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Therapeutic Use of Enzymes for Tendinitis and Soft Tissue Injuries

Jennifer Hammer, M.S., CCN, CSCS*D, Stan Bynum, Ph.D.

Introduction
Tendinitis can be treated with enzymes. Enzymes serve as the body’s labor force to perform every single function required for our daily activities and are required to keep us alive and also prevent conditions like tendinitis. They are responsible for all the functions of every organ system in the body. They are especially important in supporting our body defenses and immune system. In fact, 22 of the 27 known subproteins in the immune complement system are enzymes(23).

Proteolytic enzymes have powerful applications to many health problems and conditions that face people of all ages, including problems with the circulatory system and circulating immune complexes, fibromyalgia, allergies, low immunity, tendinitis / tendonitis and other sports injuries. While all these conditions may seem different, they are all very closely linked to impairment of the immune system and to the stresses put on the body that destroy its ability to fight various ailments.

Research shows that highly concentrated proteolytic enzymes are able to break down undigested protein, cellular debris and toxins in the blood; provide a buffering system to prevent accumulation of acid waste; break up waste protein occurring in an area of tendinitis injury; help inflammation and circulation; help the body fight muscle spasms; and help the body ward off food and airborne allergies(2;3;19-21;23;24;26).

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Purported Mechanism of Action
The European pharmacological and medical literature cites the mechanisms of action of oral hydrolytic enzymes as fibrinolytic, anti-edematous, anti-inflammatory and analgesic(19;20;23;24;26). They are also thought to stimulate the elimination of submetabolites, debris and toxins via the activation of the mononuclear phagocyte system(17). Additionally, they are believed to have a selective anticancer cell activity (selective oncocytolysis) causing cancer cells to lose their nuclei, substantially disintegrate and finally progress to complete cell destruction or cytolysis(23). Studies have also reported that proteolytic enzymes activated macrophages and natural killer cells by breaking down immune complexes which block these cells(16-18;23).

Some of the documented mechanisms for the anti-inflammatory actions of protease to treat tendinitis and other sport injuries include(8):

1. Destroy or inactivate cell surface enzymes involved in the formation of eicosanoids;
2. Destroy or inactivate bradykinins (reduction of pain, prevention of progression of inflammation);
3. Reduction in viscosity of extracellular fluid (increased nutrient and waste transport to and from injured site; reduces edema);
4. Activation of endogenous proteases (plasmin);
5. Induction of antiproteases (antiproteases mediate inflammation, inhibit progression of inflammation in tendinitis and soft tissue injuries; reduction of acute phase reactants);
6. Substitute for endogenous proteases (activation of endogenous systems for resolution of inflammation; formation of regulatory peptides);
7. Molecular debridement (removal of necrotic tissue, proteins; aids phagocyte functions; reduces edema).
   

Enzymes and the Circulatory System
With a high level of proteolytic enzymes, debris and toxins in the blood are more easily broken up, which can improve circulation to the heart and vital muscles, tissues and organs in the body. People experiencing circulatory problems are often deficient in proteolytic enzymes, which can lead to the build up of arterial restrictions.

Proteolytic enzymes also assist the body in the fibrinolytic processes(19;21). Plasmin and thrombin are non-specific proteolytic enzymes and are the body’s "most important" enzymes of clotting and lysis. Besides plasmin, other proteolytic enzymes can be used as fibrinolytic and thrombolytic remedies(19;21;29).

Enzymes and Arthritis
Arthritis is directly linked to problems with the circulatory system. Arthritis can result when too many circulating immune complexes (CICs) collect in the body’s tissues, most commonly in joint tissue. This accumulation of antigen-antibody complexes that the body’s detox mechanism should have taken care of, but for some reason has not, can provide the trigger for arthritic inflammation(16;23;29). The direct response to these toxic accumulations is for the immune system to send white blood cells to attack and break up the inflammatory waste products. However, in the process, healthy tissue often is attacked as well, putting the body in a state of autoimmunity and an often chronic and painful state of inflammation.

