Enzymes and Virus Research

see Antiviral/antimicrobial Components in Dairy

see Enzymes and Immune System

last updated 8.25.05

A Study of Serum Glycolytic Enzymes and Serum B Hepatitis in Relation to LIV.52 Therapy

Patney NL, Pachori S. The Medicine and Surgery 1986;4:9
Stauder G, Kabil S. Oral enzyme therapy in hepatitis C patients. Int J Immunother 1997;3:153-158
Kabil S, Stauder G. Oral enzyme therapy in hepatitis C patients. Int J Tiss Reac 1997;1-2

Clinical use of Belosorb and Wobenzym in the Treatment of Viral Hepatitis B
Nikolaev V.G., Matiasch V.I., Kononenko V.V.
Kiev, Ukraine. Presented at the conference “Current approaches in infectology, epidemiology, and microbiology”, Kiev, 1998.

20 patients with clinico-laboratory signs of progressive liver insufficiency were observed. 16 patients suffered from mid-severe and 4 with severe course of the disease. These patients were treated by a combination of Wobenzym and Belosorb (test group). Equivalent control group was established and treated by conventional therapy. Enterosorbent Belosorb and Wobenzym were administered in combination – dosage 6 dragees 3 times a day (Wobenzym) and 18 tablets daily (Belosorb) – for 12-14 days. Patients received also symptomatic therapy – vitamins, allochol, karsil, glucose-salt solutions i.v. A faster tendency to recover, normalization of spleen and liver size, restoring of liver functional activity accompanied by a decrease of hyperbilirubinemia and transaminase activity were found in the test group.

Oral Enzyme Therapy in Hepatitis C patients
Stauder G.,1 Kabil S.2. Int. J. Immunotherapy XIII(3/4) 153-158 (1997).
1Mucos Pharma Clinical Research, Malvenweg 2, D-82538 Geretsried, Germany, 2Department of Hepatology, Gastroenterology & Infectious Diseases, Benha University Hospital, Cairo, Egypt.


Summary
In an open, randomized, clinical pilot trial, four groups with 20 hepatitis C patients each were treated with either 'liver support' therapy, with established medications (one group with ribavirin, one group with a-interferon), or with a novel oral test drug, Phlogenzym®, a combination of hydrolytic enzymes with the flavonoid rutosid. The liver transaminases, AST, ALT, and S-g-GT markedly improved over the period of three months in the three drug groups, but only marginally in the liver support group. The best results were found with Phlogenzym®, which was even superior to ribavirin and a-interferon. The tolerance of the oral enzymes was excellent. Further clinical trials with longer observation times, greater numbers of patients, double-blind and partly placebo-controlled, are under way.

Mechanism of therapeutic efficacy of Wobenzym in the Treatment of Toxic Hepatitis
Korpan M.I., Korpan N.N., Tschekman I.S., Fialka V.
National Medical University, Kiev. Dopovidi Nacionalnoi akademii nauk Ukrainy, 1997, 9, 184-187

The experimental study was held to clear up a mechanism of the treatment effect of the drug Wobenzym in rats with toxic hepatitis, which was provoked by carbon tetrachloride. Wobenzym in doses of 5, 20, and 100 mg/kg manifests a normalizing influence on the activity of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and on the amounts of common and connected bilirubins in blood plasma of rats in the case of toxic hepatitis.

Hydrolytic Enzymes in the Treatment of HIV Infections
H. Jäger. Allgemeinmedizin (1990) 19: 160-164
Kuratorium für Immunschwäche, München.

