Serrapeptase is an enzyme derived from silkworms that is traditionally used to treat inflammation and pain.
The most recent data, however, does not fully support these claims, as many of the studies performed were poorly structured, with inadequate control groups. Future studies will help shed light on the ability of serrapeptase to treat these and other conditions.
Serrapeptase is also known as serratia peptidase and serratiopeptidase.
Serrapeptase is a proteolytic enzyme (meaning it is used by the body to break down proteins into amino acids) and is sometimes referred to as “silkworm enzyme,” due to it being produced from Serratia bacteria, found in the intestines of the silkworm. It is the enzyme responsible for dissolving a silkworm’s cocoon (1).
Serrapeptase helps reduce inflammation and swelling. A prospective study of the effect of serrapeptase (Aniflazym) on post-operative swelling and pain was carried out in three randomized groups of patients. Sixty-six patients participating in the study were treated surgically for a rupture of the lateral ligament of the knee.
In the group receiving serrapeptase, the swelling decreased by 50 percent on the third post-operative day, while in the other two control groups (elevation of the leg, bed rest, with and without the application of ice) no reduction in swelling had occurred at that time.
Along with a reduction in swelling, participants experienced decreased pain (2).
According to a 2017 issue of BioMed Research International, serratiopeptidase reduces swelling by decreasing the amount of fluid in the tissues, thinning the fluid and facilitating fluid drainage. In addition, its enzyme activity dissolves dead tissue surrounding the injured area so that healing is accelerated (3).
In a group of 174 patients undergoing a surgical procedure known as Caldwell-Luc antrostomy (done when sinusitis is not cured by medication or other non-invasive techniques), researchers evaluated serrapeptase’s effect on post-operative swelling.
Eighty-eight patients received 10 mg serrapeptase 3 times on the day before surgery, once on the night of the surgery and 3 times daily for 5 days after surgery; the other 86 received placebo.
Swelling in the serrapeptase-treated patients was significantly less than that in the placebo-treated patients throughout the observation period. No side effects were reported (4).
Serrapeptase reduces pain. There are several studies illustrating the ability of this enzyme to reduce pain. In one study, the use of serrapeptase was evaluated in 70 patients presenting with breast engorgement — the development of hard, painful, swollen breasts from too much breast milk.
Serrapeptase was noted to be superior to placebo for improvement of breast pain, breast swelling and hardening. “Moderate to marked” improvement was experienced in 85.7 percent of the patients receiving supplementation, while only 60 percent of the patients receiving placebo had similar improvement. “Marked” improvement was found in 22.9 percent of the treatment group versus only 2.9 percent of the placebo group.
No adverse reactions were reported with use (5).
In another study centered on investigating the pain-relieving effect of this enzyme after surgical extraction of molars, results were equally promising. There was a significant reduction in the extent of cheek swelling and pain intensity in the serrapeptase group at the 2nd, 3rd and 7th postoperative days (6).
One carpal tunnel syndrome study noted that 65 percent of patients given 10mg of serratiopeptidase twice a day, after an initial short course of nimesulide, (a fast- acting and potent nonsteroidal anti-inflammatory drug) showed significant clinical improvement (7).
Carpal tunnel syndrome is a condition characterized by pain, numbness and tingling in the hand and arm. It is caused when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist (8).
There was no placebo, however, for comparison; more studies are needed (9).
Serrapeptase reduces mucous. Serrapeptase has been found to reduce bacterial biofilms (reducing bacteria’s ability to stick to surfaces and each other). As a result, it may be able to reduce phlegm buildup, nasal discharge and help other compounds fight bacteria.
Serrapeptase reduces the viscosity (the resistance to flow) of many secretions such as mucus. In patients suffering from chronic airway disease, 30mg of serrapeptase daily for 4 weeks has been noted to decrease mucus secretion. Supplementation is also linked to a significant decrease in the frequency of coughing and expectoration (10).
Researchers are hopeful that supplementation may be of use for both nasal discharge and lung sputum.
Serrapeptase may help treat symptoms of superficial thrombophlebitis. Superficial thrombophlebitis is a painful condition caused by a blood clot in a vein just under the skin (11).
An Italian study was performed to compare the efficacy of serratiopeptidase relative to the drug seaprose S in the treatment of venous inflammatory disease. It was concluded that both treatments effectively reduced pain and symptoms of thrombophlebitis.
Seaprose S, however, outperformed serratiopeptidase: pain was reduced 68.7 percent from the baseline mean score as compared with a 63.3 percent reduction in the serratiopeptidase group; pain on pressure was reduced 61.1 percent with seaprose S compared to 57.6 percent with the reference treatment; edema was reduced respectively 75 percent and 56.2 percent; and nighttime cramps were 61.1 percent less compared with 52.9 percent 12.
Serrapeptase has been linked to skin conditions (skin lesions), muscle ache, joint pain, and nausea and stomach disturbances.
Combining serrapeptase with drugs such as warfarin and aspirin or natural substances such as fish oil can increase the risks of bleeding and bruising.
Research on the long-term safety of this enzyme is lacking.
While dosages in studies have ranged from 10-60mg, more human evidence is needed to determine the optimal dose of serrapeptase.
Serrapeptase is an enzyme that has traditionally been used for the treatment of inflammation and pain. It also appears to be an effective preparation for the post-operative reduction of swelling, and may be an alternative to conservative measures, such as, the application of ice.
Supplementation of this enzyme may also be of use for both nasal discharge and lung sputum and may treat symptoms of superficial thrombophlebitis.
While the early results of research are promising, clinical studies proving serrapeptase’s effectiveness in treating certain medical conditions are limited and larger, better-designed, placebo-controlled trials are needed. Further evaluation into the side effects and long-term safety of this enzyme is also warranted.