Chymopapain chemonucleolysis

Konings, J. G.

doi:10.3109/17453679309160110

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…Lysis of the herniated intervertebral disc using papain enzyme is a well-recognized procedure that was found to be effective in alleviating neurological signs and symptoms of herniated intervertebral disc [4][5][6][7]. Although this procedure was fairly safe and effective, it was abandoned because there were reports of neurological complications [8] and there was concern about anaphylaxis [4]. It has been reported that the prevalence of allergic reactions to chymopapain is between 0.5 and 0.7%.…”

Section: Discussionmentioning

confidence: 99%

“…Examination of the cartilaginous tissues from these rabbit ears found a significant portion of the matrix had disappeared; however, a smaller cartilage plate containing relatively normal chondrocytes remained stable in the tissue sample. Based on this, papain has been used in the past in a procedure called chemonucleolysis to lyse lumbar disc herniation [4][5][6][7]. Though a small percentage of patients treated with these enzymes experienced anaphylactic reactions [4], the results of the procedure were good.…”

Section: Existing Literaturementioning

confidence: 99%

“…Based on this, papain has been used in the past in a procedure called chemonucleolysis to lyse lumbar disc herniation [4][5][6][7]. Though a small percentage of patients treated with these enzymes experienced anaphylactic reactions [4], the results of the procedure were good. In two meta-analysis studies, the ability of chymopapain to induce chemonucleolysis was determined to be more effective than placebo [5,6].…”

Section: Existing Literaturementioning

confidence: 99%

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Chemical septoplasty using papain enzyme—a feasibility study

Patil

Simmons

Nilles-Melchert

et al. 2021

Egypt J Otolaryngol

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Background Though surgery can correct nasal septal defects through a procedure called septoplasty, many people seek non-surgical options. Papain enzyme has been used in the past to lyse intervertebral disc and has shown to have a lytic effect on cartilage. Therefore, in this paper, the feasibility to use papain for septoplasty was studied. First, an in vitro study on chicken cartilage was done. Cartilage pieces were emerged in papain solution (5 mg/ml of papain in normal saline) and plain normal saline solution (as control) for 2 weeks at room and refrigeration temperatures. Then, the papain solution was injected in a formalin-fixed cadaver in the submucosal space around the nasal septal cartilage. The control group was injected with normal saline. Results The treated group showed significant lysis with the disintegration of the cartilage, both in the in vitro and cadaver study. Conclusion This study shows that papain can lyse cartilage. It also shows that submucosal injection of papain around nasal cartilage will lyse the septal cartilage. Based on prior experience with papain for disc herniation and the present study, it is worthwhile to further investigate this procedure using live animals.

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