Clinical
observations and literature review both affirm the conviction that
providing "systemic enzyme support," using Wobenzym N
or Wobenzym PS, is an essential component in successfully managing
inflammation disorders and other conditions with immune system dysregulation.
In addition to improving clinical outcomes in conditions with overt
inflammation, such as rheumatoid arthritis, thrombophlebitis, pyelonephritis,
prostatitis, and psoriasis, systemic enzyme support is also effective
in conditions with covert inflammation, such as osteoarthritis,
angina, atherosclerosis, myocardial infarctions, and diabetes, to
name a few. The adjuvant properties of systemic enzyme support have
also been observed and documented for a number of cases including
adnexitis, arthritis, papillomas and various forms of cancer. This
article will familiarize clinicians with the therapeutic benefits
of systemic enzyme support and review pertinent findings related
to this treatment.
Systemic Enzyme
Support Formulations
A significant amount of the published international literature describing
the clinical benefits of systemic enzyme support is based on various
formulations made for many decades by MUCOS Pharma, a Germany pharmaceutical
company. Although the company was sold, Wobenzym N is still manufactured
in Germany, and is distributed by MUCOS LLC, an American company.
The history of Wobenzym is significant in that systemic enzyme support
requires sophisticated processing techniques to be effective. Systemic
enzyme support formulations are considered prescription drugs in
part of Europe, and manufactured to the same high standards as pharmaceuticals.
The Wobenzym N and Wobenzym PS animal enzyme, plant enzyme, and
rutosid combinations are the most researched systemic enzyme formulations
in the world, used by athletes, doctors and millions of others to
help normalize inflammation, speed recovery from sports and other
routine injuries, and promote healthy circulation.
The active constituents in Wobenzym N and Wobenzym PS are delivered
through tablets that have a special enteric coating which can withstand
the acid environment in the stomach, which is important since enzymes
can be damaged by stomach acid. Once the tablet has passed a safe
distance from the stomach acids, it dissolves and the enzymes are
efficiently absorbed by the mucosal membrane of the intestine. This
process is most effective if the tablets are taken away from meals.
Inflammation Observed
Enzymes are biological molecules that increase the rate of chemical
reactions. In the human body, thousands of chemical reactions occur
during the course of normal metabolic processes. These reactions
require significant energy in order to take place. Enzymes act as
catalysts to lower the energy needed for the reaction to move forward.
As such, enzymes maintain optimal function of the various systems
in the body and support overall good health and optimal quality
of life.
The immune system is very dependent on proper enzyme function in
regard to regulating inflammation as well as protecting cells from
damage. Cytokine activity, and the clearance of excessive inflammatory
cytokines, is regulated by proteases, enzymes which degrade proteins.
The clearance of tissue proteins and peptides damaged by inflammation
is also mediated by proteases. Proteases significantly reduce concentrations
of advance glycation end-products (AGEs) and protect cells by decreasing
their receptor (RAGE) activation. Proteases also downregulate adhesion
molecule activity in inflamed as well as malignant cells.
This inflammation response can be quite aggressive, and manifest
as the five cardinal signs of inflammation recognized ages ago:
redness, heat, swelling, pain and loss of function, classically
referred to in Latin as rubor, calor, tumor, dolor, and functio
laesa. These symptoms diminish quality of life and may portend serious
disease. Therefore, clinically evident inflammation is often recognized
as the body's communicating an inability to control proper cellular
processes.
In addition to the clinical signs of inflammation, laboratory tests
often show increased levels in the various biomarkers of inflammation
that are also associated with increased morbidity and mortality.
These include the well known erythrocyte sedimentation rate (ESR)
and C-reactive protein (CRP). Circulating immune complexes (CICs)
and immunoglobulins (IgG, IgE, IgA, and IgM) are often elevated
by excessive inflammation. Excessive fibrin activity and increased
amyloid beta-peptide can also be quantified in the presence of imbalanced
inflammation. Certain cytokine levels may also increase, which may
cause further imbalance in the immune system.
The change in certain cytokine levels is of specific interest because
it allows us to recognize when the immune system has become significantly
imbalanced, and elucidates how immunomodulation can be achieved
through the use of systemic enzymes.
