The enzyme serrapeptase (also known as serratiopeptidase) was first isolated from the microorganism Serratia E15, commonly found in the intestines of the silkworm. Scientists found that the enzymes secreted by the bacteria dissolve avital, or ‘non-living’ tissue, without negatively affecting the silkworm’s healthy living cells. This special proteolytic enzyme is used by the silkworm to dissolve its protective cocoon (avital tissue), an essential step before it can emerge and take flight. The serrapeptase enzyme seems to be unique in its ability to selectively dissolve only the ‘non-living’ tissues, such as the silk cocoon, so the moth can safely emerge unharmed.

Following the discovery of this enzyme, researchers have developed a natural process for its production as a supplement and continue to study its clinical effects in humans. Considerable benefits have been found for a range of inflammatory conditions, benefits which are, most importantly, without adverse side effects. However more recently, following the COVID-19 pandemic, serrapeptase has been suggested as a useful adjuvant for the management of COVID-19 due to its wide range of therapeutic effects. Here we delve a little deeper.

Mucolytic actions
In individuals with COVID-19, sputum production, nasal congestion and cough are reported one of the common symptoms after fever. Mucolytics either enhance bronchial mucus secretion or reduce mucus viscosity and further facilitate its removal by coughing. As serrapeptase has caseinolytic and mucolytic actions on the sputum, it may be beneficial. Serrapeptase has shown to enhance mucociliary transportability and mucociliary clearance by decreasing neutrophils and modulating sputum viscoelasticity in patients with airway diseases. Additionally, serrapeptase has shown to relieve cough and promote airway hygiene and so may be useful in delaying pulmonary complications and improving quality of life in COVID-19.

Anti-inflammatory
Elevated levels of inflammatory cytokines play a vital role in the pathogenesis and progression of complications, severity, and mortality in COVID-19. Serrapeptase has been shown to exert anti-inflammatory effects by reducing inflammatory cytokines and adhesion molecules, thus regulating inflammatory cells movement to the site of inflammation. One mechanism is its ability to reduce neutrophil count, which is believed to reduce elastase, a serine protease released from activated neutrophils. Elastase promotes the generation of reactive oxygen species (ROS), alters the permeability of lung barriers and triggers pro-inflammatory cytokines. Thus, elastase inhibition by serrapeptase could be useful in suppressing cytokine storm, causing acute lung injury in COVID-19.

Antithrombotic & Fibrinolytic
Higher fibrinogen and lower antithrombin levels were reported in patients with COVID-19 and associated with the severity of infection, mortality, and prognosis in survivors. Serrapeptase possesses the ability to degrade blood clots, cysts and arterial plaques, therefore being useful under the conditions of increased risk of stroke, atherosclerosis, and thrombophlebitis. This suggests its potential benefits in reducing the severity of vascular complications involving thrombosis or coagulopathy in COVID-19.

The potential of serrapeptase to its promising benefits in COVID-19 can’t be overlooked, however, to date, no studies have demonstrated the experimental or clinical effects of serrapeptase in COVID-19. Nonetheless it joins a long list of natural agents suggested for the management of COVID-19 which should be considered.

Reference
Sharma C, Jha NK, Meeran MNF, et al. Serratiopeptidase, A serine protease anti-inflammatory, fibrinolytic, and mucolytic drug, can be a useful adjuvant for management in COVID-19. Frontiers in Pharmacology, 2021;12. doi: 10.3389/fphar.2021.603997

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