Tissue Reactions to Chymopapain in Cats

Shealy, C. Norman

doi:10.3171/jns.1967.26.3.0327

Cited by 24 publications

(4 citation statements)

References 6 publications

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Section: Discussionmentioning

confidence: 99%

“…Tissue necrosis has been found wherever chymopapain is injected with necrotising inflammation of small and medium blood vessels, the liver, nerve and muscle [11]. Arachnoid thickening occurred when chymopapain was applied epidurally [11]. Injection into the nerve sheath has been shown to produce degeneration and disturbance of nerve conduction, due to microvascular damage [10].…”

Section: Discussionmentioning

confidence: 99%

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The response of nerve tissue to chymopapain

Moon

Kim

et al. 1990

International Orthopaedics

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This study was undertaken to clarify the effects of topically injected chymopapain on the spinal cord and peripheral nerves in rabbits, and also the effect of ganglioside on sciatic nerves which had been damaged by chymopapain. There were no abnormal macroscopic or microscopic findings when chymopapain was injected around the sciatic nerve sheath or around the spinal dura mater, but when it was injected directly into the nerve sheath there was immediate paralysis and severe axonal necrosis; the Schwann sheath remained intact and there was haemorrhage. Injection into the dura resulted in massive haemorrhage, perivascular neutrophil infiltration and necrosis of grey matter. In those treated with ganglioside, regeneration of the damaged sciatic nerve was shorter than in those not so treated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The response of nerve tissue to chymopapain

Moon

Kim

et al. 1990

International Orthopaedics

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“…8,35,48,50,61 Zook and Kobrine 62 observed histological findings that suggested degenerative neuropathy when high-dose chymopapain (750 pKat U) was injected into the lumbar nerve roots of primates; no such changes occurred when the root was simply bathed in a similar concentration of the enzyme. Mackinnon and colleagues 35 noted that an intrafascicular injection of chymopapain produced dose-related nerve fiber damage in both rats and primates.…”

Section: Chymopapain Chemonucleolysis: Mechanism(s) and Implications mentioning

confidence: 96%

Chymopapain-induced reduction of proinflammatory phospholipase A2 activity and amelioration of neuropathic behavioral changes in an in vivo model of acute sciatica

Sawin¹,

Traynelis²,

Rich³

et al. 1997

Journal of Neurosurgery

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The mechanism of action underlying chymopapain (Chymodiactin) chemonucleolysis remains obscure. Radiographic studies suggest that chymopapain does not alter disc fragment size acutely; nonetheless, patients often report symptom resolution within a few days, even hours, of treatment. The authors postulate that, in addition to its chemonucleolytic action, chymopapain may possess antiinflammatory properties. To test this hypothesis, the authors assessed the ability of chymopapain to modulate the activity of the proinflammatory enzyme phospholipase A2 (PLA2) and to ameliorate behavioral changes associated with inflammatory neuropathy in an in vivo model of sciatica. Thirty-nine male Fischer rats were randomly assigned to one of three treatment groups: 1) saline, 2) betamethasone, or 3) chymopapain. All of the rats underwent unilateral sciatic nerve ligation with loose chromic gut suture to induce inflammatory mononeuropathy. The animals were tested for thermal and mechanical hyperalgesia on Days 0 (preoperation), 7 (pretreatment), and 14 (prior to death). Three animals were killed on Day 0 to determine the baseline PLA2 activity within unmanipulated rat sciatic nerves. On Day 7, three animals from each group were killed to assess PLA2 activity prior to treatment. The remainder were given a single infusion of saline, betamethasone (0.3 mg/kg), or chymopapain (100 pKat U) around the inflamed nerve. On Day 14, the remaining animals were killed and their sciatic nerves were removed. The tissue was homogenized and the PLA2 activity was determined using [14C]arachidonate-labeled Escherichia coli phospholipid membrane as a substrate. Lipids were extracted and separated by thin-layer chromatography. All animals developed behavioral changes consistent with inflammatory mononeuropathy 24 to 72 hours postoperatively; these included gait disturbance, flexion deformity, and hyperalgesia of the involved hindlimb. The degree of mechanical and thermal hyperalgesia was comparable between groups at Day 7. By Day 14, the thermal hyperalgesia had resolved; the mechanical hyperalgesia was less evident in the betamethasone- and chymopapain-treated groups than in the saline-treated controls (p = 0.003; saline- vs. chymopapain-treated groups p = 0.004; saline- vs. betamethasone-treated groups p = 0.008). The mean PLA2 activity at baseline (Day 0) was 11.6 +/- 4.9 nmol phospholipid hydrolyzed per minute per milligram of protein. The PLA2 activity at Day 7 was 74.4 +/- 18.2 (ligated side) and 21.2 +/- 11.7 (nonligated side). At Day 14, PLA2 activity was reduced in the chymopapain- (47.8 +/- 12.3) and betamethasone- (39.7 +/- 9.5) treated groups compared with the saline control group (62.3 +/- 11.2), (saline- vs. chymopapain-treated groups p < 0.05; saline- vs. betamethasone-treated groups p < 0.01). The PLA2 activity in nonligated specimens was 18.6 +/- 10.1. These data indicate that chymopapain exhibits antiinflammatory properties in vivo, reducing PLA2 activity and ameliorating mechanical hyperalgesia in this model of inflammatory sciatic n...

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“…(Accepted 2 December 1975. ) however, have been diminished by additional observations on the potential hazards of such treatment (Shealy, 1967;Travenol, 1970;Scoville and Silver, 1975;Sussman, 1975;Watts et al, 1975b).…”

mentioning

confidence: 99%

Chymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients.

Maroon¹,

Holst²,

Osgood³

1976

Journal of Neurology, Neurosurgery & Psychiatry

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SYNOPSISThe results of chemonucleolysis in 48 patients with lumbar disc disease revealed marked improvement in 58 %, slight improvement in 23 %, and no improvement in 19 %. Serious anaphylactic reactions occurred in two patients. These results and those of other neurosurgical and orthopaedic studies are summarized and compared with the 70 % improvement rate obtained with a placebo in a recent double blind controlled cooperative study. Only those few investigators participating in the double blind study are now permitted to use intradiscal chymopapain. It is concluded that the ultimate place of chemonucleolysis, if any, in the treatment of ruptured lumbar discs remains to be determined.

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Tissue Reactions to Chymopapain in Cats

Cited by 24 publications

References 6 publications

The response of nerve tissue to chymopapain

The response of nerve tissue to chymopapain

Chymopapain-induced reduction of proinflammatory phospholipase A2 activity and amelioration of neuropathic behavioral changes in an in vivo model of acute sciatica

Chymopapain in the treatment of ruptured lumbar discs. Preliminary experience in 48 patients.

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