By Andrew Gaeddert
A bacteria that lives in the intestines of the silkworm offers a side-effect free alternative to the millions of Americans who take anti-inflammatory medications to relieve pain and treat chronic inflammatory diseases.
Serratiopeptidase, also known as serrapep-tase and Serramend™, is an enzyme produced by bacteria in the intestines of silkworms to digest the tough mulberry leaves they feed on and dissolve their cocoon walls; it is a proteolytic enzyme, which means that it breaks down proteins. In humans it decreases inflammation and digests non-living tissue such as blood clots, cysts, and arterial plaque.
Serramend treats inflammation in three ways. It breaks down fibrin and other damaged tissues that form atherosclerotic plaque without harming the arteries themselves, prevents atherosclerosis (hardening of the arteries) and decreases the risk for heart attack or stroke. Serramend speeds tissue repair by thinning the fluids formed by inflammation and facilitating their drainage. Finally, it inhibits the release of bradykinin, a substance that causes pain.
Doctors in Europe and Asia have used Serramend for 30 years as an alternative to anti- inflammatory medications to treat a wide variety of chronic, inflammatory conditions including arthritis, colitis and fibromyalgia. Research in Japan dating back to the 1960s shows that the enzyme improves respiratory symptoms, and it has long been used in Japan to treat chronic sinusitis, emphysema, asthma, bronchitis, ear, nose and throat infections, and chronic obstructive pulmonary disease. Research has also shown that it dissolves breast and ovarian cysts, eases arthritis pain, and speeds healing of torn ligaments and sports injuries and following surgery. Recent studies show that Serramend dissolves blood clots and arterial plaque, protects against strokes, and shrinks varicose veins. It also helps fight infections by preventing the formation of biofilms that cause bacterial resistance to antibiotics.
PROTEOLYTIC ENZYMES AND INFLAMMATION
Serramend is a proteolytic enzyme. Enzymes are protein molecules that regulate biological reactions. Enzymes are also catalysts that speed up chemical reactions in the body. For example, digestive enzymes speed the breakdown of food.
The role that proteolytic enzymes (also known as proteinases or peptidases) play in the body is to break bonds in proteins. Clinical studies have shown that proteolytic enzymes can reduce pain, swelling and inflammation associated with injury and surgery. They reduce inflammation by neutralizing bradykinins and eicosanoids to allow healing without inhibiting inflammation so much that the body is unable to trigger the normal healing process. Proteolytic enzymes in common use today as supplements include Serramend, bromelain, trypsin and chymotrypsin.
Proteolytic enzymes have been used therapeutically since the early 1950s, when it was found that intravenous trypsin relieved the symptoms of inflammatory conditions including rheumatoid arthritis, ulcerative colitis, and atypical viral pneumonia. When nonsteroidal anti-inflammatory drugs (NSAIDs) came on the scene in the 1960s, interest in proteolytic enzymes decreased dramatically, and there was little research on them until the 1990s, when scientists took another look at proteolytic enzymes, with European studies which showed impressive reductions in healing times of patients who used them. Today bromelain, an enzyme derived from pineapple, is commonly used as an anti-inflammatory supplement to heal sports injuries, fight urinary infections and thin blood.
Large doses of proteolytic enzymes have also been used as an alternative therapy to treat all forms of cancer. In a 2000 review of clinical studies of the use of proteolytic enzymes in oncology (mostly examining preparations combining papain, trypsin and chymotrypsin), Swiss researchers concluded that enzyme therapy reduces the adverse effects caused by radiotherapy and chemotherapy, and prolongs survival with some types of tumors. Noting that the beneficial effect of enzyme therapy was probably due to its anti-inflammatory effects, researchers also re- marked that proteolytic enzyme supplements influence the ratio of proteinases to antiproteinases, which is used as a prognostic marker in oncology, and alters cytokine composition.1
RESPIRATORY DISEASE
Much of the clinical research on Serramend has focused on its effects in treating respiratory diseases, and numerous studies have demonstrated its effectiveness. While medications used to treat respiratory diseases often deplete mucus, this enzyme thins mucus to improve its elimination without depleting it.
Serramend is widely used in Japan to treat respiratory disease; a 2003 study measured the effect of the enzyme on sputum properties and symptoms in patients with chronic airway disease. After taking 30mg of Serramend daily for four weeks, fifteen patients with chronic airway diseases showed significant beneficial effects compared to a control group of fourteen patients not receiving the enzyme, including significant decreases in coughing, expectoration, as well as sputum weight, viscosity, elasticity and neutrophil content. (The mean mucociliary transportability index increased from 13.3+/- 1.8 to 24.4 =/- 2.5; P =0.0103.) Researchers concluded this unique enzyme “may exert a beneficial effect on mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum in patients with chronic airway diseases.”2
In a 1988 Japanese study, adult patients with chronic rhinitis taking 30mg of Serramend daily for four weeks showed decreased mucus viscosity and improved elimination of lung secretions. Researchers concluded that supplementation reduced the viscosity and improved elimination of nasal mucus.3
Researchers in Italy documented the benefits of using Serramend in treating a variety of chronic, inflammatory ear, nose and throat conditions. In a 1990 double-blind study of 193 patients recruited from clinics throughout Italy, patients taking 5mg three times daily for a week experienced a significant reduction in symptoms in three days. The physicians’ assessments of the effectiveness of treatment were excellent or good for 97.3% of patients treated with the enzyme, compared to only 21.9% of those treated with placebo. Patients with laryngitis, catarrhal rhinopharyngitis and sinusitis showed particularly rapid improvement. Researchers concluded that it ‘has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation.”4
REDUCING INFLAMMATION AND HEALING INJURIES
In an Indian study from SMS Medical College and Hospital in Jaipur, published in 2000, 65% of ten patients with carpal tunnel syndrome taking 10mg of Serramend twice daily for six weeks with nimesulide, a non-steroidal anti-inflammatory showed significant clinical improvement along with significant improvement in electrophysiologycal assessments compared to pre-study baselines. Researchers concluded the enzyme to be a useful alternative mode of conservative treatment,” and called for a larger study to establish its role in treating carpal tunnel syndrome.5
A 1989 German double-blind study on post- operative swelling and pain in 66 patients who had undergone surgery for rupture of the lateral collateral ligament of the knee found that those taking one to two, 5mg capsules three times daily showed a 50% reduction in swelling three days after surgery. They also had significantly less pain than two control groups treated with leg elevation, bed rest, with and without the application of ice. The control groups showed no reduction in swelling after three days. The patients receiving Serramend were pain- free more quickly than the controls — by the tenth day, their pain had disappeared completely.
