Efect of Anaheal (Bromelain) Drug on the Periodontal Clinical Indices in Nonsurgical Periodontal Treatment of Patients with Chronic Periodontitis

Objective: To evaluate the effect of Anaheal (Bromelain) drug on the periodontal clinical indices in nonsurgical periodontal treatment of patients with chronic periodontitis. Material and Methods: In this double blind clinical trial, 80 patients with chronic moderate periodontitis and a healthy systemic status were chosen, and divided into two 40-subject groups. Thereafter, the standard treatment of periodontitis including scaling and root planning in one session by the unit operator was performed for all patients. Eventually, one group of the patients was administered Bromelain medication (500-mg capsule twice a day) one hour before food, while the other group was given placebo. Four and eight weeks after the treatment, the clinical periodontal indicators were measured and recorded in both groups. The data were assessed using descriptive statistics and analytical test methods (Mann-U-Whitney and Chi-square). P value less than 0.05 was considered statistically significant. Results: Gingival index, probing depth and plaque index before the treatment were similar in both groups (Anaheal and placebo). However, four and eight weeks after the treatment, the three studied indices were significantly lower in the Anaheal group as compared to the placebo (p<0.05). The index of bleeding on probing was also similar before the treatment and four weeks after the treatment in both groups. However, eight weeks after the treatment, this index was significantly lower in the Anaheal group as compared to the placebo group (p<0.05). Conclusion: Administration of oral Anaheal medication after nonsurgical periodontal treatments reduced all the clinical periodontal indices among patients with chronic periodontitis as compared to the control group. Therefore, it can be a suitable substitute for the common oral industrial antibiotics.

Caracterización cinética de un preparado semipurificado de bromelina para uso antitumoral / Kinetic characterization of a semipurified preparation from bromelain for antitumor use

INTRODUCCIÓN: la mayor parte de la producción mundial de enzimas está destinada a la obtención de proteasas. Las aplicaciones de estas biomoléculas con fines terapéuticos son muy variadas. Algunas se conocen como remedios naturales y otras son fármacos modificadores de la respuesta biológica. Las plantas de piña contienen varias cisteíno-proteasas, el componente mayoritario aislado del tallo es la bromelina de tallo (EC 3.4.22.32). En el campo de la salud se le atribuyen varias acciones entre las que se destaca la de inducir la diferenciación de células tumorales y atenuar el crecimiento del tumor. OBJETIVOS: caracterizar cinéticamente un preparado semipurificado de bromelina obtenida por un procedimiento desarrollado en Cuba para ser evaluado en el campo de la salud. MÉTODOS: el extracto crudo de bromelina, obtenido a partir de tallos de plantas adultas de Ananas comosus (L.) Merr cv Española roja (piña) se purificó por cromatografía de intercambio iónico en carboximetilcelulosa-52 en un sistema semibach. RESULTADOS: la caracterización cinética del extracto purificado permitió comprobar la existencia de un preparado activo y estable con una actividad específica de 0,94 U/mg de proteínas (2,34 veces superior a la del extracto crudo original), con una fracción proteica mayoritaria de masa molar 24 500 Da y un punto isoeléctrico, localizado en la zona de pH básico (9,55). Tiene pH óptimo 6,8 al utilizar hemoglobina 2 por ciento como sustrato a 37 ºC y una estabilidad en función del pH y de la temperatura aceptable. Si se conserva liofilizado a - 20 ºC mantiene 80 por ciento de la actividad durante 1 año. CONCLUSIONES: la cromatografía de intercambio iónico en carboximetilcelulosa-52 posibilitó la obtención de un preparado semipurificado de bromelina, con una actividad específica superior a la del extracto original que puede ser utilizado en la medicina como antitumoral

INTRODUCTION: most of the world production of enzymes is devoted to proteases obtaining. Applications of these biomolecules for therapeutical objectives are very varied. Some are known as natural remedies and other are drugs modifying the biological response. Pineapple plants contain some cysteine-proteases, the majority component isolated from stem is the stem Bromelain (EC 3.4.22.32). In the health field it has attributed some actions including the differentiation induction of tumor cells and attenuation of tumor growth. OBJECTIVES: to characterize kinetically a semipurified preparation from Bromelain obtained by a procedure developed in Cuba to be assessed in the health field. METHODS: the crude extract from Bromelain obtained from the adult plant stems of Ananas comosus (L.) Merr Cv Spanish red (pineapple) was purified by ion-exchange chromatography in carboxylmethylcelulose-52 in semibatch system. RESULTS: kinetic characterization of purified extract allowed us to verify the existence of a stable and active preparation with a specific activity of 0,94 U/mg of proteins (2,34 times superior to that of original crude extract) with a protein fraction in the main of molar mass 24 500 Da and a isoelectric point, located in the basic pH zone (9,55). It has a 6,8optimal pH using the 2 percent hemoglobin as substrate at 37ºC and stability depending on pH and on acceptable temperature. If it is preserved lyophilized at 20 ºC it maintains the 80 percent of activity for a year. CONCLUSIONS: the ion-exchange chromatography in carboxyl methylcellulose-52 allowed the achievement of semipurified preparation from Bromelain with a specific activity higher to that of original extract that may to be used in medicine as antitumor agent

Efficacy and safety of phlogenzym--a protease formulation, in sepsis in children.

