alpha-chymotrypsin and Fatigue

Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic radiotherapy?. Fifty-six patients with an indication for adjuvant pelvic irradiation after curative surgery were double-blind randomized. All patients took 3 x 4 capsules study medication daily during radiotherapy. Twenty-eight patients in the enzyme group (EG) received capsules containing papain, trypsin and chymotrypsin, 28 in the placebo group (PG) received placebo capsules. All patients were irradiated with 5 x 1.8 Gy weekly to 50.4 Gy using four-field-box technique after CT-based planning. Primary objective was the grade of diarrhea, nausea, vomiting, fatigue and epitheliolysis during radiotherapy. Secondary objectives were the number of supportive medications and treatment interruptions due to acute toxicity.. None/mild diarrhea: 43% EG, 64% PG. Moderate/severe diarrhea: 57% EG, 36% PG (P = 0.11). Mean duration: 11 days in EG, 10 days in PG. None/mild nausea: 93% EG, 93% PG. Moderate/severe nausea: 7% EG, 7% PG. None/mild vomiting: 100% EG, 97% PG. None/mild fatigue: 82% EG, 93% PG. Moderate/severe fatigue: 18% EG, 7% PG (P = 0.23). None/mild epitheliolysis: 75% EG, 93% PG. Moderate/severe epitheliolysis: 25% EG, 7% PG (P = 0.16). Treatment interruption (mean days): 2.44 in EG, 1.46 in PG. Number of supportive medication: 29 in EG, 19 in PG.. The prophylactic use of proteolytic enzymes does not reduce acute toxicities, treatment interruptions and number of supportive medication and therefore does not improve tolerance of adjuvant pelvic radiotherapy.

Topics: Chymotrypsin; Combined Modality Therapy; Diarrhea; Double-Blind Method; Drug Combinations; Fatigue; Female; Humans; Male; Middle Aged; Nausea; Pancreatic Extracts; Papain; Pelvic Neoplasms; Peptide Hydrolases; Radiation Injuries; Radiotherapy, Adjuvant; Skin Diseases; Thymus Extracts; Treatment Outcome; Trypsin; Vomiting

In order to improve the antioxidant and anti-fatigue capacities of whey protein for wider utilization, it was hydrolyzed by chymotrypsin (EC 3.4.21.1) to produce whey protein hydrolysate (WPH). Fractions of WPH with different molecular weight (MW) were separated by ultrafiltration. Kunming mice in various treatment groups were orally administered (1.5 g kg(-1) body weight) whey protein isolate (WPI), WPH or WPHs with different MW (<5, 5-10, 10-30 or >30 kDa) for 6 weeks to explore whether different MW fractions of WPH affected mice fatigue.. Compared with the control group (orally administered 9 g kg(-1) saline) or the WPI group, low-MW (<10 kDa) WPH groups showed prolonged swimming time (P < 0.05) and had higher concentrations (P < 0.05) of glucose, non-esterfied fatty acid, liver glycogen, superoxide dismutase and glutathione peroxidase and lower concentration of lactate. Low-MW (<10 kDa) WPHs had higher hydroxyl- and α,α-diphenyl-β-picrylhydrazyl-scavenging abilities and ferrous-chelating capacity than WPI.. The results proved that low-MW (<10 kDa) WPHs with higher anti-fatigue capacity showed higher free radical-scavenging and ferrous-chelating activities.

Topics: Animals; Antioxidants; Blood Glucose; Chymotrypsin; Fatigue; Fatty Acids, Nonesterified; Ferrous Compounds; Free Radical Scavengers; Glycogen; Hydrolysis; Iron Chelating Agents; Lactic Acid; Liver; Male; Mice; Milk Proteins; Molecular Weight; Muscle, Skeletal; Physical Exertion; Protein Hydrolysates; Swimming; Whey Proteins