Serrapeptase Literature Review

(aka Serrapeptidase, Serratiopeptidase & Serratia Peptidase)

Peptizyme® SP is a proteolytic enzyme variously called serrapeptase, serrapeptidase, serratiopeptidase and serratia peptidase. It is isolated from the microorganism Serratia, which is naturally present in the intestine of silkworms. This enzyme enables the emerging moth to dissolve its fibrous cocoon. Peptizyme® SP is an enterically coated version and preferred form of this remarkable proteolytic enzyme.

In human nutrition, Peptizyme® SP is classified as a systemic enzyme. That is, one absorbed directly from intestine into the blood stream. Research confirms that orally administered serrapeptase is absorbed into the circulation in its enzymatically active form.1 To be sure, serrapeptase has numerous beneficial properties. By reviewing the scientific literature, we can gain an appreciation for some of these properties.

Fibrinolytic Activity

Like other proteases, serrapeptase has potent anti-inflammatory activity as well as several other beneficial properties. However, probably the most important aspect of serrapeptase is its fibrinolytic activity. It is this fibrinolytic activity that is of particular interest to clinicians and nutritionists. To understand fibrinolytic activity, first one must understand the basic process of coagulation or clotting of blood. In damaged tissue, the broken blood vessel releases a compound called thromboplastin. At the same time platelets adhere to the broken edges of the vessel and disintegrate, releasing platelet factor 3. Both of these react with protein factors and calcium ions to form prothrombin activator. Once the prothrombin activator is formed, the process from prothrombin to fibrin and finally a clot follows.2

Blood clots (thrombi) form when strands of fibrin accumulate in the circulatory system. These clots can cause blockage of blood flow. If blood flow is blocked, the oxygen supply to that tissue is cut off and it eventually dies. In the heart, this can result in myocardial infarction (heart attack). In the brain, it can result in strokes or mini-strokes. Deep vein thrombosis can result in pulmonary emboli. All these events can be life threatening. Of course, clotting forms an important function in tissue repair. However, improper build up of fibrin in the circulatory system becomes a significant risk factor for cardiovascular disease.

Diverse Anti-Inflammatory and/or Pain Research

Researchers in India conducted a study to assess the response of serrapeptase in patients with carpal tunnel syndrome (CTS). They wanted to determine if a conservative, non-surgical approach would be beneficial. Twenty patients with CTS were evaluated clinically after 6 weeks taking serrapeptase. Sixty five percent showed significant clinical improvement, which was supported by improvement in electrophysiological parameters. No significant side effects were observed. The doctors concluded that serrapeptase therapy may prove to be a useful alternative conservative treatment.3

Another study was conducted comparing the efficacy of two proteolytic enzymes in the treatment of venous inflammatory disease. The efficacy of Serrapeptase and Seaprose S was assessed using good or excellent results as the measure of effective treatment. Serrapeptase was effective in 65% of the cases compared to 85% for Seaprose S. Though Seaprose S had better overall results, both enzymes were effective. It can thus be confirmed that both enzymes were effective in patients with inflammatory venous disease.4 (Note: Seaprose S has since been withdrawn from the market).

A clinical evaluation of serrapeptase was conducted to determine its efficacy in reducing inflammation in patients with breast engorgement. Serrapeptase was noted to be superior to placebo for improvement of breast pain, breast swelling and induration and while 85.7% of the patients receiving serrapeptase had "Moderate to Marked" improvement. No adverse reactions were reported with the use of serrapeptase. The researchers conclude that serrapeptase is a safe and effective method for the treatment of breast engorgement.5

A prospective study was conducted on the effect of serrapeptase on post-operative swelling and pain of the ankle. In the serrapeptase group, the swelling decreased by 50% on the third post-operative day, while in the control groups (no treatment and treatment with ice) no reduction in swelling occurred. A decrease in pain correlated for the most part with the reduction in swelling. On the basis of these results, serrapeptase would appear to be an effective preparation for the post-operative reduction of swelling, in comparison with the classical conservative measures, for example, the application of ice.6

Moving to another part of the body, a study was conducted in men with amicrobial prostato-vesiculitis (APV is a non-infectious inflammation of the prostate). The researchers wanted to determine if treatment with nonsteroidal anti-inflammatory (NSAIDS) drugs, including serrapeptase, could reduce inflammation and swelling of the prostate. The doctors conclude that in APV patients, the treatment with NSAIDS, including serrapeptase is an effective therapy, producing multiple positive effects.7

The efficacy of serrapeptase was evaluated in a multicentre, double-blind, placebo-controlled study of 193 subjects suffering from acute or chronic ear, nose or throat disorders. After 3-4 days' treatment, significant symptom regression was observed in serrapeptase treated patients. Statistical comparison confirmed the greater efficacy of serrapeptase against all the symptoms examined. It was concluded that serrapeptase has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation.8

A multi-centre, double-blind, placebo-controlled trial was carried out to investigate the clinical efficacy of the anti-inflammatory enzyme Serratiopeptidase in 174 patients who underwent Caldwell-Luc antrotomy for chronic empyema(puncturing and draining pus from the nasal maxillary sinus). This puncture is placed under the top lip and above the gum line. Changes in swelling at the puncture sites after the procedure were observed. The degree of swelling in the Serratiopeptidase-treated patients was significantly less than that in the placebo-treated patients at every point of observation.  No side-effects were reported.9