Summary
In the pathogenesis of HIV infection, a number of autoimmune mechanisms have been replicated, particularly in the more advanced clinically symptomatic stages of the diseases. Thus different autoantibodies and increased levels of circulating immune complexes (CIC) have been described. CIC are postulated to play an important rote in the manifestation of a variety of diseases. Their contribution in the pathogenesis of AIDS was discussed shortly after the first description of the disease. Increased levels of CIC have been demonstrated in several investigations of asymptomatic HIV-infected patients with lymphadenopathy syndrome, AIDS-related complex (ARC) and AIDS. A correlation of the immune complex (IC) levels and the progress of HIV infection has been demonstrated by several authors. CIC in HIV infection are formed by the binding of retroviral antigens to corresponding antibodies, mostly of the IgG and IgA classes. Under physiological circumstances most CIC are bound to erythrocyte CR1 receptors and transported to the reticuloendothelial system (RES) where they are eliminated. In HIV infection, the number of CR1 receptors is reduced. Additionally, the Fc-receptor-dependent clearance of IC by monocytes and macrophages is impaired. Persistently elevated levels of CIC may lead to their binding to different circulating and tissue cells, e.g., to CD4-T cells, which in turn is followed by complement activation. As the complement activation progresses to the terminal complement cascade ("membrane attack complex"), the involved cells are lysed. This process is associated with consumption of early complement components C3 arid C4. An inverse correlation of C3 and C4 has previously been described for advanced HIV infection. The destruction of CD4-T-cells contributes to immune deficiency. When antibodies bind to HIV envelope protein, gp 120 is expressed on the surface of infected cells, or deposited on the membrane of uninfected cells, cell-bound immune complexes are formed which in turn may activate the complement cascade.

The elimination of IC has been associated with an improvement in several IC-mediated diseases. Reduction of CIC levels has been achieved by plasmapheresis or protein A immunoadsorption. Another method of fighting IC-related diseases (e.g., rheumatoid arthritis, multiple sclerosis) is to reduce the CIC levels by treatment with hydrolytic enzymes. These enzymes mobilize cell-bound IC and induce its clearance by stimulation of the macrophages. Furthermore, hydrolytic enzymes split the Fc part of cell-bound IC, thereby preventing activation of the complement system and cell destruction. We report the results of open clinical pilot trials with HIV-infected patients (stages 1 -5 according to the Walter Reed classification). Patients experienced good tolerance of enzyme therapy, an increase in body weight, and an improvement in the general condition with unchanged CD4 and CD8 counts, as well as a reduced total number of typical HIV clinical symptoms. So far, most of our experience was achieved with a 3 x 10 dosage of enteric coated tablets (Wobenzymâ ) or 3 x 1 measuring spoon (Wobenzyâ ) granulate.

Wobe-Mugos® E in the Treatment of Varicella zoster Infections
Efficacy and Tolerance Study No.: MU-695502
Randomised double-blind study phase III with parallel groups vs. acyclovir according to the guidelines of good clinical practice (GCP)
Integrated final report according to ICH E3 guidelines
Primary Investigator: Amado Gonzales Mendoza, M.D.
Instituto Dermatologico de Jalisco, Federalismo Norte # 3102, Atemajac, 44220 Guadalajara, Jalisco, Mexico
Evaluation by: MUCOS Pharma GmbH & Co, Clinical Research Dpt., Malvenweg 2, D-82538 Geretsried, Germany
Report by: PharmaScript, Primelweg 2, D-82538 Geretsried, Germany

Summary
In this double-blind clinical study efficacy and tolerance of Wobe-Mugos® E as compared with the virostatic drug acyclovir was tested in patients with varicella zoster infections (herpes zoster).

40 patients were enrolled: 20 patients received the enzyme preparation Wobe-Mugos® E (enzyme group), and 20 patients acyclovir (acyclovir group). In two patients of the acyclovir group only the baseline values were available. The data of these two patients were not evaluated. Thus, the data of 38 patients was evaluable, 20 of the enzyme group and 18 of the acyclovir group.

The trial was carried out by Amado Gonzales Mendoza, M.D., Instituto Dermatologico de Jalisco, Federalismo Norte # 3102, Atemajac, 44220 Guadalajara, Jalisco, Mexico.
At baseline the patients were comparable with regard to age, sex, weight, height and duration of complaints (p > 0.05, Wilcoxon-Mann-Whitney-U-test).

