindicated in pregnancy and breastfeeding as its safety has not been established in these conditions. As mentioned, serrapeptase might interfere with blood clotting. Thus, there is a concern that it might increase bleeding during and after surgery, so people who take it should stop using serrapeptase at least 2 weeks before a scheduled surgery (4).



Interactions


This enzyme may interact with blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), or ASA (Aspirin) and may increase the chances of bleeding or bruising.

This increased risk of bleeding may also occur when this enzyme is taken with other natural remedies such as herbs & supplements, e.g., garlic, fish oil, and turmeric.



Overall 


In conclusion, Serratiopeptidase is a promising enzyme for many health issues. Serratiopeptidase is used in many clinical specialties for its anti-inflammatory, anti-oedemic (anti-swelling), and analgesic effects. However, evidence-based recommendations on the analgesic (painkilling), anti-atherosclerotic efficacy (that prevents hardening of the arteries, and coronary heart disease, safety, and tolerability of Serratiopeptidase are needed (2).


Reference 

(Retrieved: August 14, 2016):

1. https://en.wikipedia.org/wiki/Serratiopeptidase

2. http://www.journal-surgery.net/article/S1743-9191(13)00026-5/abstract

3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043339/  

4.http://www.webmd.com/vitamins-supplements/ingredientmono-1115-serrapeptase.aspx?activeingredientid=1115

5.http://www.pharmaceutical-drug-manufacturers.com/articles/serratiopeptidase-side-effects.html

6. https://www.drugs.com/international/serrapeptase.html

7. http://www.ncbi.nlm.nih.gov/pubmed/11019569

8. http://www.ncbi.nlm.nih.gov/pubmed/19348276   

9. http://www.ncbi.nlm.nih.gov/pubmed/2693781

10. http://www.ncbi.nlm.nih.gov/pubmed/25177625

 


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