Other Applications Research

Serrapeptase is widely used in clinical practice in Japan. One research trial in Japan investigated the effect of serrapeptase on sputum properties and symptoms in patients with chronic airway diseases. After 4 weeks of serrapeptase treatment, sputum output, viscosity and sputum neutrophil count decreased significantly. In addition, the frequency of coughing and of expectoration also decreased. The researchers concluded serrapeptase may exert a beneficial effect on mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum in patients with chronic airway diseases.10

Another clinical study evaluated the effect of serrapeptase on the elasticity and viscosity of the nasal mucus in adult patients with chronic sinusitis. Serrapeptase was administered orally for 4 weeks. The dynamic viscosity of the mucus at week 4 was significantly lower than that at week 0. The authors conclude that serrapeptase may have some application in patients with chronic sinusitis.11

An unusual clinical trial evaluated the effectivenessof serratiopeptidase in the eradicationof a periprosthetic infection (an infection at the site of an implanted orthopedic device) in an in vivo animal model. Infections of slime-forming bacteria are especially difficult at these sites. Rats were inoculated with Staphylococcus epidermidis at the prosthetic site. After two weeks, infection persisted in 63.2% of animals in the no-treatmentgroup; 37.5% of animalsin an antibiotic-only group; and only 5.6% of animals in the serratiopeptidase-and-antibioticgroup. The authors conclude that serratiopeptidase was effective at eradicating infectionin this experimental animal model and may enhance antibioticefficacy in the treatment of staphylococcal infections.12

Clearly, the potential applications for Peptizyme® SP are many and varied. Whether the application is fibrinolytic, anti-inflammatory, analgesic, antibacterial, a mucolytic expectorant, as well as others, Peptizyme® SP is the cutting edge in systemic enzyme therapy.

1. Intestinal absorption of serrapeptase (TSP) in rats.Moriya N, Nakata M, Nakamura M, Takaoka M, Iwasa S, Kato K, Kakinuma A.
2. Guyton, A. Function of the Human Body. WB Saunders pp. 83-84
3. A preliminary trial of serratiopeptidase in patients with carpal tunnel syndrome. J Assoc Physicians India. 2000 Nov;48(11):1130.
Dept. of Neurology, SMS Medical College and Hospital, Jaipur.
Panagariya A, Sharma AK.
4. Clinical study of the efficacy of and tolerance to seaprose S in inflammatory venous disease. Controlled study versus serratio-peptidase[Article in Italian] Minerva Cardioangiol. 1996 Oct;44(10):515-24.
Bracale G, Selvetella L.
Divisione di Chirurgia Vascolare, Università degli Studi di Napoli, Federico II.
5. The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind controlled trial. Singapore Med J. 1989 Feb;30(1):48-54.
Kee WH, Tan SL, Lee V, Salmon YM.
6. Reduction of postoperative swelling. Objective measurement of swelling of the upper ankle joint in treatment with serrapeptase-- a prospective study(German). Fortschr Med. 1989 Feb 10;107(4):67-8, 71-2.
Esch PM, Gerngross H, Fabian A.
7. Treatment with non-steroidal anti-inflammatory drugs in patients with amicrobial chronic prostato-vesiculitis: transrectal ultrasound and seminal findings][Article in Italian] Minerva Urol Nefrol. 2005 Mar;57(1):53-9.Links
Vicari E, La Vignera S, Battiato C, Arancio A.
Sezione di Endocrinologia, Andrologia e Medicina Interna, Dipartimento di Scienze Biomediche, Ospedale Garibaldi, Università degli Studi di Catania, Catania, Italy.
8. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo.J Int Med Res. 1990; 18(5):379-88.
Institute of Clinical Otorhinolaryngology, University of Naples, Italy.
Mazzone A, Catalani M, Costanzo M, Drusian A, Mandoli A, Russo S, Guarini E, Vesperini G.
9. A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling. Pharmatherapeutica. 1984;3(8):526-30.
Tachibana M, Mizukoshi O, Harada Y, Kawamoto K, Nakai Y.
10. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease.
Nakamura S, Hashimoto Y, Mikami M, Yamanaka E, Soma T, Hino M, Azuma A, Kudoh S. Respirology. 2003 Sep;8(3):316-20. Links
Department of Respiratory Medicine, Tokyo Metropolitan Hiroo General Hospital, Japan.
11. The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus. Arch Otorhinolaryngol. 1988;244(6):355-9.
Department of Otorhinolaryngology, Mie University School of Medicine, Japan.
Majima Y, Inagaki M, Hirata K, Takeuchi K, Morishita A, Sakakura Y.
12. The effect of proteolytic enzyme serratiopeptidase in the treatment of experimental implant-related infection.
Mecikoglu M, Saygi B, Yildirim Y, Karadag-Saygi E, Ramadan SS, Esemenli T.
Animal Research Laboratory, Marmara University School of Medicine, Istanbul, Turkey. J Bone Joint Surg Am. 2006 Jun;88(6):1208-14. Links

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