As main endpoints for statistical evaluation the following variables were defined: pain on day 7, sum of pain over 7 days, days until complete release of pain, last day of occurrence of new lesions and weeks until more than 50% of the erosions were incrusted or healed. They were tested in the given sequence that no adjustment of a was necessary. As secondary criteria the change in the state of the skin, consumption of analgesics (days and dose), crust formation, adverse events, and the global judgments by the physician and by the patients were evaluated descriptively.

The main endpoints "pain on day 7" showed statistically significant difference (p = 0.0095) in favor of the enzyme group, also the second main endpoint, "cumulative pain over 7 days" (p = 0.0427). For the other main endpoints no statistically significant difference could be proven. The Mann-Whitney statistics indicated a superiority (> 0.56) of the parameters "pain on day 7", "cumulative pain over 7 days", "days until complete release of pain", and "weeks until more than 50% of the erosions were incrusted or healed".

The efficacy of the drug was judged in the enzyme group by the physician as 1.3 ("very good" to "good") and by the patients as 1.2 ("very good"). In the acyclovir group the physician judged the efficacy of the drug as 1.7 ("very good" to "good") and the patients as 1.6 ("very good" to "good"). There were no differences between the groups (p > 0.05). The tolerance of the drugs was judged in the enzyme group as 1.0 ("very good") by the physician and by the patients as 1.1 ("very good") and in the acyclovir group by the physician as 1.2 ("very good") and by the patients as 1.3 ("very good" to "good"). In the judgment by the physician there was a statistical significant difference in favor of the enzyme group (p = 0.0415).

Adverse events were documented in six patients in the enzyme group (vomiting, headache, loose stool, nausea and vomiting, epigastric pain, meteorism), and in two patients in the acyclovir group (urticaria, nausea). They started on average after 3.5 days in the enzyme group and after 2.5 days in the acyclovir group. The mean duration was 4.7 days in the enzyme group and 3.0 days in the acyclovir group. They were judged as "mild" in both groups. They were without residual complaints in all cases. The difference was not significant (p > 0.05).

Introduction to Oral Enzyme Therapy and Its Use in Varicella zoster Treatment
Kleine M.-W., Ertl D.
Allergist, Egenhofenstrasse 18, 82152 Planegg/Munich, Germany
Int J Tiss Reac XIX (1/2), 1997 - abstracts of 7th Interscience World Conference on Inflammation, Antirheumatics, Analgesics, Immunomodulators, May 19-21, Geneva, Switzerland

Abstract
Oral enzyme therapy is the therapy with orally administered, intestinally absorbed, and systemically acting enzyme combinations. It is not the substitution of intestinal enzyme deficiencies. In medicine, mostly enzymes from animals (e.g. trypsin, chymotrypsin) and plants (e.g. bromelin, papain) are used, often in combination with a flavonoid (e.g. rutosid). The absorption of active enzymes from the intestine has been proven in animal and human studies. After absorption, enzymes are bound to e.g. a2-macroglobulin (a2M), which acts as carrier molecule and does not inhibit the activities of the enzymes on certain substrates.

Pharmacological properties, investigated in in vitro, animal, and human trials, include antiinflammatory, anti-oedematous, and immunomodulating effects. Different enzymes have different optima of activity and different modes of action. Therefore combinations are more effective than single enzymes. Because of the very central targets of enzymes this therapy is indicated in numerous inflammatory and autoimmune diseases.

In a clinical trial we have investigated the efficacy and tolerance of oral enzyme therapy in varicella zoster patients as compared with a standard acyclovir treatment. 96 patients were evaluated. All main symptoms, including crust formation and total pain, improved equivalently in both groups. In follow-ups after 1 year in only each 1 patient in either group a post zoster neuralgia was documented. The excellent tolerance of oral enzymes has been demonstrated in numerous clinical trials. An investigation in volunteers where we measured all relevant blood, urine and general parameters has also verified the safety of this treatment.

