Patients with autoimmune diseases often are effected with numerous little inflammations through the whole body. It was presumed that direct catalytic effects of the active center of the enzyme after its resorption from the intestinal tract into the bloodstream led to the therapeutic effects. These effects had already been described from bromelain in traumatology where edemas heal more rapidly in acute inflammations. This is attributable to proteases activation the MPS (monomuclear phagocytic system), a division of cell fragments and proteins, such as, for example albumins. However, this mechanism alone did not supply an explanation for other positive therapeutic effects registered in the treatment of chronic inflammatory diseases, autoimmune diseases and in cancer. In the mid 1990s, research was thus not only focused on the enzyme molecules but also on their transport molecules a (als alpha)-1 antitrypsin and a (alpha)-2-macroglobulin, which bond directly to proteases after successful resorption. The bonding changes the structure of all transport molecules, in particular that of the a (alpha)-2-macroglobulin, which alters from the rather "slow form" to the active "fast form".
As of this point in time there is a vehement change in the attachment behavior of the cytokine which is released way in excess of the physiological dimension.
When present in the "slow form" in the body, a transport molecule can reversibly attach two cytokines. On the other hand in the active "fast form", is is capable of irreversibly attaching up to five cytokines and elimination them from the bloodstream in the long term.
With these scientific findings, it was possible to explain many of the empirically observed effects of proteolytic enzymes based on a modulation of the cytokine concentration.
Books: Baumhackl U., Fordermair S.: Enzyme therapy in multiple scleroses. A preliminary report on a multicenter study. Allgemeinmedizin 19 1990
Carillo W. et al. Anti-inflammatory and Anti-Inceptive Activities of Native and Modified Hen Egg White Lysozyme. J Med Food 28 2016
Errast ME et al: Evaluation of Anti-Inflammatory Activity of Pseudomonas macrodontes (Morr.) Harms (Bromeliaceae) Fruit Extract in Rats . Z Naturforsch 68 2012
Uffelmann K., Vogler W., Fruth Ch.: Der Einsatz hydrolytischer Enzyme beim extraartikulären Rheumatismus. Allgemeinmedizin 19 1990