Talk:Serratiopeptidase

20 MAR 08 Renovation
I've gutted this article and rebuilt it to comply with WP:V, WP:NPOV and WP:FRINGE.

As it stood, it was an unreferenced, uninformative, and un-encyclopedic pro-homeopathy push piece. I've added reliable references and summarized the assessment by the Bandolier British medical journal that, thus far, no scientifically sound studies exist which suggest serratiopeptidase is effective as a treatment for any disease. It's officially classified as a homeopathic by the US FDA (meaning in the US the manufacturers can't legally claim it's actually designed to do anything or treat any disease), and finding a medical dictionary which was even willing to list it as biologically-active was tough. I'd worry about undue-weight except for the fact that the two sources I put in the article were the only verifiable, independent Internet sources that were willing to touch this with a 10-foot pole.

There is, however, the standard web-based collection of 3rd-party hearsay and anecdotes, as well as a variety of foreign-based websites hawking homeopathics that don't have to obey US law on product labeling and advertising and will thus, of course, say absolutely anything that sells bottles of pills. A lot of them will refer to studies that don't exist, create fake ones out of thin air, or create fake medical informational pages to provide the illusion of approval from the medical community. Needless to say, none of this nonsense carries weight here.

I doubt anyone will care, since this page has never seen a comment, but I felt an explanation was in order. Bullzeye (Ring for Service) 07:10, 20 March 2008 (UTC)

Do not merge with article "Serratio peptidase"!
The two articles which have been proposed to be merged represent opposite viewpoints, and so should remain "forked" (i.e., separate articles). Any merger is likely to result in an "edit war" (i.e. an ongoing conflict between the author of opposing viewpoints, who delete each others writings and re-write the article from their own point of view). —Preceding unsigned comment added by 0XQ (talk • contribs)


 * Nope. POV content forks like that are considered a bad thing. There should only be one article on this. Dougweller (talk) 18:37, 2 April 2009 (UTC)
 * I was about to say that! I redirected it here as it was an obvious POV fork, thanks for bringing it to my attention OXQ. Verbal   chat  18:41, 2 April 2009 (UTC)

Deliberately misleading article
As for the references cited in this article, the 1st reference from Bandolier (http://www.medicine.ox.ac.uk/bandolier/booth/alternat/serrapep.html) is about "back pain"; serratiopeptidase is is not found effective against this. (The 2nd reference leads to a large collection of irrelevant articles.) Of the 2 articles from the website reference.md, the 1st (http://www.ncbi.nlm.nih.gov/sites/entrez?holding=MEDPLUS,PMC,PLoS&Db=pubmed&Cmd=DetailsSearch&tool=Reference.MD&email=info@res.ca&Term=((%22serratiopeptidase%22[NM]%20OR%20%22serratiopeptidase%22[ALL])%20OR%20%22Jpn%20J%20Antibiot%22[TA]%20AND%201977[DP]%20AND%20223[PG])) is about "peritonitis"; the 2nd (http://www.ncbi.nlm.nih.gov/sites/entrez?holding=MEDPLUS,PMC,PLoS&Db=pubmed&Cmd=DetailsSearch&tool=Reference.MD&email=info@res.ca&Term=((%22serratiopeptidase%22[NM]%20OR%20%22serratiopeptidase%22[ALL])%20OR%20%22Jpn%20J%20Antibiot%22[TA]%20AND%201979[DP]%20AND%20806[PG])) is about "pneumonia"; serratiopeptidase is not found effective against either. Of course; serrapeptidase has not been claimed to be effective against any of these ailments; what is is effective against is apoplexy (stroke) and pulmonary fibrosis. It is typical of deliberately misleading medical journals to claim that a medication is not useful simply because it cannot cure ailments that is not claimed to cure and is not sold as a cure for. This is dishonesty at its height; it is a faking attempt to deceive the gullible public, so that the gullible will trust in the ineffective, outdated methods used by hospitals.0XQ (talk) 14:48, 3 April 2009 (UTC)


 * Thanks for taking the time to find the various references you list above. If you think an article requires expansion and you believe you have reliable sources for the changes, by all means go ahead and do them. If there is disagreement over your additions and theya re reverted, bring them here to discuss and seek consensus. Euryalus (talk) 09:16, 5 April 2009 (UTC)
 * If there is disagreement over your additions and theya re reverted, bring them here to discuss and seek consensus."

