- Therapeutic Applications of Enzymes and Isoenzymes refer to the use of naturally occurring or engineered enzymes and their isoforms (isoenzymes) in the diagnosis, treatment, and management of diseases.
- These Therapeutic Applications include enzyme replacement therapies, clot dissolution, anti-inflammatory treatments, cancer therapy, and diagnostic biomarker
Enzyme Replacement Therapy (ERT):
- Purpose: To compensate for deficient or malfunctioning enzymes in patients with inherited metabolic disorders.
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Examples:
- Gaucher Disease: Caused by a deficiency of glucocerebrosidase. ERT with recombinant glucocerebrosidase (imiglucerase) reduces the accumulation of glucocerebroside in tissues.
- Fabry Disease: Deficiency of α-galactosidase A leads to lipid accumulation. Administration of recombinant α-galactosidase A alleviates symptoms.
- Pompe Disease: Lack of acid α-glucosidase causes glycogen buildup. ERT with alglucosidase alfa helps reduce glycogen storage in muscles.
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Thrombolytic Therapy:
- Purpose: To dissolve blood clots in conditions like myocardial infarction, pulmonary embolism, and ischemic stroke.
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Enzymes Used:
- Streptokinase: Activates plasminogen to plasmin, which breaks down fibrin clots.
- Urokinase: Directly converts plasminogen to plasmin.
- Tissue Plasminogen Activator (tPA): Recombinant enzyme that specifically targets fibrin-bound plasminogen, minimizing systemic effects.
Cancer Therapy:
- Asparaginase: Used in treating acute lymphoblastic leukemia (ALL). It depletes asparagine, an amino acid essential for the survival of certain leukemia cells, leading to cell death.
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Digestive Aids:
- Pancreatic Enzymes: Such as pancrelipase, a mixture of lipase, amylase, and protease, used in patients with pancreatic insufficiency to aid digestion.
- Lactase Supplements: Help individuals with lactose intolerance digest lactose in dairy products.
Anti-Inflammatory Agents:
- Serratiopeptidase and Bromelain: Enzymes used to reduce inflammation and edema in various conditions.
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Wound Debridement:
- Collagenase and Papain: Enzymes applied topically to remove dead tissue and promote healing in chronic wounds and burns.
Treatment of Gout:
- Uricase (Rasburicase): Converts uric acid to allantoin, which is more soluble and easily excreted, reducing uric acid levels in patients with gout or tumor lysis syndrome.
Enzyme Therapy for Genetic Disorders:
- Adenosine Deaminase (ADA) Deficiency: Treated with PEGylated ADA (pegademase bovine) to restore immune function in patients with severe combined immunodeficiency (SCID).
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