Proteolytic enzymes can assist the body in reducing CICs, which are responsible for helping the body get rid of antigens that enter into the bloodstream(16;23). Under normal conditions, CICs are formed when harmful antigens are bound to antibodies, which will then circulate in the bloodstream until the body can get rid of them through the action of lysomal enzymes. When this process is impaired due to enzyme deficiency and low immunity, proteolytic enzymes will help restore the balance and efficiency of the immune system as a whole. Supplemental proteolytic enzymes can go to the source of the arthritis and break up the waste accumulations that cause painful arthritic conditions(16;23). This is much more effective and health-promoting than the temporary relief from arthritis pain offered by most prescription and over-the-counter medication.

Protease in Inflammation, Tendinitis and Sports Injuries
Since proteases were shown to exert anti-inflammatory activities, oral administration of proteases in tendinitis and sports injuries has been studied in over 20 reports(1;4-14;22;25). Many of these studies were done in the 1960s. Since that time very little published research has occurred in this area, but three reports from Germany were published in 1990 (1;22;25) that demonstrated the effectiveness of oral protease supplementation in tendinitis and sports injuries. In these studies standard care was also given. Thus, protease results were seen in addition to regular care of injured athletes.

Proteolytic enzyme formulas have demonstrated the ability to remove toxic waste and excess free radicals in the tendinitis areas that inhibit recovery from injury(9;21;23;26;29). As a result, proteolytic enzymes build up immune system efficiency to help the body heal faster. And because proteolytic enzymes go to the source of the problem, it doesn’t have the limited, temporary "Band-Aid" effect of most other healing aids commonly used to deal with the pain associated with injury.

The Role of Protease in the Immune System and Viral Infections
Proteolytic enzymes are the mediators of the body’s defense and homeostatic mechanisms, but the importance of protease in the immune system is often neglected. Enzymes play several roles in supporting our body defenses and immune system, including an important immune activation system - the complement system. In fact, 22 of the 27 known subproteins in the immune complement system are enzymes(23). Additionally, studies in vitro and in vivo have shown that protease can directly alter lymphocyte responses in a dose-dependent manner(15;27;28). Both lymphocytes and macrophages expose cell surface protease in response to antigen and during antibody production. Supplemental protease can enhance lymphocyte response and assist in immune system functions(15;16;27-29).

Supplemental Protease can raise the proteolytic potential in the blood, which can then be applied as an efficient therapy or prophylactic for viral infection through lysis or inactivation of the viral protein coat. Viruses in their extracellular phase do not have any protection against lysis and therefore may be dissolved or at least inactivated by proteases. Successful inhibition of infection has been accomplished in many different viruses including six different influenza type A viruses, polio and other entero-viruses, varicell viruses, vaccinia viruses, and others(29).

Summary
Enzymes are required for our blood and coagulation system, cardiovascular functions, kidneys, liver, elimination of toxic production, excretion and more. Supplemental enzymes can play a key role in assisting the body in normal function and potentially restoring function of the body’s systems in disease, stress and/or tendinitis and sports injury.

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Reference List
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2. Bergkvist, R. The proteolytic enzymes of Aspergillus oryzae II: properties of the proteolytic enzymes. Acta chemie Scandanavia 17: 1541-1551, 1963.
3. Bergkvist, R. and P. O. Svard. Studies on the thrombolytic effect of a protease from Aspergillus oryzae. Acta Physiologie Scandanavia 60: 363-371, 1964.
4. Blonstein, J. L. The use of 'buccal Varidase' in boxing injuries. Practitioner 185: 78, 1960.
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26. Scheef, W. and M. Pischnamazadeh. Proteolytic enzymes as a simple and safe method for the prevention of lymphedema after mastectomy. Medical World (Med.Welt.) 35: 1032-1033, 1984.
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28. Vischer, T. L. In vitro stimulation of lymphocytes by neutral proteinases from human polymorphonuclear leukocyte granules. Journal of Experimental Medicine 144: 863-872, 1976.
29. Wolf, M. and K. Ransberger. Enzyme Therapy. New York, Vantage Press. 1972, 119-134.

© 2001 Infinity2, Inc. adapted from Form #1913 Rev. 04/03/01