I had written long articles with numerous references to reliable sources, but they were entirely deleted by forcible "merger" (over my protest) into this defective, meager article. This is already an ongoing case of disagreement, and I am requesting that you take a look at the materials deleted when they were "merged".0XQ (talk) 01:55, 10 April 2009 (UTC)71.76.32.220 (talk) 01:54, 10 April 2009 (UTC)
 * That is the way to handle this. What is not the way to handle a content dispute is to set up separate articles, I think we all agree on that except 0XQ. Dougweller (talk) 10:13, 5 April 2009 (UTC)


 * I would like to point out that the "Source" column in Reference.MD is typically the first authoritative paper to describe a substance. More recent papers should be reviewed in most cases to determine the current state of the evidence.  This can be done by editing the PubMed query that is generated to include more recent references. Tono-bungay (talk) 17:58, 3 July 2009 (UTC)

Another POV fork
At Serrapeptase, which I have redirected here. Anything useful can be found in the history. Verbal  chat  21:21, 4 April 2009 (UTC)

Comment offered in response to RfC
This post offers a comment in reply to the "Request for Comment" (at http://en.wikipedia.org/wiki/Wikipedia:Requests_for_comment/RFCsci/manual). The paragraph on that page finished with: We request uninvolved editors' action on this matter, to obviate an edit war.0XQ (talk) 21:15, 4 April 2009 (UTC) So the present comment is a response to that.

Seeing that in the Wikipedia 'pseudonymous editing environment' [an apt description from User:Protonk] personal credentials can hardly be assessed, I won't try to offer any. The following comment is offered on a FWIW basis.

I have not been able to access any of the deleted material referred to on the RfC page because I can't see any specific indication (e.g. a link) about where it is to be found.

The article as it exists (14/04/2009) is indeed very bare. There are two cited references, one is for definition of the material, and the other citation, heavily relied on, is a negative article from Bandolier mainly about lack of proof of utility.

The external Bandolier link, as referenced in the current wikipedia article text, is out of date and broken (so I wonder when it was last read?), and on search I found that the current link is to http://www.medicine.ox.ac.uk/bandolier/booth/alternat/serrapep.html

When I compare the 'Bandolier' article itself with the way in which the current Wikipedia article text uses it, I form a strong impression that the current Wikipedia article text (as of 14 April 2009) tends to misrepresent the Bandolier article, by offering an uneven and perhaps exaggerated view of its content and significance, plus a without-context quote, and by making no reference to its limitations -- though I do not suggest that there was any actual intent here to mislead.

Facts about the Bandolier article, as I read it, are that it is a response to a reader who sent in a newspaper article about serratiopeptidase. (No accompanying question was stated, it presumably asked for an opinion about the credibility of claims, as reported in the newspaper article, for the (presumably oral) use of this material for back pain.) The anonymous author of the Bandolier article did a search through literature sources available to him/her, describing the aim explicitly in these terms: "Bandolier decided to see if there are any randomised, controlled trials." The search carried out clearly was not limited to the indications suggested in the newspaper article. The answer arrived at was, in effect, that none of the literature found provided any convincingly positive trial result for any indication, and some was negative -- but not for the indication stated in the newspaper article. Much of what was found, that could be related to the category of trial evidence sought by Bandolier, was also judged to be of unsatisfactory quality (by implication -- when considered against criteria for clinical trials).

The first specific and important limitation in the 'Bandolier' article is its restricted aim, stated in the article itself as: "Bandolier decided to see if there are any randomised, controlled trials." Other kinds of evidence -- indeed if there are any in this case -- were clearly not specifically searched for, and the literature yielded by the search was clearly evaluated from this restricted point of view. (It might help in this connection for editing to take account both of Evidence-based medicine and also of Criticism of evidence-based medicine.)

On the other hand, it's a pertinent question whether there exists out there any reliable and notable information about the subject of the article. The general field in which this article falls does contain many hopeful selling claims with insufficient evidence to make them credible or reliable, many are from commercially interested sources that perhaps could not be used in Wikipedia without infringing either the 'COI' or 'RS' guidelines or both, so that it is obviously reasonable to take care to screen out material of a kind that would offend against them.

