This is the study review I was referring to earlier. The studies were executed in a disease context, not on healthy subjects, but nevertheless the remarks regarding the quality of the studies is applicable to all of us I guess. So, on the positive side of interpretation, proteolytic enzymes might work, but we just don't know.
But maybe I'm generalizing to much...?
[Proteolytic enzymes as an alternative in comparison with nonsteroidal anti-inflammatory drugs (NSAID) in the treatment of degenerative and inflammatory rheumatic disease: systematic review][Article in German]
Heyll U, Münnich U, Senger V.
Abteilung Medizinische Beratung, Deutsche Krankenversicherung AG, Köln. dr.uwe.heyll@dkv.com
BACKGROUND AND PURPOSE: The comparably high number of severe side effects due to treatment with nonsteroidal anti-inflammatory drugs (NSAID) calls for better tolerated substances. One possible alternative is seen in the systemic treatment with proteolytic enzyme preparations for oral administration. The aim of this study was to determine whether the results from controlled randomized trials on enzyme therapy prove equal anti-inflammatory effectiveness compared to NSAID in the treatment of degenerative or inflammatory rheumatic disease. METHODS: All drug preparations registered in Germany as having anti-inflammatory properties were listed. Among these preparations, a systematic search was carried out for randomized clinical therapeutic trials giving evidence for the anti-inflammatory effectiveness of enzyme preparations or their components. RESULTS: The anti-inflammatory effectiveness of three out of eight registered enzyme preparations was investigated in randomized trials. In total, seven trials were judged to be sufficiently documented and to allow valuation. All studies show severe methodical deficits, and the standard trial design (clinical trials during inpatient rehabilitation in combination with extensive accompanying treatment) does not allow clear-cut conclusions. CONCLUSION: According to the present state of knowledge, oral proteolytic enzyme treatment does not offer a justified alternative in comparison with NSAID in the anti-inflammatory treatment of rheumatic disease.
PMID: 14631536
But on the other side, to add to the state of confusion we are in:
[Experimental evaluation of the wound healing dynamics][Article in Russian]
Minaev SV.
The experimental clinical investigation of the influence of systemic enzymotherapy on the course of the wound process was carried out in rats and in clinic. The rats of the experimental group have demonstrated more rapid debridement of the wound from blood clots and tissue detritus, intensive formation of granular tissue and its ripening. The experimental investigation has shown that using the preparation of systemic enzymotherapy (Vobenzyme) stimulates processes of healing at the expense of quicker changing the inflammation phases as well as prevents the development of early and late complications on the side of postoperative wounds. It was confirmed by clinical observations in 36 patients from 4 to 14 years of age.
PMID: 14569780 [PubMed - indexed for MEDLINE]
[The use of vobenzym in the comprehensive treatment of patients with digital flexor tendon injury][Article in Russian]
Strafun SS, Tovmasian VV.
The results of treatment of 56 patients with tendons of digital flexors were analyzed. In 28 of them in complex of treatment vobenzim was included, and an early active mobilization as well. Considerable antiinflammatory, antioedematous, secondarily analgetic effect of preparation, its application in early period permitted to realize active movements, to reach high functional result of treatment of patients' were noted.
PMID: 10857342 [PubMed - indexed for MEDLINE]
[The pathogenetic basis for and clinical use of systemic enzyme therapy in traumatology and orthopedics][Article in Russian]
Neverov VA, Klimov AV.
The authors have generalized their experiences with using "Wobenzym" in 140 patients. Schemes of the effective systemic enzyme therapy are proposed for patients of the orthopedic-traumatological profile.
PMID: 10491833 [PubMed - indexed for MEDLINE]
And this. With my limited level of knowledge I would evaluate this as being negative. What confuses me is this bit "These findings point to an immunomodulatory capacity of WE in adjuvant tumor therapy". What's your opinion?
Stimulation of reactive oxygen species production and cytotoxicity in human neutrophils in vitro and after oral administration of a polyenzyme preparation.Zavadova E, Desser L, Mohr T.
Institute of Applied and Experimental Oncology, University of Vienna, Austria.
Polymorphonuclear neutrophils (PMN) can be primed for enhanced release of reactive oxygen species (ROS) by exposure to cytokines and biological response modifiers. ROS are considered to possess tumoricidal activity. The polyenzyme preparation Wobenzym (WE) contains pancreatin, papain, bromelain trypsin and chymotrypsin and is used in adjuvant tumor therapy. We investigated killing of WE-exposed PMN against tumor cells and analyzed WE influence on ROS production in a chemiluminescence assay in PMN in vitro and in vivo. Depending on dose WE stimulates the cytotoxic capacity of PMN in vitro against tumor cells (50 micrograms/ml:p < 0.01). Exposure of PMN to Wobenzym caused a time-dependent significant (p < 0.02) increase in release of ROS. Similarly, oral administration of Wobenzym to healthy volunteers (n = 28) resulted in significant increases (p < 0.01) in ROS production, depending on dose (peak with 20 tablets) and time (peak 4 hours after Wobenzym administration). In contrast, ROS production was not elevated in the PMN of healthy volunteers receiving placebo (n = 8) or no treatment (n = 16). These findings point to an immunomodulatory capacity of WE in adjuvant tumor therapy.
PMID: 7663574 [PubMed - indexed for MEDLINE]
Edited by brainbox, 01 March 2008 - 12:44 PM.