Enzyme preparations are widely used in medicine as diagnostic (enzyme diagnostics) and therapeutic (enzyme therapy) agents. Enzymes are also used as specific reagents that determine a number of substances. For example, using glucooxidase, the quantitative composition of glucose in the blood and urine is determined. The urease enzyme is used to detect urea. Through various kinds of dehydrogenases, the corresponding substrates are found, such as ethyl alcohol, pyruvate, etc.
Consider the use of enzymes in more detail.
Diagnostic enzymes
The essence of enzyme diagnostics is to establish a diagnosis of a disease or syndrome by detecting the activity of enzymes in biological fluids of the body.
Enzymodiagnostics is based on the following principles:
- if the cells in the blood or other biological fluids are damaged, the concentration of intracellular enzymes in the damaged cells increases;
- the amount of enzyme that is released is sufficient to detect;
- when cell damage is detected, the activity of enzymes in the composition of biological fluids is stable over time and varies with normal values;
- some enzymes are predominantly or absolutely localized in various organs, that is, organ specificity is inherent in them;
- there are differences in the localization of a number of enzymes within the cells.
The use of enzymes is now more common.
The reasons for the increase in the content of enzymes in the blood
Enzymes contained in blood plasma are divided into two groups:
- it is actively secreted by certain organs into the plasma (a rather small group);
- enzymes that are released from cells during their normal functioning (a large group of enzymes that function directly in the cell and do not matter in plasma from the point of view of physiology; in a healthy person, their activity is low and permanent, since the ratio of the rates of release from cells and destruction constant).
So what is the essence of using enzymes?
During the course of most diseases, the cells are damaged, and everything contained in them, including enzymes, is released directly into the blood. This is due to a defect in the permeability of the cell membrane during inflammatory processes or the damaged integrity of the cells themselves with necrosis. In biochemical laboratories, the activity of many enzymes in the blood is very accurately determined, and this helps a lot in the diagnosis of diseases of skeletal muscles, liver, heart and other tissues. There is a correlation of the level of enzyme activity in the plasma and the degree of cellular damage.
Importance for Enzymodiagnostics
Awareness of the subcellular localization of enzymes is also of great importance for enzyme diagnostics. For example, if enzymes appear in the plasma that have exclusively cytosolic localization, then we can talk about the inflammatory process; if nuclear or mitochondrial enzymes are found, then this already indicates deeper cell damage, for example, necrosis.
But it is worth considering that the concentration of enzymes (the application will be discussed below) does not always increase due to tissue damage.
If cell proliferation is excessive (for example, with an increased speed of a number of enzymes in the cells, during oncoproliferative processes, or with clearance that has impairment), an increase in the concentration of any enzymes is detected in the blood. Therefore, doctors should always remember that the norm of the values of enzyme activity in the blood of pregnant women and children are different from those that are observed in healthy adults.
The use of enzymes and coenzymes in pharmacy
Due to the high immunogenicity, enzymes as therapeutic agents are used to a limited extent. Despite this, enzyme therapy is quite actively progressing in such areas as:
- part of complex therapy, when enzymes are used along with other therapy;
- replacement therapy, in which enzymes are used if they are not enough.
Enzyme replacement therapy has a high effect in the presence of gastrointestinal diseases, which are caused by insufficient secretion of digestive juices. So, pepsin is used for hypoacid and anacid gastritis, achilia. The lack of pancreatic enzymes can be compensated for by taking medications that include the main enzymes contained in the pancreas (Mezim-Fort, Enzistal, Festal and others). What is the use of enzymes in medicine based on?
In medicine
As an additional means of therapy, enzymes are used in the presence of certain diseases. For example, proteolytic (chymotrypsin, trypsin) are used in the treatment of purulent wounds by local exposure in order to break down dead cell proteins and remove viscous secrets or blood clots in various inflammation of the respiratory tract. In addition, enzyme-based drugs have become quite common in thromboembolism and thrombosis. For this, streptodecases, streptoliasis, urokinase, as well as fibrinolysin preparations are used. This confirms the instructions for use for enzymes.
Hyaluronidase (or lidase), which catalyzes the process of cleavage of hyaluronic acid, is used both intramuscularly and subcutaneously to help the scars resolve after surgery or burns, since hyaluronic acid cross-links the connective tissue.
Also, enzyme-based drugs are actively used in cancer diseases. For example, asparaginase, which catalyzes the catabolism of an amino acid such as asparagine, is used to treat leukemia.
The antileukemic effect of asparaginase was preceded by the detection of a defective asparagine synthetase enzyme in leukemia cells, which catalyzes the reaction of the asparagine synthesis process. Leukemia cells cannot participate in it, receiving asparagine from blood plasma. If the asparagine contained in it is destroyed by the introduction of asparaginase, then in leukemic cells a deficiency of asparagine is formed, as a result of which cellular metabolism is disrupted and the progression of the disease stops.
Immobilized enzymes include those that are located in a polymer capsule or are bound to a solid carrier.
Often for greater effectiveness, the use of poly-enzymes and De-Nola at the same time is prescribed.
Basic approaches to enzyme immobilization
In order to immobilize enzymes, two main methods are used:
- their chemical modification;
- physical isolation in an inert material.
Another way is the use of capsules of lipids, that is, liposomes that freely pass through the membrane and produce the desired effects in the cell.
The positive properties of immobilized enzymes are as follows:
- easy separation from the reaction medium, as a result of which the enzyme can be reused (the product is not contaminated with it);
- there is the possibility of continuous implementation of the enzymatic process;
- enzyme stability increases.
Other goals
In addition, these enzymes can be used for the following purposes:
- Preparative - milk processing, production of syrups using glucose isomerase, in which a high content of fructose is observed, production of L-amino acids by aminoacylase).
- Analytical. There are a number of devices - automatic analyzers, enzyme electrodes, test systems, etc.).
So, the enzyme Super Maya is popular. Instructions for use indicate that it is used for making cheese and feta cheese at home.
It is based on water, salt 15%, microbial protease (M.miehei 1%).
Dietary supplement Food Enzymes from NSP with digestive enzymes (instructions for use is attached) - the optimal combination of highly active enzymes of animal and vegetable origin, is a source of hydrochloric acid in the form of betaine hydrochloride, promotes the absorption and breakdown of all food substances.