Wobe-Mugos® in the Therapy of Herpes zoster Infections
Efficacy and tolerance. Study Nr.: MU-88110
Randomised multisite clinical triel with two parallel groups against Delimmun®
Integrierter biometrisch-medizinischer Abschlußbericht gemäß FDA- und CPMP-Richtlinien
Leiter der Studie: Dr. med. Klaus Uffelmann
Krälingstraße 13, W-3573 Gemünden, Germany
Auswertung durch: MUCOS Pharma GmbH & Co, Abt. Klinische Forschung, Kirchplatz 8, W-8192 Geretsried 1, Germany
Bericht erstellt von: PHARMASCRIPT, Kathi-Kobus-Steig 1, W-8190 Wolfratshausen, Germany

Summary
In this randomised multisite clinical trial with two parallel groups the efficacy and the tolerance of WOBE-MUGOS® were to be tested in the therapy of herpes zoster infections and to be compared with the immune system stimulating drug, delimmun®. 115 patients with herpes zoster (verified by clinical symptoms and signs and/or demonstration of Varicella Zoster virus) were taken into this stud. 58 patients received WOBE-MUGOS® , 57 delimmun®. The study was carried out in 13 centers. The date of all patients were evaluable. The principal investigator was Klaus Uffelmann, M.D., Krälingstrasse 13, W3573 Gemünden, Germany.

The patients took daily 5 enteric coated tablets WOBE-MUGOS® t.i.d. (= 15 tablets per day) or 2 tablets delimmun® t.i.d. (= 6 tablets per day). The therapy should last until all symptoms have disappeared but at least for two weeks.

At baseline, the patients were comparable with response to age, sex, height, and symptoms (redness, clear vesicles, purulent vesicles, hemorrhagic vesicles, necrosis, localisation of her- pes zoster, temperature, lymphadenopathy, hyperesthesia and segmental pain). As main endpoints for statistical evaluation the segmental pain and segmental redness on day 14 and day 7 were defined. The tests were computed in this sequence; therefore no adjustment for the a-error had to be calculated. The other clinical symptoms were evaluated exploratively.

For the main criterium "segmental pain" there were statistically significant differences (p < 0.05) in favor of the enzyme group on day 14 and day 7. For the "segmental redness" there were no statistically significant differences (p > 0.05). For the secondary criteria there were - except for hyperesthesia (last value) - no statistically significant differences (p > 0.05) among the groups. The last value of the symptom hyperesthesia showed a statistically significant difference on the 5%-level (p < 0.05) in favor of the enzyme therapy.

Seven patients of the enzyme group and l6 patients of the delimmun group complained of a postzosteric neuralgia (PZN). Pains due to the PZN were reported in the enzyme group by statistically significantly (p < 0.05) less patients. The frequency of pain attacks (number per month) was less under enzyme therapy, too (mean 0.7 vs. 2.2 in the delimmun group).
The efficacy of the drug was judged by the physician at end of therapy as 1.5 ("very good" to "good") in the enzyme group and as 2.3 ("good") in the delimmun group; the judgment by the patients was 1.5 ("very good" to "good") in the enzyme group and 2.2 ("good") in the delimmun group. In both judgments the differences were statistically significant (p < 0.001) in favor of the enzyme therapy. The tolerance of the drugs was judged by the physician at end of therapy as 1.1 ("very good") in the enzyme group and as 1.4 ("very good" to "good") in the delimmun group; the judgment by the patients was 1.1 ("very good") in the enzyme group and 1.7 ("very good" to "good") in the delimmun group. Both judgments were statistically significant (p < 0.001) in favor of the enzyme therapy. No adverse events were documented in either group.

Wobe-Mugos® in the Therapy of Herpes zoster
Efficacy and Tolerance
Study Nr.: MU-89105
Randomised double-blind multisite clinical trial with two parallel groups against Acyclovir
Integrierter biometrisch-medizinischer Abschlußbericht gemäß FDA- und CPMP-Richtlinien
The principal investigator was Peter W. Billigmann, M. D., Moerikestrasse 11, W-5444 Polch, Germany.
Mörikestraße 11, W-5444 Polch, Germany
Auswertung durch: MUCOS Pharma GmbH & Co, Abt. Klinische Forschung, Kirchplatz 8, W-8192 Geretsried 1, Germany
Bericht erstellt durch: PHARMASCRIPT, Kathi-Kobus-Steig 1, W-8190 Wolfratshausen, Germany

