Chymopapain, effect

The use of enzymes, such as papain, to cleave beadxell rosettes has also been investigated chymopapain, used at 200 U/mL of cells (107/mL m TC199 tissue-culture medium) for 10 mm at 37°C, has been found to be most effective and least toxic to KGla human leukemia cells, giving 100% recovery of viable cells (45)... 

One important problem in determining efficacy of treatment seems to be the choice of the type of control. While in most cases the same volume of saline is injected into the intervertebral disk as a control 96], little or no rf ia are available that compare the effect of chymopapain treatment with the natural history of the disease [97]. This problem was discussed in an editorial in the Lancet in 1986 [98]. However, a number of studies have been published that compare chemonucleolysis with traditional surgical disc removal [99-1021. These studies indicate that surgical disc removal has an equal or slightly better overall success rate than chemonucleolysis. It has been argued that if chymopapain treatment fails, subsequent surgery may be less successful, especially if the operation Is delayed [103], but recent results indicate that this is not the case [104],... 

Several reports have been published comparing the effects of chymopapain with other agents thought to be possible alternatives for chemonucleolysis. In 1987 and 1992. Hedtmann lenorted the results or nrosoective. comparative... 

The water-insoluble fraction was more readily digested than the water-soluble fraction. Heat denaturation naturally made meat proteins more readily digested by these enzymes, and the effect of denaturation was more significant in the water-soluble fraction than the other fraction. As expected, hydrolysis of the native connective tissue by these enzymes as indicated by increased hydroxyproline was extremely low. Connective tissue after heat denaturation was readily hydrolyzed. Papaya peptidase A showed about a fivefold increase while papain and chymopapain increased their hydrolyses seven- to tenfold. 

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