Unlocking Nature's Enzymes: Exploring Clinical Uses of Nattokinase and Serrapeptase

 Written by Dr. Kate Leavens, ND, Lac

Nattokinase and serratopeptase are proteolytic enzymes belonging to the class of serine proteases, a class of enzymes involved in digestion, blood clotting and fibrinolysis, immune response, tissue remodeling, and hormone signaling.¹ Proteolytic enzymes play an important role in disintegrating and removing non-essential proteins from the body, such as scar tissue, fibroids, and arterial plaque. This guide will review the function and clinical application of these two enzymes to highlight their use for efficacy and safety. 

Nattokinase

Overview: Nattokinase is a bacterial protease derived from soybeans that undergo fermentation with Bacillus subtilis. Extracted from natto, a traditional Japanese food with a history of over 1,000 years, nattokinase is considered to have potent fibrinolytic activity contributing to its reported antithrombotic and antihypertensive effects.² The mechanism of action suggests that nattokinase plays a role in averting arteriosclerosis by engaging in direct antioxidation, consequently lowering lipid peroxidation and enhancing lipid metabolism, specifically inhibiting the oxidation of LDL (low-density lipoprotein).³ Additionally, it exhibits a thrombus-dissolving activity four times greater than plasmin and has been demonstrated to enhance natural fibrinolysis by cleaving and deactivating plasminogen activator inhibitor 1 (PAI-1). This process leads to the effective dissolution of harmful blood coagulation within the body. Nattokinase not only has the capability to dissolve blood clots but also degrades amyloid fibrils.⁴

Clinical Indications: Due to its proteolytic, fibrinolytic, and antioxidant effects, nattokinase is most indicated for aiding in cardiovascular health and vascular inflammation as well as improving circulation.  Research suggests potential benefits in the following ways :

• Dissolves blood clots and blood clot prevention
• Lowers blood pressure
• Reduces atherosclerosis and hyperlipidemia
• Stroke prevention

Serrapeptase

Overview: Serrapeptase is a proteolytic and fibrinolytic enzyme produced by the non-pathogenic enterobacteria Serratia E15 isolated from the intestine of the silkworm Bombyx mori that is used to break down cocoon walls.⁵  Serrapeptase is most widely known for its anti-inflammatory, anti-edemic, and analgesic effects, and secondarily for its anti-atherosclerotic effects.  This is due to its ability to induce the degradation of insoluble protein products like fibrin, biofilm, and inflammatory mediators.⁶ 

Clinical Indications: Serratiopeptidase has a strong affinity for cyclooxygenase (COX) I and II, which are crucially linked with interleukin (IL), prostaglandin (PGs), and thromboxane (TXs) production, leading to its anti-inflammatory and analgesic effects.⁷  Additionally, its role in protein and fibrin degradation make it possibly suitable for the following conditions:

• Wound healing
• Pain reduction
• Local and systemic inflammation
• Respiratory tract infections
• Biofilm disruption
• Scar tissue

Discussion:

Both nattokinase and serrapeptase offer promising therapeutic potential, with nattokinase primarily beneficial for cardiovascular health and serrapeptase showing efficacy in reducing pain, inflammation, and improving respiratory health. Further research is needed to elucidate their complete therapeutic roles.

References

1. Di Cera E. Serine proteases. IUBMB Life. 2009;61(5):510-515. doi:10.1002/iub.186
2. Hodis HN, Mack WJ, Meiselman HJ, et al. Nattokinase atherothrombotic prevention study: A randomized controlled trial. Clin Hemorheol Microcirc. 2021;78(4):339-353. doi:10.3233/CH-211147
3. Chen, H., Chen, J., Zhang, F., Li, Y., Wang, R., Zheng, Q., Zhang, X., Zeng, J., Xu, F., & Lin, Y. (2022). Effective management of atherosclerosis progress and hyperlipidemia with nattokinase: A clinical study with 1,062 participants. Frontiers in Cardiovascular Medicine, 9.
4. Fadl NN, Ahmed HH, Booles HF, Sayed AH. Serrapeptase and nattokinase intervention for relieving Alzheimer's disease pathophysiology in rat model. Hum Exp Toxicol. 2013;32(7):721-735. doi:10.1177/0960327112467040
5. Jadhav, S. B., Shah, N., Rathi, A., Rathi, V., & Rathi, A. (2020). Serratiopeptidase: Insights into the therapeutic applications. https://doi.org/10.1016/j.btre.2020.e00544
6. Klein G and Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes: randomised, doubleblind study versus Diclofenac. Clin Drug Invest 2000; 19: 15–23.
7. Nair SR, C SD. Serratiopeptidase: An integrated View of Multifaceted Therapeutic Enzyme. Biomolecules. 2022;12(10):1468. Published 2022 Oct 13. doi:10.3390/biom12101468