[Systemic enzyme therapy: problems of resorption of enzyme macromolecules]

Systemic enzyme therapy represents a special therapeutic approach consisting in the oral application of high doses of hydrolytic animal and plant enzyme combinations. The originally empirical method was by detailed experimental analyses and successful clinical studies transformed into a widely appreciated therapeutic method of various pathologic processes. In spite of this fact systemic enzyme therapy has been repeatedly questioned by referring to an almost hundred year old dogma claiming the unabsorbality of enzymes in the macromolecular form. The authors present arguments denying the unexceptional validity of this dogma. The histological, radiological, biochemical (chromatographical, enzymological), immunological and biological methods have convincingly proven that a part of swallowed enzymes may pass the intestinal barrier in an undamaged macromolecular form and realize their activities in the body. The most important elements able to absorb macromolecules seem to be so called "M-cells" (FAE) which cover lymphoid foci of the organized gut lymphoid tissue. Other mechanisms of enzyme resorption are under discussion. The absorbed enzymes are rapidly complexed with naturally occurring blood antiproteases. In these complexes the potential immunogenicity of enzymes is restricted and they are concentrated into pathologically affected areas of the body. Complexes in addition display important immunoregulatory activities.