Chymopapain treatment of intervertebral disc disease.
In the first of a two-part study, the authors review the known biochemical, pharmacological, toxicological, and experimental data concerning chymopapain and the intervertebral disc. They describe the action of this proteolytic enzyme, which apparently disrupts the protein mucopolysaccharide component of disc material, most marked in the nucleus pulposus. A rapid conversion to collagen causes a loss of disc space height; toxicity appears to result from alteration of bonding between capillary endothelial cells that in turn produces hemorrhage. Part 2 reviews significant reported results and complications of clinical chemonucleolysis.
D000707:Anaphylaxis / Q000209:etiology; D000818:Animals; D001100:Arachnoiditis / Q000139:chemically induced; D002384:Catalysis; D002415:Cats; D002422:Causalgia / Q000139:chemically induced; D055598:Chemical Phenomena; D002621:Chemistry; D002917:Chymopapain / Q000009:adverse effects / Q000627:therapeutic use* / Q000633:toxicity; D003951:Diagnostic Errors; D004285:Dogs; D004342:Drug Hypersensitivity / Q000209:etiology; D010450:Endopeptidases / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006025:Glycosaminoglycans; D006168:Guinea Pigs; D006801:Humans; D007249:Inflammation / Q000139:chemically induced; D007274:Injections, Intraperitoneal; D007275:Injections, Intravenous; D007278:Injections, Spinal; D007403:Intervertebral Disc / Q000187:drug effects; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000188:drug therapy*; D011817:Rabbits; D013118:Spinal Cord Diseases / Q000139:chemically induced; D013997:Time Factors
D006025:Glycosaminoglycans; D010450:Endopeptidases; D002917:Chymopapain