I did a very short search myself, and found rather little that could qualify as independently corroborated, though I make no inference from that except that the result seemed to be a bit more than nothing: a reference in Japan J Antibiot. (1977) 30(3) 223, which reports, as the effect of the proteolytic-enzyme preparation used concomitantly with an antibiotic, that it increased the antibiotic concentration at a target site. This effect seems to be also referred to in current manufacturers' material, but I have not explored the reliability of any source, nor the notability of any of this.

All in all, I'd suggest that a route towards editorial consensus on the serratia peptidase article might lie in careful exploration of the true scope and effect of the 'Bandolier' article, so that it can be acknowledged in its proper scope without misrepresentation that may possibly inflame further dispute -- plus a careful scrutiny of any other sources offered, to distinguish and separate any corroborated evidential material that there may be, and to exclude any material that is no more than a hopeful selling 'puff', and any material for which there would be a conflict of interest in posting it.

With good wishes, Terry0051 (talk) 13:54, 14 April 2009 (UTC)
 * It's probably the stuff here - badly edited which is why you can't see it all. Don't bother to follow the link, here it is:


 * ''Serratio peptidase, also written Serratiopeptidase, and also known as serrapeptidase, is a powerful proteolyticenzyme obtained from silkworms. The enzyme is produced by the microorganism Serratia E 15 which lives in the gut wall of the silkworm.
 * This enzyme helps in the proteolysis of cocoons and emergence of the moth. This enzyme is an ingredient ofanti-inflammatory drugs used for the treatment of arthritis, synovitis, and several other inflammatory conditions of muscle and bones.
 * The enzyme causes proteolysis of all non-vital tissues including blood clots, cysts, tissue plaques and cellular debris and reduce the inflammatory response. Unlike other anti-inflammatory drugs like steroids and NSAIDs, Serratio peptidase does not inhibitprostaglandins and is safe to the gastrointestinal system.''
 * Dougweller (talk) 15:24, 14 April 2009 (UTC)

[From Terry0051] Thanks for the copy of the deleted information. To me it looks thin, sketchy, in places obviously inaccurate, and mostly lacking in relevant citations, so I just did a little digging myself.

First off, it seems clear there are various different proteolytic enzymes that have been used or proposed as therapeutic agents (e.g. bromelain and a whole lot of others), and there are also very many different proteolytic enzymes produced by bacteria of the genus Serratia and its relatives.

The existing Protease article says nothing about pharmaceutical uses of proteases, so it clearly leaves a gap.

There are also miscellaneous articles on individual proteases or groups, such as bromelain, papain, Wobenzym (a trade mark?), and these refer variously to pharmaceutical uses.

So an article devoted to the pharmaceutical use of just this one Serratia protease might perhaps look somewhat suspicious, like a sales push -- but it seems to have some precedents in Wikipedia.

A propos potential conflicts, this protease or peptidase material has been known for nearly 40 years and the initial patents for it have long since expired, so that particular source of conflict of interest seems largely out of the way.

There are also a few possibly interesting clinical reports since the date of the 'Bandolier' article.

Without anticipating the result of any discussion about notability or suitability of the article to be in WP at all, here are a few comments about what might be suitable ingredients for the article.

(1) I suggest there would need to be a short but good citation-supported description, suitable for an encyclopedia, of what the substance is, and where it came from. The current text seems weak to non-existent on this point.

By digging just a little, I found what must be something close to the original descriptions. They are in two US Patents:

"Method for producing protease" [USP 3691014] (issued 12 Sept 1972); and Method of treating inflammation and composition therefor" [USP 3,792,160] (issued 12 Feb 1974): The authors were Masao ISONO, Katsumi TOMODA, Koichi MIYATA, Kazutaka MAEJIMA and Reijiro KODAMA, associated with Takeda in Japan.

These authors also published parallel papers including: K K Miyata, K Maejima, K Tomoda, M Isono, "Serratia protease. Part I. Purification and general propreties of the enzyme." Agric. Biol. Chem. (1970) 34, pp 310-318; -- and -- K K Miyata, K Tomoda, M Isono, "Serratia protease. Part III. Characteristics of the enzyme as a metalloenzyme." Agric. Biol. Chem. (1971) 35, pp 460-467.

