60
2.5.2 Fibrinolysin/DNase
Fibrinolysin/DNase contains fibrinolysin from bovine plasma and DNase from
bovine pancreas. Fibrinolysin aids in debridement by dissolution of fibrin. It also
inhibits clotting and dilates blood vessels. Fibrinolysin when dissolved in aqueous
solution loses it activity within 6–8 h. Deoxyribonuclease (DNase) helps to break
down nucleic acid materials and nucleoproteins present in exudates and necrotic
tissue (Falabella 2006). It is commercially available as Elase
®
.
2.5.3 Papain-Based Debridement
Papaya juice has been used for wound debridement since ancient times. Papain, a
cysteine protease enzyme isolated from Carica papaya, breaks the fibrinous material in necrotic tissue and thus promotes the wound healing process. It is a nonselective enzyme. Papain is used in combination with urea. Papain requires
activators and urea helps to expose the enzyme to activators. Another advantage of
urea is that it denatures proteins in necrotic tissue and hence makes them easily
digestible by papain. Papain/urea-based formulation was found to be effective in
wound debridement. Papain produces inflammatory response and thus induces pain.
In order to relieve pain chlorophyllin copper complex (CCC) along with papain/
urea is used in commercial formulations (Shapira et al. 1973). It has been found to
be useful in the treatment of pressure ulcers. Panafil
®
is a commercially available
papain/urea formulation and is active at a wide range of pH from 3 to 12.
2.5.4 Trypsin
Trypsin is an endopeptidase secreted by pancreas and apart from digestion of proteins in food trypsin finds various other applications. Topical application of trypsin
is often implemented for wound healing. Trypsin is a mild debriding agent and
speeds the healing of dermal wounds (White et al. 2013). Wounding is often associated with clotting, leaving serum on the wound. Trypsin cleaves serum albumin,
which in turn initiates fibrocyte differentiation and thereby facilitates wound healing. Xenaderm
®
and Granulex
®
are two products containing trypsin available for
topical application.
2.6
Enzymes to Treat Lysosomal Storage Diseases (LSD)
Lysosomal storage diseases (LSD) are a group of disorders comprising over 50
diseases. Lysosomes are the site of intracellular digestion in eukaryotic cells and
can digest almost all kinds of macromolecules such as glycogen, nucleic acids,
proteins, glycosphingolipids, mucopolysaccharides, etc. which are engulfed within
lysosomes. Lack of enzyme hydrolysis of various macromolecules within
S.S. Kumar and S. Abdulhameed
2.5.2 Fibrinolysin/DNase
Fibrinolysin/DNase contains fibrinolysin from bovine plasma and DNase from
bovine pancreas. Fibrinolysin aids in debridement by dissolution of fibrin. It also
inhibits clotting and dilates blood vessels. Fibrinolysin when dissolved in aqueous
solution loses it activity within 6–8 h. Deoxyribonuclease (DNase) helps to break
down nucleic acid materials and nucleoproteins present in exudates and necrotic
tissue (Falabella 2006). It is commercially available as Elase
®
.
2.5.3 Papain-Based Debridement
Papaya juice has been used for wound debridement since ancient times. Papain, a
cysteine protease enzyme isolated from Carica papaya, breaks the fibrinous material in necrotic tissue and thus promotes the wound healing process. It is a nonselective enzyme. Papain is used in combination with urea. Papain requires
activators and urea helps to expose the enzyme to activators. Another advantage of
urea is that it denatures proteins in necrotic tissue and hence makes them easily
digestible by papain. Papain/urea-based formulation was found to be effective in
wound debridement. Papain produces inflammatory response and thus induces pain.
In order to relieve pain chlorophyllin copper complex (CCC) along with papain/
urea is used in commercial formulations (Shapira et al. 1973). It has been found to
be useful in the treatment of pressure ulcers. Panafil
®
is a commercially available
papain/urea formulation and is active at a wide range of pH from 3 to 12.
2.5.4 Trypsin
Trypsin is an endopeptidase secreted by pancreas and apart from digestion of proteins in food trypsin finds various other applications. Topical application of trypsin
is often implemented for wound healing. Trypsin is a mild debriding agent and
speeds the healing of dermal wounds (White et al. 2013). Wounding is often associated with clotting, leaving serum on the wound. Trypsin cleaves serum albumin,
which in turn initiates fibrocyte differentiation and thereby facilitates wound healing. Xenaderm
®
and Granulex
®
are two products containing trypsin available for
topical application.
2.6
Enzymes to Treat Lysosomal Storage Diseases (LSD)
Lysosomal storage diseases (LSD) are a group of disorders comprising over 50
diseases. Lysosomes are the site of intracellular digestion in eukaryotic cells and
can digest almost all kinds of macromolecules such as glycogen, nucleic acids,
proteins, glycosphingolipids, mucopolysaccharides, etc. which are engulfed within
lysosomes. Lack of enzyme hydrolysis of various macromolecules within
S.S. Kumar and S. Abdulhameed