Summary
In a randomised double-blind multisite clinical trial with two parallel groups the efficacy and the tolerance of WOBE-MUGOS® in the therapy of herpes zoster were to be compared with the virostatic drug Aciclovir. 192 patients with herpes zoster, verified by clinical symptoms and signs and/or demonstration of germs, were taken into this multisite study. 96 patients received WOBE-MUGOS®, 96 patients Aciclovir. The study was carried out in 21 centers. The data of all patients were evaluable.

The patients took 4 trial-capsules WOBE-MUGOS® (equivalent to 15 tablets WOBE-MUGOS®) or aciclovir (equivalent to 4,000 mgs.) t.i.d. The therapy should last until all symptoms have disappeared, at least for two weeks. At baseline, the patients were comparable with response to sex, height, weight and symptoms (redness, clear vesicles, purulent vesicles, hemorrhagic vesicles, necrosis, aberrent vesicles, localisation of herpes zoster, temperature, lymphadenopathy, hyperesthesia and segmental pain).

As main endpoints for statistical evaluation the segmental pain and segmental redness on day 14 and day 7 were defined. The tests were computed for equivalence. The other clinical symptoms were evaluated exploratively. For the main endpoint "segmental pain" there were no statistical differences (p > 0.05) on day 14 and day 7 among the treatment groups. Evaluation of the "segmental redness" on day 14 showed a significant difference (p = 0.015) in favour of the Aciclovir therapy. 0n day 7 there was no difference among the groups (p > 0.05). For the secondary criteria there were no statistically significant differences (p > 0.05) among the groups.

25 patients of the enzyme group and 16 patients of the aciclovir group complained of a post-zosteric neuralgia (PZN). There were no significant differences among the groups with intensity of pain and frequency (number per month) of pain attacks (p > 0.05). The efficacy of the drug was judged at end of therapy by the physician as well as by the patients as 1.6 ("very good" to "good") in either group. The tolerance of the drugs was judged by the physician at end of therapy as 1.2 ("very good" ) in the enzyme group and as 1.4 ("very good" to "good") in the aciclovir group; the judgement by the patients was 1.3 ("very good" to "good") in the enzyme group and 1.4 ("very good" to "good") in the aciclovir group. The differences were statistically not significant (p > 0.05).

Adverse events were documented in five patients of the enzyme group and in 13 patients of the aciclovir group. Most of the adverse events affected the gastrointestinal tract. They started on average in the enzyme group after 5.2 days and in the aciclovir group after 4.4 days. The mean duration was in the enzyme group 4.8 days and in the aciclovir group 8.6 days. In both groups they were "moderate" on average. In the aciclovir group the therapy was therefore stopped in two cases. In this group there was no patient with residual complaints; in the enzyme group there was one patient with a slight residual complaint, but not in need of treatment. The number of adverse events was statistically less in the enzyme group (p < 0.05).

Possibility to Treat Herpes zoster Using Enzymes
I. Mikazans
Department of Dermatology, Medical Academy of Latvia, Riga, Latvia
Australasian Journal of Dermatology 38 (2), 1997. Abstracts of the 19th World Congress of Dermatology, 15-20 June, 1997, Sydney, Australia

Abstract
Herpes zoster - frequent viral disease which affects skin and nervous system. Treatment with acyclovir often leads to postherapeutic neuralgia (PHN), sometimes toxic adverse effects are observed. The objective of presented research was to improve treatment methods of Herpes zoster patients, using enzymes per os and locally, to examine immunity changes during treatment. Herpes zoster patients (9 male, 7 female; 16-47 years of age) were divided into 2 equal groups. Group I (8 patients) was treated by acyclovir, in group II (8 patients) the complex treatment method was used including Wobenzym per os in tablets - 5 tablets 3 times per day until clinical signs started to reduce continuing with 3 tablets 3 times per day until signs disappeared. Locally Ung. Wobe- Mugos E was applied 3 times per day. In group I skin eruptions reduced in 6 days - 2 patients, clinical recovery was observed in 14 days - 3 patients, pain release in 7 days - 3 patients, pain feeling remained for a month in 3 patients.