Extract of part of their description: Serratia sp. E-15 was isolated by the authors from a silkworm intestine. A specimen of Serratia sp. E-15 has been deposited at the American Type Culture Collection, in Maryland, under the accession number ATCC 21074. When Serratia sp. E-15 is cultivated in a medium containing milk casein and soybean meal extract, it produces a protease with caseinolytic and fibrinolytic activities. Protease is recovered and purified from the culture medium.

This protease was proposed as an anti-inflammatory agent -- in the light of results from experiments on laboratory rats injected intraperitoneally with the enzyme and then with some irritant substance, (described in more detail by the authors).

(2) In the material that was deleted from the existing article there is an existing citation to clinical or experimental results. This turns out to be published by an interested manufacturer, and is only a stringing-together of abstracts in an information sheet. I suggest it would be very much better to find independently-reported papers or abstracts corresponding to these (PubMed probably shows them all), and to cite those independent disinterested sources instead -- so far as they are relevant.

For what it may be worth, I also noticed another and more recent optimistic clinical report. Serratiopeptidase was reported as effective for eradicating infection caused by biofilm-forming bacteria in an experimental animal model, which involved carrying out experimental limb surgery on rats, at the same time experimentally introducing Staphylococcus infection. "The antibiofilm property of the enzyme may enhance antibiotic efficacy in the treatment of staphylococcal infections." (The Journal of Bone and Joint Surgery (American). 2006;88:1208-1214. "The Effect of Proteolytic Enzyme Serratiopeptidase in the Treatment of Experimental Implant-Related Infection" by Mete Mecikoglu, MD, Baransel Saygi, MD, Yakup Yildirim, MD, Evrim Karadag-Saygi, MD, Saime Sezgin Ramadan, MD and Tanil Esemenli, MD,  Marmara University School of Medicine, Istanbul, Turkey).

(3) I'm sorry I don't have time to try to put all of this together myself. More importantly, I'm also wondering if this really is worth a separate article --- as compared with, say, a more comprehensive article about proteases in medicine, with suitable redirects from Serratia peptidase and some of the others.

Good wishes, Terry0051 (talk) 19:04, 14 April 2009 (UTC)
 * Not my field, but your last suggestion certainly has merit. Dougweller (talk) 21:07, 14 April 2009 (UTC)


 * [From Terry0051] I've added some citation-based information about the enzyme material itself, and also aligned the text that relates to the Bandolier article more exactly to the content of that article -- for which the broken link is also mended. Terry0051 (talk) 12:02, 12 May 2009 (UTC)

Explanation for edit: how the material appears to be different from homeopathic materials
References to homeopathy have been deleted because there appears to be no connexion between this material and homeopathy.

Specifically, homeopathy, as described by its Wikipedia article, essentially has to do with medical treatments using heavily diluted preparations created from substances that would ordinarily cause effects similar to the disease's symptoms.

By contrast, the Serratiopeptidase article has to do with a biological preparation of a particular proteolytic enzyme. There appears to be some diversity of view about what if any medical efficacy it may have. Equally, the current text of the article may be susceptible of criticisms on various grounds, and is no doubt in need of improvement.

But no citation-supported suggestion has been expressed that this material, whatever it may be worth, is intended to be applied in the heavily-diluted form which appears to be the mark of a homeopathic remedy, or in amounts other than those related to its proteolytic activity. Terry0051 (talk) 11:51, 17 April 2009 (UTC)

Misleading lead?
The page carries misleading information. It says it come from the silkworm which is wrong. I propose to change the first two paragraphs and add an extra paragraph to the following:

Serratiopeptidase commonly known as serrapeptase (also known as, serratiapeptase, serratia peptidase, serratio peptidase, or serrapeptidase) is a proteolytic enzyme isolated from the non-pathogenic enterobacteria Serratia E15 originally found in silkworms. It not extracted from the silkworm for commercial use rather is fermented in tanks using Serratia E15 and a growth medium. It has been prescribed by medical doctors in Germany and Japan for over 20 years and has a history of use in Japan and Europe in alternative medicine for pain and inflammation.

Serratiopeptidase (serrapetase) formulations are available over-the-counter in the United States and most other countries.