Inflammation and
Cytokines
Cytokines are signaling proteins and glycoproteins involved in cellular
communications that play a dominant role in maintaining the normal
inflammatory processes of the immune system. Cytokines such as interferon-gamma
(INF-g), tumor necrosis factor-alpha (TNF-a), transforming growth
factor beta (TGF-b), and interleukins (IL-2, IL-6, IL-12, IL-4,
IL-5, IL-10) are produced de novo (on demand) in various cells as
a direct response to stimulation of the immune system. They are
produced by a wide variety of cells and are typically subdivided
into two categories, Th1 and Th2. A balance between Th1 and Th2
responses is best for optimal health.
Th1 cytokines tend to produce the pro-inflammatory responses involved
in antibacterial, antiviral, and antifungal responses. Excessive
Th1 responses can lead to uncontrolled tissue damage and may perpetuate
autoimmune responses. A relative excess in Th1 is also observed
in acute inflammation. Th2 cytokines tend to produce anti-inflammatory
responses and can counteract the Th1-mediated microbicidal actions.
Excessive TH2 responses are associated with allergies and atopy
(asthma, eczema, allergic rhinitis, and allergic conjunctivitis).
A relative excess in Th2 is also observed in chronic inflammation.
The binding and removal of excessive cytokines is mediated by a-2-macroglobulin
(alpha 2-macroglobulin), a naturally occurring high-molecular-weight
plasma glycoprotein. Proteases bind with a-2-macroglobulins to create
a-2-macroglobulin-protease complexes and transform the a-2-macroglobulin
from its native form into the active form.1 Systemic
enzyme support increases endogenous proteases and promotes the activation
of a-2-macroglobulin.
The newly activated a-2-macroglobulin-protease complex now has increased
binding capacity for certain cytokines, as well as other proteins
and glycoproteins.2 Protease activation of a-2-macroglobulin
also facilitates its binding to, and elimination of, proteins damaged
by oxidative stress or heat3 as well as the degradation
and clearance of the amyloid beta peptide (A beta), a major component
of senile plaques in Alzheimer's patients.4,5
These activated alpha 2-macroglobulin-proteinase complexes, which
now bind excessive cytokines and damaged proteins, were also activated
for receptor-mediated endocytosis when they were transformed by
the protease enzymes. Therefore, these complexes, as well as the
cytokines and debris they carry, are quickly removed by hepatic
a-2M-receptors (a-2M-R)5, and other cells expressing a-2M-R, such
as macrophages.6,7 The removal of damaged proteins, cellular
debris, and unwanted peptides (such as amyloid beta peptides) is
a normal immune-system response to defend the body from all pathogenic
influences – whatever their origin, whatever their size.
Since excessive cytokines are involved in autoaggressive inflammatory
processes, the binding to cytokines and the removal of cytokines
by the activated a-2-macroglobulin proteins support a balanced and
properly functioning immune system. Therefore the removal of excessive
cytokines allows the immune system to restore Th1/Th2 balance. Once
cytokine levels are restored to their optimal physiologically balanced
state, the immune system is able to resume its function of protecting
the body and initiating the healing process. With renewal of the
normal inflammatory process, the regenerative processes of the immune
system are again allowed to function.
Restoring Immunostasis
As noted, the clearance of excessive cytokines, the clearance of
proteins and peptides damaged by inflammation, the inactivation
of AGEs, and the inactivation of adhesion molecules in inflamed
and malignant cells are all mediated by proteolytic enzymes. A balanced
immune system – immunostasis – can be manifested by
using systemic enzyme support, which provides the essential proteolytic
enzymes. Systemic enzyme support can be defined as a treatment modality
that uses oral administration of exogenous hydrolytic (mainly proteolytic)
enzymes of animal origin (trypsin, chymotrypsin) and plant origin
(bromelain, papain) in the form of enteric-coated tablets for supporting
healthy and normal inflammatory processes in the body.
