alpha-chymotrypsin and Vomiting

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

Reported is a simple and reliable method for identifying the presence of gastric fluid in forensic samples by an assay that reveals the pepsin activity. These samples are usually vomit found at the scene of a crime, either in fresh form or as a dried stain on clothing. The pepsin within the sample is assayed for its proteolytic activity which is revealed in a fibrin blue-agarose gel plate, as a result of an enzymatic reactivity that takes the form of a concentric, blue, translucent ring around the tested sample. Apart from being able to determine the pepsin content of fresh or recent forensic samples, this method has also achieved positive reactions in aged gastric fluid stains that were kept at room temperature. No body fluids other than the gastric fluid and no proteolytic enzymes other than pepsin show a positive reaction with the use of this method. This method has an additional advantage, in that the enzymatic activity seen on the gel plate can be photographed and the gel plate, on drying, can also be preserved as evidence.

Topics: Animals; Chymotrypsin; Gastric Juice; Gastrointestinal Contents; Humans; Immunodiffusion; Milk, Human; Nasal Mucosa; Papain; Pepsin A; Saliva; Semen; Swine; Trypsin; Vomiting