Studies

Nearly forty studies are listed in PubMed and although some are not of the highest quality required for drug trails a success as an anti inflammatory is indicated. —Preceding unsigned comment added by Robertredfern (talk • contribs) 16:39, 4 May 2009 (UTC)


 * Oppose change. The lead says "isolated from" and seems to be accurate. Verbal   chat  16:46, 4 May 2009 (UTC)


 * Enh, isolated from is standard terminology - cf. Paclitaxel. Bring a source describing current isolation techniques and we can discuss wording. Presenting the number of PubMed indexed studies is original research, and should be avoided. - 2/0 (formerly Eldereft) (cont.) 18:35, 4 May 2009 (UTC)


 * [From Terry0051] I'd agree "isolated from" is standard.  For encyclopedic purposes, though, it should be clearly associated with a (somewhat distant) past tense, since the sources indicate that the isolation happened in the 1960s, and Serratia sp. E-15 has been on deposit as bacterial culture ATCC 21074 since about then (see also USP 3,792,160 and (a citation specifically linking 'serratiopeptidase' and 'E-15') M. Mecikoglu et al., "The Effect of Proteolytic Enzyme Serratiopeptidase in the Treatment of Experimental Implant-Related Infection", The Journal of Bone and Joint Surgery (American) vol.88 (2006), pp.1208-1214.) Terry0051 (talk) 19:51, 4 May 2009 (UTC)

Copyvio
Compare with Robertredfern's  and  - please make sure that these revisions are not reverted to. We do not actually know the user is Robert Redfern, so even if it's an extract from his book getting quoted here and elsewhere, we cannot host it. Shoemaker&#39;s Holiday (talk) 21:47, 19 April 2009 (UTC)

Changes
I've tweaked this a bit, after I discovered most of the section on anit-inflanmmatory use wasn't justified by the references. It went on and on about its history of use, then I went to the cite - it said *nothing* about that. It could probably sue more information about the claims of the alternative medicine supporters; but we'll have to be careful to use only reliable sources that actually contain the information. Shoemaker's Holiday (talk) 18:59, 19 July 2009 (UTC)


 * Looks better now. The weasel words bothered me so I put in a ref for the anti-inflammatory claim. Rees11 (talk) 20:51, 19 July 2009 (UTC)

Use is supported
Serrapeptase is used in Japan and its effectiveness is well supported by the literature. Why does this article come across as suggesting that it's just so much hokum? Not that this is relevant to the article, but I've used it and it works great. What is relevant is that it's effectiveness is well established via two mechanisms; reduction of inflammation and prevention of pathogenic cell adhesion.

J Bone Joint Surg Am. 2006 Jun;88(6):1208-14. The effect of proteolytic enzyme serratiopeptidase in the treatment of experimental implant-related infection.

Mecikoglu M, Saygi B, Yildirim Y, Karadag-Saygi E, Ramadan SS, Esemenli T.

Animal Research Laboratory, Marmara University School of Medicine, Istanbul, Turkey.

BACKGROUND: Infection around an implanted orthopaedic device is a devastating complication, and the treatment of infections involving slime-forming bacteria is especially difficult. The purpose of the present study was to evaluate the effectiveness of a proteolytic enzyme, serratiopeptidase, in the eradication of a periprosthetic infection in an in vivo animal model. METHODS: In sixty Sprague-Dawley rats, the medullary canal of the right femur was drilled through the intercondylar notch and was inoculated with a Staphylococcus epidermidis strain (ATCC 35984) with a high slime-producing capacity. The cavity was filled with polymethylmethacrylate cement, and a Kirschner wire that had contact with the knee joint was inserted. None of the animals received any treatment for two weeks. Twenty rats were killed at two weeks after the inoculation in order to determine if the infection had become established. The remaining forty rats were randomized into two groups. One group received serratiopeptidase enzyme injections into the knee joint in addition to antibiotic therapy for four weeks, and the other group received intra-articular saline solution injections together with the same antibiotic therapy. The animals from both groups were killed two weeks after the end of therapy (on Day 56). The knee specimens were evaluated bacteriologically and histologically to determine the prevalence of persistent infection and the effects of the enzyme on local tissue. RESULTS: At two weeks, inoculated bacteria grew on culture of specimens from twelve (63.2%) of nineteen animals in the no-treatment group. Microbiological testing suggested that infection persisted in only one (5.6%) of eighteen animals in the serratiopeptidase-and-antibiotic group, whereas it was present in six (37.5%) of sixteen animals in the antibiotic-only group (p = 0.001). Histological evaluation showed similar results (kappa = 0.92). CONCLUSIONS: Serratiopeptidase was effective for eradicating infection caused by biofilm-forming bacteria in this experimental animal model. The antibiofilm property of the enzyme may enhance antibiotic efficacy in the treatment of staphylococcal infections.

