Serrapeptase : Benefits, Usage, and Potential for Inflammation, Cardiovascular Health, and Post-Surgical Recovery

Serrapeptase or serratiopeptidase is a proteolytic enzyme (an enzyme that breakdown proteins into amino acids) derived from the bacteria Serratia marcescens E-15 in the intestine of silkworms. It was found that exposure of Serratia marcescens bacteria to UV radiation and chemical mutagens such as ethyl sulfonate can lead to an increase in production as well as activity of the enzyme. The specialty of this enzyme is that it breaks the non-living proteins inside the body that are formed during inflammation, pain, and clogging.^[1] It is used to treat arthritis, trauma, surgery, dentistry, and carpal tunnel syndrome (severe pain in the hand and palm region). Also, it possesses anti-analgesic and anti-atherosclerotic properties.

For the first time, its anti-inflammatory property was studied in Japan. Later in the 1960s, this parenteral enzyme formulation was replaced with an oral enteric-coated tablet (the enteric-coated tablet that does not break down in the stomach but instead shows the breakdown in the intestine region) to demonstrate the effect on intestinal inflammation. After the 1970s these enzyme formulations were marketed very rapidly.

The research was conducted in Europe and Japan during the 1980s and 1990s and concluded that serrapeptase was the best enzymatic preparation for reducing inflammation compared to other enzymatic preparation such as parenteral trypsin and chymotrypsin.^[1]

The Mechanism Behind Inflammation: Inflammation is an innate immune response that causes pain, redness, and swelling in the human body. It is the defense mechanism of the body that is produced in response to any foreign particle, or irritant and can be caused by many such reasons such as pathogens and injury. It is regarded as the healing mechanism of the body and necessary to maintain homeostasis.^[4]

Type of Inflammation and General Treatment: Based on the pathological condition of the body it can be acute or chronic. Acute inflammation is the protective measure against injury or infection and failure of its resolution/treatment can lead to chronic inflammation.

Disease-Associated With Inflammation: Various diseases are associated with inflammation such as arthritis, sinusitis, bronchitis, and fibrocystic breast disease, which are common worldwide.^[3]

Generally, nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat inflammation and diseases associated with it. NSAIDs are used alone or in combination with other prescribed drugs to treat acute inflammation, whereas steroidal drugs are combined with NSAIDs to treat chronic inflammation conditions in humans.^[1]

There are various types of side effects and limitations associated with these drugs that lead scientists to develop more specific treatment approaches for inflammation. To overcome the limitations of conventionally used drugs, enzyme-based drugs are used for the treatment as they offer low side effects and have an accurate target action that leads to the development of their uses.

Serratiopeptidase inhibits the cyclooxygenase pathway of inflammation (inhibit COX1 and COX2) and stops the production of interleukins, prostaglandins that are the important mediator of inflammation.^[3] It is found to act on the exact inflammation site which will results in decreased side effects and increase target-based action. The oral administration of serratiopeptidase tablets reduces pain and inflammation.^[3] It is also combined with other NSAIDs to achieve the combined effect. It is mainly combined with diclofenac and ibuprofen and has more effect in reducing swelling and pain.

As we know the cardiovascular system is formed by the pumping system of the body through arteries and veins and the heart. Arteries carry blood away from the heart and veins carry blood to the heart, any type of clot or plaque formation inside these arteries and veins can lead to the interrupted blood supply to the heart as well as organs and throughout the body.

This will lead to a major problem in the cardiovascular system and stroke in patients. Therefore, to treat this condition of plaque or clot formation inside the arteries we need to dissolve that clot as soon as possible by using possible medications. But as we know every medication has its disadvantages associated with it, to overcome this disadvantage scientists have found that a serine protease is a group of enzymes that includes fibrinolytic enzymes that dissolve clots.^[5]

Serratiopeptidase as a Fibrinolytic Agent: Serratiopeptidase is a serine protease having high fibrinolytic activity. This enzyme has been shown to have the property of blood clot lysis and can remove arterial blockage. It acts by breaking down dead/damaged tissue and fibrin (a tough protein found in blood clots).^[5] In this way, it can remove plaque or clots inside the arteries and may prevent heart stroke in patients.

In the case of covid-19, there are increased no of heart complications in patients due to the development of thrombosis and it is believed that the serratiopeptidase due to its fibrinolytic action was useful in the treatment of vascular disease associated with covid-19.^[6]

Serratiopeptidase in Post-Surgical Recovery: It is found to be very effective in post-surgical recovery by various mechanisms such as reducing inflammation, and pain, and its wound healing property is also helpful in the recovery of the patients after surgery.

Serratiopeptidase is an enzyme that is known to have anti-inflammatory activity and has proven beneficial in post-surgical recovery by reducing inflammation. The wound-healing mechanism of serratiopeptidase is also found to have beneficial effects in the recovery of patients after surgery.^[7]

It also has an analgesic effect, so it is used in recovery from dental surgeries as well as for those who had surgery for carpal tunnel syndrome. It reduces pain due to its ability to hydrolyse bradykinin, histamine, and serotonin.^[7]

A clinical trial on 70 patients with breast engorgement found that serratiopeptidase treatment resulted in decreased pain and swelling with no serious side effects.

Serratiopeptidase is a proteolytic enzyme that is found to be effective in the treatment of inflammation, preventing heart stroke due to its fibrinolytic effect, and also used in wound healing as well as post-surgical recovery in patients with dental surgery like tooth removal, etc. However, there is no significant clinical studies are available that claim its efficacy in post-surgical recovery. The research is undergoing to know the exact mechanism behind its benefit in post-surgical recovery as well as its fibrinolytic effect.

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Also Read:

• What is Serrapeptase & How Does it Work, Know its Uses, Benefits, Side Effects?
• Serrapeptase : A Potential Enzyme-Based Treatment for Lyme Disease
• Serrapeptase : Mechanism of Action, Recommended Dosing, and Safety Profile