BACKGROUND: Infections are a major cause of hospitalisation wherein the host mounts an inflammatory response against the infecting agent. Administration of proteolytic enzymes could regulate the host's immune system and help early recovery from sepsis. OBJECTIVE: To test the efficacy and safety of an oral enzyme formulation, Phlogenzym (Mucos Pharma GmbH, Geretsried, Germany; constituents of each enteric-coated tablet were bromelain 90 mg, trypsin 48 mg, rutin 100 mg) as adjuvant therapy in treatment of sepsis in children. SUBJECTS AND METHODS: Double-blind, randomised, controlled phase III study at a tertiary care centre wherein 60 eligible children aged one month to 12 years with sepsis were randomised to receive either phlogenzym (n=30; 17 boys) or placebo (n=30; 22 boys) tablets (1 tablet/10 kg body weight up to maximum six tablets a day in two or three divided doses for 14-21 days) along with appropriate antibiotics and supportive treatment. RESULTS: Median time taken for fever to subside was three days (range 1-12; 95% CI--1.14 to 7.14) in the phlogenzym group vs four days (range 1-18; 95% CI--3.52 to 11.52) in the placebo group (p < 0.05); haemodynamic support was needed for two days (range 1-3; 95% CI--0.84 to 3.16) in the phlogenzym group but three days (range 1-8; 95% CI--0.76 to 5.24) in the placebo group (p < 0.05). The modified Glasgow coma scale score normalized in three days (range 1-14; 95% CI--4.62 to 9.62) in the phlogenzym group vs 5.5 days (range 1-18; 95% CI--2.52 to 13.52) in the placebo group (p > 0.05). Oral feeds could be started in four days (range 1-15; 95% CI--1.74 to 9.74) in the phlogenzym group vs five days (range 1-11; 95% CI--1.26 to 11.26) in the placebo group (p > 0.05). Two patients died in the placebo group. CONCLUSION: Phlogenzym is effective as an adjuvant with antibiotics and supportive treatment for early improvement of pediatric patients with sepsis.

Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthrosis of knee joint: an open randomized controlled clinical trial.

OBJECTIVE: To compare the efficacy and tolerability of an oral enzyme preparation (Phlogenzym) with that of an NSAID (diclofenac) in the treatment of active osteoarthrosis. METHODS: Prospective, randomized, controlled, single-blind study of seven weeks duration at a tertiary care centre wherein 50 patients aged 40-75 years, with activated osteoarthrosis of knee joint were randomized to receive phlogenzym tablets (2-3 tablets, bid) or diclofenac sodium 50 mg bid for three weeks. RESULTS: At the end of therapy (three weeks) and at follow-up visit at seven weeks there was reduction in pain and joint tenderness and swelling in both groups, and slight improvement in the range of movement in the study group. The reduction in joint tenderness was greater (p < 0.05) in the study group receiving phlogenzym. CONCLUSION: Phlogenzym is as efficacious and well tolerated as diclofenac sodium in the management of active osteoarthrosis over three weeks of treatment.

Análisis fisiológico de la acción fibrinolítica de bromelinas sobre una trombosis experimental / Physiological analysis of fibrinolytic action of bromelain on an experimental thrombosis

Se evaluó la acción fibrinolítica de las bromelinas (BRO) sobre una trombosis experimental inducida por destrucción del endotelio vascular en una porción de la arteria femoral de perros (n=10). Se hicieron registros de: resistencia galvánica de la piel (RGP), temperatura subcutánea proximal (TP) y distal (TD) y flujo sanguíneo distal al sitio de lesión, frecuencia cardíaca y de ventilación y presión arterial (PA). Solo a 5 de los sujetos se les administró una dosis BRO (10mg/kg, vía I.V.) 48 horas después de inducir la trombosis. Al final, se realizó el análisis histológico del ramo arterial lesionado, el cual comprendió: extensión y penetración de la inflamación, infiltración hemorrágica y grado de trombosis. El análisis computarizado de los registros poligráficos mostró gran variabilidad entre los sujetos desde los períodos controles. Sin embargo, el análisis individual mostró una acción del tratamiento, especialmente en las variables RGP, flujo sanguíneo, TP, TD, y PA en la mayoría de los animales. En todos los sujetos se observó necrosis del endotelio, ruptura focal de la lámina elástica interna y diverso grado de trombosis. Los resultados apoyan una acción fibrinolítica de las BRO sugiriendo otros estudios con dosis mayores o repetidas que justifiquen su utilización en el tratamiento de enfermedades tromboembólicas