http://www.ncbi.nlm.nih.gov/pubmed/16757752

Jpn J Antibiot. 1980 May;33(5):623-35. [Studies on the distributions of antibiotics in the oral tissues: Experimental staphylococcal infection in rats, and effect of serratiopeptidase on the distributions of antibiotics (author's transl)]

[Article in Japanese]

Aratani H, Tateishi H, Negita S.

1) A focal infection was prepared by inoculation of staphylococci into rat gingiva. Then, concentrations in oral tissues (gingiva, tongue and masseter), serum and liver of the infected rats which were given ciclacillin, ampicillin, cephalexin and minocycline in a dose of 100 mg/kg p.o. were investigated and effects of serratiopeptidase (20 mg/kg) on these concentrations were studied. .... Gingival concentrations of antibiotics were higher than those of tongue and masseter and serratiopeptidase elevated gingival concentrations.

(note that reduction of inflammation would increase antibiotic concentrations)

Minerva Cardioangiol. 1996 Oct;44(10):515-24. [Clinical study of the efficacy of and tolerance to seaprose S in inflammatory venous disease. Controlled study versus serratio-peptidase]

[Article in Italian]

Bracale G, Selvetella L.

Divisione di Chirurgia Vascolare, Università degli Studi di Napoli, Federico II.

This study was designed to compare the efficacy and safety of seaprose S and serratio-peptidase in the treatment of venous inflammatory disease. Forty patients entered the study (11 males, 29 females), mean age 54.3 years (range 30-77), mean weight 74.8 kg (range 51-96), with superficial thrombophlebitis. The trial was conducted following a controlled, between patients, randomized experimental design. Seaprose S was administered as 30 mg tablets at a daily dosage of 90 mg (one tab t.i.d.), and serratio-peptidase as 5 mg tablets, at a dose of 30 mg per day (two tabs t.i.d.), both orally, for 14 days. Twenty patients received seaprose S and 20 serratio-peptidase. The findings indicate that seaprose S was more effective and better tolerated than serratio-peptidase. Although the group of patients assigned to seaprose S had considerably more severe initial symptoms, by the end of treatment spontaneous pain was reduced 68.7% from the baseline mean score (from 3.2 to 1.0), as compared with a 63.3% reduction in the serratio-peptidase group (from 3.0 to 1.1). Pain on pressure was reduced 61.1% with seaprose S (from 3.6 to 1.4), compared to 57.6% with the reference treatment (from 3.3 to 1.4). Edema was reduced respectively 75% (from 1.6 to 0.4) and 56.2% (from 1.6 to 0.7); erythema diminished 72.4% (from 2.9 to 0.8) and 58.3% (from 2.4 to 1.0); nighttime cramps were 61.1% less (from 1.8 to 0.7) compared with 52.9% (from 1.7 to 0.8); hemorrhagic suffusion was 53.3% less (from 1.5 to 0.7) compared with 41.7% (from 1.2 to 0.7); cutaneous dystrophy was reduced by 11.1% (from 1.8 to 1.6) and 7.7% (from 1.3 to 1.2). At the end of the treatment with seaprose S efficacy was assessed as good or excellent in 85% of the cases, compared with 65% for serratio-peptidase. Seaprose S caused no adverse reactions. During serratio-peptidase treatment one patient reported diarrhea, requiring temporary dosage reduction and specific treatment. It can thus be confirmed that seaprose S was effective and well tolerated in patients with inflammatory venous diseases.

Intestinal absorption of serrapeptase (TSP) in rats.

Moriya N, Nakata M, Nakamura M, Takaoka M, Iwasa S, Kato K, Kakinuma A.

