Allergology International

Allergology International

Volume 66, Issue 4, October 2017, Pages 594-602
Allergology International

Original article
Nattokinase, profibrinolytic enzyme, effectively shrinks the nasal polyp tissue and decreases viscosity of mucus

https://doi.org/10.1016/j.alit.2017.03.007Get rights and content
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Abstract

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is often comorbid with asthma and resistant to therapeutic interventions. We recently reported that excessive fibrin deposition caused by impairment of fibrinolysis might play pivotal role in forming nasal polyp. Nattokinase (NK), a serine protease produced by Bacillus subtilis, has been reported to be a strong fibrinolytic enzyme. NK could be a promising drug candidate for use in the treatment of both CRSwNP and asthma. The objective of this study was to investigate the effects of NK on nasal polyp tissues from patients with CRSwNP. The nasal discharge from patients with CRSwNP and sputum from subjects with asthma were also used to investigate whether NK influences the viscosity of mucus.

Methods

To examine the effects on NK on nasal polyp tissues, pieces of nasal polyps were incubated either with saline or NK (10–1000 FU/ml) at 37 °C for 24 h. We assessed the presence of fibrin in nasal polyp tissue incubated with NK by means of immunohistochemistry. To examine the effects of NK on nasal discharge and sputum from patients with CRSwNP and asthma, respectively, were incubated with NK solution at 37 °C for 1 h.

Results

NK effectively shrinks the nasal polyp tissue through fibrin degradation. We also found that the viscosity of the nasal discharge and sputum from patients with CRSwNP and asthma, respectively, was significantly reduced by incubation with NK solution.

Conclusions

NK may be an effective alternative therapeutic option in patients with CRSwNP and comorbid asthma by causing fibrin degradation.

Keywords

Asthma
Chronic rhinosinusitis
Fibrin
Nasal polyps
Nattokinase

Abbreviations

CRS
Chronic rhinosinusitis
CRSwNP
CRS with nasal polyps
CRSsNP
CRS without nasal polyps
NK
Nattokinase
t-PA
tissue plasminogen activator
PAI-1
plasminogen activator inhibitor-1
FU
fibrin degradation units
UFH
unfractionated heparin
LMWH
low molecular weight heparin
FXIII-A
factor XIII-A
FDPs
fibrin degradation products

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Peer review under responsibility of Japanese Society of Allergology.