Enzymes are biological catalysts that speed up chemical reactions in the body. Several therapeutic enzymes are used clinically. Streptokinase, produced by bacteria, treats thromboembolic disorders by activating plasminogen to plasmin. Urokinase, produced in the kidneys, works similarly. Asparaginase is used in leukemia chemotherapy. Recombinant human DNase improves cystic fibrosis by breaking down DNA in thick mucus. Digestive enzymes including pancreatin, amylase, protease, and lipase are formulated to survive stomach acid and aid digestion for deficiencies.

1. Therapeutic enzymes

2. Enzymes
 Enzymes are proteins that serve as biological
catalysts.
 Most enzymatic reactions, under optimal
conditions, proceeds 108 to 1011 times more
rapidly than the corresponding non-enzymatic
reaction.
 Since most chemical reactions in the body
require the action of an enzyme, enzymes
often serve as the focal point for the regulation
of body function. 2

3. Streptokinase
 Extracellular bacterial protein produced by
Streptococcus haemolyticus group C.
 a widely employed thrombolytic agent.
 It is administered to treat a variety of
thrombo-embolic disorders, including:
 pulmonary embolism (blockage of the pulmonary
artery)
 deep-vein thrombosis ( usually in the legs)
 arterial occlusions
 acute myocardial infarction.
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4. Streptokinase
 Induces its thrombolytic effect by binding
specifically and tightly to plasminogen.
 the streptokinase–plasminogen complex
catalyses the proteolytic conversion of
plasminogen to active plasmin.
 Limitations:
 Elicits immunity
 causes mild or severe allergy
 increased risk of haemorrhage
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5. Streptokinase
 Streptokinase-activated plasminogen is
capable of lysing not only clot-associated
fibrin, but also free plasma fibrinogen.
Can result in low serum fibrinogen levels
and, hence, compromise haemostatic ability.
 It should not be administered to, for example,
patients suffering from coagulation disorders
or bleeding conditions such as ulcers
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6. Urokinase
 Urokinase is an enzyme produced by the
kidney and is found in both the plasma and
urine.
 Capable of proteolytically converting
plasminogen into plasmin.
 Urokinase is used clinically under the same
circumstances as streptokinase.
 Because of its human origin, adverse 6

7. Asparaginase
 An enzyme that catalyzes hydrolysis of L-
asparagine to L-aspartate and ammonia
 It is usually obtained from E.coli or Erwinia
caratovora
 Used in chemotherapy of different forms of
leukimia in combination with other drugs.
 Lack of intracellular L-asparagine results in
decrease in protein synthesis and causes
apoptosis.
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8. Recombinant human DNase
(Pulmozyme®)
 Used in the treatment of cystic fibrosis (CF)
since the end of 1993.
 CF is an inherited, life-threatening disorder
that damages the lungs and digestive tract.
It is caused by a defective gene that
triggers the production of thickened mucus
which clogs airways and blocks the
secretion of digestive enzymes.
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9. Recombinant human DNase
(Pulmozyme®)
 There is no cure for CF but there are
treatments that can improve both the length
and quality of one's life.
 These include airway clearance
techniques, inhaled antibiotics, mucus
thinners, pancreatic enzymes, a high-
calorie diet, and newer generation
medications known as CFTR modulators.
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10. Recombinant human DNase
(Pulmozyme®)
 Recombinant human DNase selectively
cleaves DNA which present at high
concentrations in the secretions of CF
patients following release from leukocytes
that accumulate in response to infection.
 Its reduces the viscoelasticity of the
secretion.
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11. Digestive aids
 Aid digestion, particularly for conditions in
which deficiencies of natural digistive enzyme
exist.
 They contain some or all of the following
catagories of enzymes: amylolytic, proteolytic,
cellulytic, and lipolytic.
 In addition the preparations often include bile
salts.
 The acidic conditions of the stomach may
denature some of these enzymes.
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12. Digestive aids
 The ingested enzymes would be exposed
to endogenous proteolytic activities
associated with the stomach and small
intestine.
 The preparations are formulated as tablets
coated with an acid-resistant polymer to
protect the enzyme as it passes through the
stomach.
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13. Digestive aids
 Pancreatin
 pancreatic extract usually obtained from the
pancrease of slaughterhouse animals
(bovine and porcine).
 It contains a mixture of enzymes,
principally amylase, protease and lipase.
 formulated as enteric-coated granules or
capsules.
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14. Digestive aids
 Individual enzymes papain, pepsin or
bromelains (proteases) or α-amylase are
sometimes used in place of pancreatin.
 Bromelain is a protease enzyme found in
the juice and stem of pineapple. It is similar
to Pepsin.
 Papain is protease enzyme derived from
the latex of papaya.
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15. Digestive aids
 Cellulase
 Is not produced in the human digestive
system
 Its ingestion improve digestion of high-fibre
diets.
 enzyme preparations are obtained from
Aspergillus niger or other fungal sources.
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16. Digestive aids
 α-galactosidase
absent in human digistive system
is used to reduce gassiness or bloating
following ingestion of grains, cereals,
nuts, seeds or vegetables containing
raffinose, verbascose, and stachyose.
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17. Digestive aids
 β-galactosidase (Lactase)
 It is derived from yeast.
 catalyses the hydrolysis of lactose,
releasing the constituent monosaccharides.
 Add to or ingested with milk for patients
suffering from lactose intolerance (lactase
insufficiency).
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