Biotechnology Research Laboratories, Takeda Chemical Industries Ltd., Osaka, Japan.

A sensitive sandwich enzyme immunoassay (e.i.a.) for serrapeptase (TSP)... These results indicate that orally administered TSP was absorbed from the intestinal tract and transferred into the circulation in an enzymically active form.

. http://www.ncbi.nlm.nih.gov/pubmed/7917060

J Int Med Res. 1990 Sep-Oct;18(5):379-88. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo.

Mazzone A, Catalani M, Costanzo M, Drusian A, Mandoli A, Russo S, Guarini E, Vesperini G.

Institute of Clinical Otorhinolaryngology, University of Naples, Italy.

The efficacy and tolerability of Serratia peptidase were evaluated in a multicentre, double-blind, placebo-controlled study of 193 subjects suffering from acute or chronic ear, nose or throat disorders. Treatment lasted 7-8 days, with the drug or placebo being administered at a rate of two tablets three times a day. After 3-4 days' treatment, significant symptom regression was observed in peptidase-treated patients. There was also a significant reduction in symptoms after 7-8 days for patients in both treatment groups but the response was more marked in those patients receiving the active drug. Statistical comparison between the two groups confirmed the greater efficacy and rapid action of the peptidase against all the symptoms examined at both stages. Tolerance was found to be very good and similar for both groups. It is concluded that Serratia peptidase has anti-inflammatory, anti-oedemic and fibrinolytic activity and acts rapidly on localized inflammation.

http://www.ncbi.nlm.nih.gov/pubmed/2257960

[Reduction of postoperative swelling. Objective measurement of swelling of the upper ankle joint in treatment with serrapeptase-- a prospective study]

[Article in German]

Esch PM, Gerngross H, Fabian A.

Using a quantitative standardized procedure, the swelling of the ankle produced by supination trauma was measured. In the 66 patients with fresh rupture of the lateral ligament treated surgically at our Department between December 1986 and April 1987, a prospective study of the effect of serrapeptase (Aniflazym) on post-operative swelling and pain was carried out in 3 randomized groups of patients. In the group receiving the test substance, the swelling had decreased by 50% 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. The difference is statistically significant (p = 0.013). Decreasing pain correlated for the most part with the reduction in swelling. Thus, the patients receiving the test substance more rapidly became pain-free than did the control groups. On the basis of these results, serrapeptase would appear to be an effective preparation for the post-operative reduction of swelling, in comparison with the classical conservative measures, for example, the application of ice.

http://www.ncbi.nlm.nih.gov/pubmed/2647603

--64.68.128.198 (talk) 01:34, 8 March 2010 (UTC)

--Ryan Wise (talk) 01:35, 8 March 2010 (UTC)

Despite Numerous Medical Citations Supporting it's Use, this Article Continues to be One-Sided
I love Wikipedia but this is an all-too common problem. You get a little gang of opinionated editors pushing their ideas, and no one with contrary evidence or ideas can overcome the "edit-war" of the local dominant gang of editors. In this case it's almost tragic because there is a lot of clinical evidence that serratiopeptidase does have powerful anti-inflammatory benefits as well as other benefits. In a truly fair world both sides would be cited in the article, so long as citations exist. However in reality, your citations don't mean a thing if they don't support the opinions of the local Wiki-gang dominating that particular article. Sad. Very sad. 66.27.48.50 (talk) 00:00, 26 April 2013 (UTC)

Wikipedia is a complete joke when it comes to anything that even resembles a huge benefit of health and this non scientific entry seemingly bias proves it. It looks like more and more people are catching on to this and hopefully more and more are donating to them less and less in response to their dishonesty. — Preceding unsigned comment added by 38.88.222.106 (talk) 22:52, 10 December 2015 (UTC)

Contradictory claim
The fact mentioned "may cause lysis of fibrin" which is harmful in case of an abscess is actually a confirmation that serratiopeptidase is able to do exactly that. So the entire part of "not being confirmed" falls on its head. It is confirmed actually, but taken in a negative context... it can harm in some situations. So... not very useful collection of information in the article. — Preceding unsigned comment added by 85.52.230.111 (talk) 08:34, 27 September 2019 (UTC)

Information Published 2021-06
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265778/