Systemic enzyme support using Wobenzym N and Wobenzym PS is able
to influence immunity in such a fashion as to reduce pain, swelling,
inflammation, edema and lymphedema, and increase fibrinolysis, and
the clearance of harmful immune complexes that are a result of antibody
reactions. Systemic enzyme support provides enzymes that can be
utilized to assist the body's various regulatory and communications
systems and supports the function of tissues at a cellular level.
Systemic enzyme support has application for degenerative and autoimmune
diseases, and as an adjuvant to improve efficacy of anti-infectives
in infectious diseases.
Conditions Treated
with Systemic Enzyme Support
Based on clinical observations and literature review, systemic enzyme
support effectively improves the treatment of conditions with an
autoaggressive component by promoting the decomposition and elimination
of disease-associated CICs. Improvements in CRP, ESR, and other
biomarkers of inflammation are also noted. Clinical improvement
is noted in a wide range of conditions, with benefits observed in
treating various body systems.
Nervous system disorders such as multiple sclerosis showed a decrease
in number and duration of attacks because of decreased inflammatory
activity due to systemic enzyme support.8 A notable increase in
the degradation and clearance of the A beta peptide can reduce the
risk of developing Alzheimer's disease.9,10 The cardiovascular system
benefits by reduced risks of reinfarction after an MI because of
the hypolipidemic and immunonormalizing benefits of systemic enzyme
support.11 Patients with stable angina pectoris had a demonstrable
reduction in the frequency and intensity of angina pectoris attacks
and increased tolerance of physical work load with systemic enzyme
support.12 Diseases of the venous system, including acute thrombophlebitis
and postthrombophlebitic syndrome, were dramatically improved by
systemic enzyme support, with a notable decrease of pain and reduction
of edema and throphic ulcers.13,14 Other research showed highly
effective resolution of lymphedema in both upper and lower extremities
due to fibrinolytic and antiedematous effects of systemic enzyme
support.15,16
Respiratory health is improved by systemic enzyme support, with
a notable reduction of both frequency and severity of recurrent
respiratory tract infections. Researchers have concluded that systemic
enzyme support represents a novel therapeutic modality that helps
in treating children showing a high sickness rate, and noted that
the number and severity of dyspnea attacks decreased in children
with proven asthma.17,18
Integumentary conditions had improved clinical success when systemic
enzyme support was added as an adjuvant to other conventional therapies.
The inclusion of systemic enzyme support in treatment of psoriasis
significantly decreases the exudative component of exacerbation,
increased regression, and decreases recurrence.19 Eczema (atopic
dermatitis) treated with only systemic enzyme support resulted in
reduced skin itching manifestations, and in combination with basic
conventional therapies, the treatment notably accelerated the desirable
effects.20
Urinary system condition improvements due to treatment with systemic
enzyme support include a major reduction in relapsing urinary tract
infections, in recurrence of kidney stones, and in progression of
diabetic nephropathy. There are also positive clinicolaboratory
results that considerably exceeded those for conventional drug treatment
in patients with pyelonephritis.21
Reproductive, thyroid, and women's and men's health conditions can
all be more effectively managed with systemic enzyme support. It
is an important part of the complex therapy of male and female sterility,
recurrent miscarriages, and chronic infections of the reproductive
system. Systemic enzyme support is an effective immunomodulator
for both autoimmune and alloimmune infertility.22,23 In women, it
is effective for treatment in chronic pelvic inflammatory disease
(PID) and as adjuvant in treatment of acute adnexitis.24,25 In men,
systemic enzyme support is a very efficient therapy for both bacterial
and abacterial prostatitis, as well as associated sexual dysfunction.26,27
Systemic enzyme support is also a very effective therapy for the
management of fibrocystic breast disease and does not interfere
with already upset hormonal balance.28,29 Autoimmune thyroid disease
treated with systemic enzyme support resulted in a significant decrease
of TSH, anti-TG and anti-TPO and allowed the lowering of L-thyroxine
dosages.30
Joint health is profoundly improved by systemic enzyme support.
