Enzymes to Fight Inflammation?

3 min

Enzymes are specialized protein molecules that catalyze (speed up) biochemical reactions. They are involved in all aspects of metabolism, growth, and development, but there is generally no point in taking them as supplements. The reason is simple: enzymes that are ingested are simply broken down in the stomach and small intestine and digested like any other proteins. The only exceptions are the digestive enzymes made by the stomach and pancreas, which work in the gastrointestinal tract. I occasionally recommend these as supplements to patients who have digestive problems. Unless you need digestive enzymes for a specific reason, however, there is no benefit in taking them.

However, the pointlessness of taking systemic enzymes orally hasn’t stopped promoters from making many claims about the benefits of their products. Perhaps the best known of these is serratiopeptidase, an enzyme found in silkworm intestines that allows the emerging moth to dissolve its cocoon. Serratiopeptidase has been promoted online and elsewhere as a treatment for pain associated with arthritis, surgery, trauma, and fibromyalgia, as well as for respiratory symptoms of Covid-19. It is also advertised as a treatment for atherosclerotic plaque (the buildup of cholesterol, fat, and calcium in arteries). The assertion is that serratiopeptidase “digests” the substances that cause plaque without harming underlying tissue. There is no scientific evidence for this claim.

On the market since 1968, serratiopeptidase has been advertised as an effective treatment for conditions ranging from chronic bronchitis to sprained ankles. Most of the early published research on it focused on its anti-inflammatory properties, including its potential as a substitute for non-steroidal anti-inflammatory drugs (NSAIDs) and as a topical treatment for inflammation. However, in February of 2011 a Japanese drug company voluntarily recalled its product, generically called serrapeptase, because double-blind studies comparing this agent to placebo showed no significant differences in anti-inflammatory activity between the two. A 2013 review of two dozen studies in published literature concluded that there was insufficient evidence to support the use of serratiopeptidase as either a painkiller or a supplement to support health.

Systemic enzyme therapy is also promoted for cancer treatment. Here, proponents claim that certain enzymes remove a protective coating from cancer cells, allowing white blood cells to identify and attack them. According to the American Cancer Society, no scientific evidence exists to support this claim and no well-designed studies have shown that enzyme supplements are effective in treating cancer. A 2022 paper published in Nature looked at the role of enzymes in “detoxifying” cancer cells, which may one day have implications for therapeutic regimens for certain cancers – but there is nothing in those findings to justify the use of systemic enzyme supplements.

One interesting 2017 study published in the Journal of Hospital Infection found some potential benefit for using enzyme therapy in combination with antibiotics to combat staph infections, and there may be other specific therapeutic uses for particular enzymes identified in the future. As general supplements for health, however, they are simply not effective.

Andrew Weil, M.D.

Sources
Nair SR, C SD. Serratiopeptidase: An integrated View of Multifaceted Therapeutic Enzyme. Biomolecules. 2022 Oct 13;12(10):1468. doi: 10.3390/biom12101468. PMID: 36291677; PMCID: PMC9599151. pubmed.ncbi.nlm.nih/36291677/

Bhagat S, Agarwal M, Roy V. Serratiopeptidase: a systematic review of the existing evidence. Int J Surg. 2013;11(3):209-17. doi: 10.1016/j.ijsu.2013.01.010. Epub 2013 Feb 1. PMID: 23380245.  pubmed.ncbi.nlm.nih/23380245/

Hogan S, Zapotoczna M, Stevens NT, Humphreys H, O’Gara JP, O’Neill E. Potential use of targeted enzymatic agents in the treatment of Staphylococcus aureus biofilm-related infections. J Hosp Infect. 2017 Jun;96(2):177-182. doi: 10.1016/j.jhin.2017.02.008. Epub 2017 Feb 16. PMID: 28351512.  pubmed.ncbi.nlm.nih/28351512/

Doshi MB, Lee N, Tseyang T, Ponomarova O, Goel HL, Spears M, Li R, Zhu LJ, Ashwood C, Simin K, Jang C, Mercurio AM, Walhout AJM, Spinelli JB, Kim D. Disruption of sugar nucleotide clearance is a therapeutic vulnerability of cancer cells. Nature. 2023 Nov;623(7987):625-632. doi: 10.1038/s41586-023-06676-3. Epub 2023 Oct 25. PMID: 37880368; PMCID: PMC10709823.

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Originally Posted January 2012. Updated March 2024.