Systemic Enzyme Therapy in Oncology
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Drugs 2000 Apr; 59 (4): 769-780 0012-6667/00/0004-0769/$25.00/0 © Adis International Limited. All rights reserved.
Systemic Enzyme Therapy in Oncology Effect and Mode of Action Jörg Leipner and Reinhard Saller Department of Natural Medicine, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Proteinases in Systemic Enzyme Therapy . . . . . . . . . . . . . . 2. Clinical Studies of Systemic Enzyme Therapy . . . . . . . . . . . . 2.1 Patients Receiving Chemotherapy . . . . . . . . . . . . . . . 2.2 Patients Receiving Radiotherapy . . . . . . . . . . . . . . . . 2.3 Summary of Clinical Effects . . . . . . . . . . . . . . . . . . . 3. Mechanism of Action . . . . . . . . . . . . . . . . . . . . . . . . . 3.1. Interaction Between Proteinases and Antiproteinases . . . 3.1.1 Serine Proteinases . . . . . . . . . . . . . . . . . . . . . 3.1.2 Plant Cysteine Proteinases . . . . . . . . . . . . . . . . 3.2 Effects on Cytokines . . . . . . . . . . . . . . . . . . . . . . . 3.3 Effects on Adhesion Molecules . . . . . . . . . . . . . . . . . 3.4 Effects on Antioxidants and Reactive Oxygen Compounds 4. Effects of Proteinase Combinations . . . . . . . . . . . . . . . . . 5. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Plant extracts with a high content of proteolytic enzymes have been used for a long time in traditional medicine. Besides proteolytic enzymes from plants, ‘modern’ enzyme therapy additionally includes pancreatic enzymes. The therapeutic use of proteolytic enzymes is partly based on scientific studies and is partly empirical. The aim of the current review is to provide an overview of clinical trials of systemic enzyme therapy in oncology, and to discuss the evidence for their possible mechanisms of action. Clinical studies of the use of proteolytic enzymes in oncology have mostly been carried out on an enzyme preparation consisting of a combination of papain, trypsin and chymotrypsin. This review of these studies showed that enzyme therapy can reduce the adverse effects caused by radiotherapy and chemotherapy. There is also evidence that, in some types of tumours, survival may be prolonged. The beneficial effect of systemic enzyme therapy seems to be based on its anti-inflammatory potential. However, the precise mechanism of act
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