It is an effective and safe alternative to NSAIDS (non-steroidal
anti-inflammatory drugs) in the treatment of painful episodes of
osteoarthritis of the knee and hip.31,32 Systemic enzyme support
protects and preserves joint cartilage significantly better than
NSAIDs in rheumatoid arthritis.33,34 Gout therapies are significantly
improved by the addition of systemic enzyme support.35 The addition
of systemic enzyme support improved both articular signs and extra-articular
manifestations in the majority of the children with juvenile chronic
arthritis and was able to help limit the use of corticosteroids
in some children. In addition to osteoarthritis, rheumatoid arthritis,
gouty arthridities, and juvenile arthritis, systemic enzyme support
has also been shown as effective in the treatment of psoriatic arthritis.
It is fair to say that systemic enzyme support could be used in
any form of arthritis.
Sports medicine is another area in which systemic enzyme support
excels. Sport- and exercise-related muscle pain and inflammation
provoked by a strong physical tension, excessive training, and heavy
competition rate are decreased with "excellent results"
due to the selective interferences of enzymes with the pathophysiologic
mechanisms of exercise-induced inflammation.36 A prophylactic administration
of systemic enzyme support in top athletes who are at risk of injury
results in significantly reduced duration of injury symptoms and
related absences from training and work. Systemic enzyme support
also improves recovery from sprains, as well as shortens recovery
from sport injuries severe enough to require surgery.37,38
Biomarkers of Inflammation
and Systemic Enzyme Support
It is again important to note that the studies showing clinical
efficacy in the aforementioned conditions are based on the enteric
coated polyenzyme formulations that originated from Germany. Clinicians
can be confident that they will observe the same degree of clinical
efficacy with Wobenzym N and Wobenzym PS, which are manufactured
in Germany by that company. As well as the clinically observable
benefits, systemic enzyme support improves or normalizes the levels
of several biomarkers of inflammation, as mentioned above.
The decreased CIC levels resulted in significant improvement in
a variety of conditions, including rheumatoid arthritis, atherosclerosis,
atopic dermatitis, Behçet's disease, chronic hepatitis, diabetes
mellitus, and myocardial infarction.39-47 Decreased erythrocyte
sedimentation rate was observed in urinary tract infections, adnexitis,
rheumatoid arthritis, and surgical cases.48-52 Decreased CRP levels
in lymphedema, rheumatoid arthritis, psoriatic arthritis, and surgical
cases were associated with improved clinical outcomes.53,54 The
normalization of cytokine levels after tissue injury and inflammation
was observed in rheumatoid arthritis and angina pectoris treated
with systemic enzyme support.55,56 Normalization of immunoglobulins
(IgG, IgE, IgA, IgM) is observable in treated cases of atopic dermatitis,
recurrent infections of respiratory tract and rheumatoid arthritis.57,58
The restoration of normal fibrinolytic properties by systemic enzyme
support is considered as vital for disease state management in rheumatology,
immune complex diseases, traumatology, surgery, oncology, inflammations,
and vascular diseases, as well as diseases with an infection component.59,60
Systemic enzyme support can also upregulate amyloid beta catabolism
and reduce the risk of developing Alzheimer's disease by preventing
amyloid beta accumulation in brain and vasculature.61
Conclusion
Systemic enzyme support has been demonstrated to be an effective
treatment either as primary therapy or adjuvant therapy that improves
clinical outcomes of diseases that are difficult to manage. Systemic
enzyme support has been reported to have excellent tolerance and
superior safety when compared with some conventional therapies.62-64
The safety and efficacy of systemic enzyme support with Wobenzym
N or Wobenzym PS is coupled with a consumer loyalty rate of over
80%. This significant compliance to systemic enzyme support is believed
to be primarily due to its effectiveness.
More information can be found at www.SystemicEnzymeSupport.org,
a noncommercial a health education and wellness promotion website
dedicated to teaching the clinical efficacy of systemic enzyme support.
Notes
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56. Mazourov VI et al. Op cit.
57. Samtsov AV et al. Op cit.
58. Vokálová I. Op cit.
59. Wrba H. Op cit.
60. Dittmar F-W, Weissenbacher ER. Op cit.
61. Lauer D et al. Op cit.
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64. Akhtar NM et al. Op cit.
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