alpha-chymotrypsin and Herpes-Zoster

Herpes Zoster requires an effective, inexpensive form of treatment not only because it impairs quality of life, but also on account of its relatively high incidence and the resulting costs incurred. Given the present situation in the health care sector, the high costs of treatment with the standard drug, acyclovir, often mean that herpes zoster patients do not receive medicinal therapy.. The aim of the present study was to establish whether the positive results of a prior investigation involving treatment with an enzyme combination preparation could be confirmed.. Over a period of 14 days, two groups of 96 patients each were given acyclovir or an enzyme combination preparation. During the course of the study, the intensity (score) of segmental pain and various skin lesions were investigated.. In terms of the first end point, "segmental pain", the test groups showed no significant difference either on day 7 or on day 14. Although the second end point "segmental reddening" did reveal a significant difference (p = 0.015) in favor of the acyclovir group on day 14, no significant difference was found for any of the other examination endpoints. Nor did any of the other skin lesions evaluated differ significantly by the end of the study.. Overall, the enzyme combination preparation showed identical efficacy with acyclovir. The results of the prior study were thus confirmed. Further investigations on the immunomodulatory potency, dosage and effects on postherpetic herpes neuralgia are, however, still required.

Topics: Acyclovir; Adolescent; Adult; Aged; Aged, 80 and over; Chymotrypsin; Complementary Therapies; Double-Blind Method; Drug Combinations; Female; Herpes Zoster; Humans; Male; Middle Aged; Neuralgia; Pain Measurement; Pancreatic Extracts; Papain; Thymus Extracts; Trypsin

Therapy with oral proteolytic enzymes (OET) with combination drug products containing papain, bromelain, trypsin, and chymotrypsin has been shown to be beneficial in clinical settings such as radiotherapy-induced fibrosis, bleomycin pneumotoxicity and immunosuppression in cancer, all of which are nowadays known to be accompanied by excessive transforming growth factor-beta (TGF-beta) production. It has been demonstrated that proteolytic enzymes reduce TGF-beta levels in serum by converting the protease inhibitor alpha2 macroglobulin (alpha2M) from the "slow" form into the "fast" form, whereby the "fast" form binds and inactivates TGF-beta irreversibly. In this study we have investigated the effect of OET on the concentration of TGF-beta1 in serum of patients with rheumatoid arthritis (RA) (n = 38), osteomyelofibrosis (OMF) (n = 7) and herpes zoster (HZ) (n = 7). Seventy-eight healthy volunteers served as controls. TGF-beta1 levels in serum were assessed by enzyme-linked immunosorbent assay (ELISA). We have demonstrated that in healthy volunteers and in patients there exists a correlation between active and latent TGF-beta1 in serum (r=0.8021; P<0.0001). Treatment with OET had no significant effect on TGF-beta1 concentration in healthy volunteers or patients with a normal level of TGF-beta1. In patients with elevated TGF-beta1 concentration (> 50 ng/ml serum), OET reduced TGF-beta1 in RA (P < 0.005), in OMF (P < 0.05) and in HZ (P < 0.05).. These results support the concept that OET is beneficial in diseases characterized in part by TGF-beta1 overproduction.

Topics: Administration, Oral; Adult; alpha-Macroglobulins; Arthritis, Rheumatoid; Bromelains; Chymotrypsin; Drug Combinations; Endopeptidases; Herpes Zoster; Humans; Papain; Primary Myelofibrosis; Rutin; Transforming Growth Factor beta; Transforming Growth Factor beta1; Trypsin