Researchers concluded that patients receiving the enzyme became pain-free more rapidly than the control groups, and that it is an effective treatment for post-operative swelling, compared to standard conservative measures such as the application of ice.6
In a 1984 multi-center, double-blind, placebo-controlled Japanese study of 174 patients who underwent surgery for chronic empyema, 88 patients receiving 10mg three times the day before operation, once on the night of the operation, and three times daily for five days following the operation showed significantly less post-operative buccal (cheek) swelling than the patients receiving placebos. The degree of buccal swelling in the treated patients was significantly less than that in the placebo-treated patients at every point of observation after operation up to the fifth day (P less than 0.01 to less than 0.05). No side-effects were reported.7
PROMOTING CARDIOVASCULAR HEALTH
The use of Serramend to improve cardio-vascular conditions was pioneered by German doctor and researcher Hans Nieper, who found that its protein-dissolving properties can gradually break down and prevent plaque build-up on the lining of arteries, preventing artery blockages, and thus, preventing atherosclerosis, stroke and heart attack. According to Dr. Nieper, taking 5mg capsules three times daily for 12 to 18 months could remove fibrous blockages from coronary arteries, as he confirmed with ultrasound examinations of his patients; it breaks down dead and damaged tissue without harming living tissue, and dissolves ather-osclerotic plaques without harming the arteries. Like aspirin, Serramend, is both anti-inflammatory and anti-clotting. But unlike aspirin, it can also dissolve existing fibrous deposits, and doesn’t cause the serious gastrointestinal side effects associated with chronic use of NSAIDs including aspirin.
CONCLUSION
Clinical studies since the 1960s have demonstrated the effectiveness of Serramend in reducing inflammation and pain, thinning mucus to treat respiratory symptoms, and improving the effectiveness of antibiotics. In vitro and in vivo studies have shown it has anti-inflammatory effects and clinical studies show it breaks down fibrin, and decreases inflammation and edema. Take as a supplement it acts similar to standard anti- inflammatory drugs with fewer side effects.
Serramend is a potent proteolytic enzyme that may help patients with a variety of conditions such as chronic and acute pain, ear, nose and throat conditions, and cardiovascular disease. It may be combined with enzyme formulas such as Resinall E™ 8 to speed up healing response, or other herbal or pharmaceutical agents. Clinical studies indicate that the enzyme is best delivered using enterically coated material, so that it does not get damaged by stomach acid. It is well tolerated, however it may cause diarrhea is some patients. Professional monitoring is especially useful if patients are on anti-coagulant drugs such as Coumadin (warfarin). The potency of Serramend is measured in units of activity. Each capsule contains 20,000 units and is enterically coated. Typical dosage is one or two capsules, twice per day between meals.
NOTES
- Leipner J, Saller R. “Systemic enzyme therapy in oncology: effect and mode of action.” Drug, 2000 Apr; 59(4):769-80.
- Nakamura S, Hashimoto Y, Midami M, Yamanaka E, Soma T, Hino M, Azuma A, Kudoh S., “Effect of the proteolytic enzyme serrapep- tase in patients with chronic airway disease,” Respirology 2003; 8:316-320.
- Majima Y, Inagaki M, Hirata K, Takeuchi K, Morishita A, Sakakura Y. “The effect of an orally administered proteolytic enzyme on the elasticity and viscosity of nasal mucus.” Arch Otorhinolaryngol. 1988; 244(6):355-9.
- Mazzone A, Catalani M, Costanzo M, Drusian A, Mandoli A, Russo S, Guarini E, Vesperini G. “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; 18:379-388.
- Panagariya A, Sharma AK. “A preliminary trial of serratiopepti- dase in patients with carpal tunnel syndrome.” J Associ Physicians India. 2000 Nov; 48(11):1130.
- Esch PM, Gerngross H, Fabian A. “Reduction in postoperative swelling: Objective measurement of swelling of the upper ankle joint in treatment with serrapeptase-a prospective study.” Fortschr Med 1989; 107:67-68, 71-72.
- Tachibana M, Mizukoshi O, Harada Y, Kawamoto K, Nakai Y. “A multi-centre, double-blind study of serrapeptase versus placebo in post-antrotomy buccal swelling.” Pharmatherapeutica 1984;3(8):526-30.
- Resinall E: (Ingredients: Enzymes: Bromelain, Papain, Tryspin, Chymotrypsin, Rutin; Herbs: Tienchi root (San Qi), Corydalis rhizome (Yan Hu Suo), Safflower flower (Hong Hua), Myrrh gum resin (Mo Yao), Indian Frankincense gum (Ru Xiang), Borneol resin (Bing Pian).
Andrew Gaeddert is an herbalist and author of the books Chinese Herbs in the Western Clinic, Healing Digestive Disorders, Digestive Health Now, Healing Skin Disorders and Healing Immune Disorders.
© February 2006; REV 2022