In group II skin eruptions disappeared in 3 days - 4 patients, complete reduction of clinical signs in 10 days - 4 days, pain release in 5 days - 6 patients, at the end of treatment course pain released in all patients. There were no any adverse effects using enzymes.

Conclusions
1. Complex treatment method with enzymes per os and locally can be used as an alternative treatment method in Herpes zoster patients.
2. This complex treatment method provides rapid clinical recovery, there are no PHN and setbacks observed.
3. This method allows to correct humoral and cellular immunity.

Clinical Experience with Systemic Enzyme Therapy in the Treatment of Herpes zoster
Pospíšilová A., Haklová L.
II. dermato-venerology clinic, Faculty Hospital Brno-Bohunice
Cesko-slovenská dermatologie, 1999, 74 (1), 17-20.

Summary
Eighteen patients with herpes zoster were treated with the enzyme preparation Wobe-Mugos - 3 x 5 tablets per day. In the course of seven-day treatment in particular the effect of the above preparation on the dynamics of the exanthema was investigated as well as subjective symptoms, also with regard to accessory immune diseases. Based on the assembled findings it may be stated that the preparation Wobe-Mugos has a positive impact on healing, reduces the period of treatment and prevents the development of postherpetic neuralgia.

Does Adjuvant Enzymotherapy Influence Recurrence of Schneiderian Papillomas?
*Mudrák J., **Sokol L., *Andrašovská M., *Koval J.
Departments of *Otorinolaryngology and **Pathology; Faculty of Medicine P.J. Šafarik University - University Hospital, Košice, Slovakia
Epithelial Tumours of the Head and Neck Proceedings XXXIst Memorial Meeting for Professor Janez Plecnik, 7.–8. prosince 2000, Ljubljana, Slovinsko

Summary
The subject of this study is systemic enzymotherapy as adjuvant treatment in papillomas of the nasal cavity and paranasal sinuses, collectively referred to as Schneiderian papillomas. The authors analyse their observations of 5 adult patients with recurrent inverted papillomas with extension to the adjacent maxillary sinus and ethmoids. After surgical extirpation and subsequent application of polyenzyme preparations, there was a significant improvement of clinical state in 3 cases. The patients have been disease-free for 3 to 5 years. In 2 patients, a new recurrence was found in period of 2 years after lateral rhinotomy.

Systemic Enzymotherapy in Recurrent Laryngeal Papillomatosis - Our Five Year's Experience
Mudrák J., Koval J., Bobák L.1
Department of Otorinolaryngology and Associated Tissue Bank1, Faculty of Medicine P.J. Šafarik University - University Hospital, Košice, Slovakia
Epithelial tumours of the head and neck Proceedings, XXXIst Memorial Meeting for Professor Janez Plecnik, December 7 – 8, 2000, Ljubljana, Slovenia

Summary
Basic knowledge of systemic enzymotherapy (proteolytic enzyme preparations) is presented. In the paper, authors analyze their observations in the five year's follow-up of 14 patients with recurrent laryngeal papillomatosis when after surgical extirpation peroral proteases were subsequently applicated. In this group, 8 patients have been disease-free from 3 to 5 years. In 4 patients only solitary lesions with very small, or no tendency to grow, were found. In the group of 2 children, no effect has been recorded.

Adjuvant therapy with hydrolytic enzymes in recurrent laryngeal papillomatosis.

Mudrak J, Bobak L, Sebova I. Acta Otolaryngol Suppl. 1997;527:128-30. Department of Otorhinolaryngology, P.J. Safarik University Hospital, Kosice, Slovak Republic. PMID: 9197501

The subject of this study is systemic enzymotherapy as adjuvant treatment in recurrent laryngeal papillomatosis. The authors analyze their observations of 5 adult patients with recurrent laryngeal papillomatosis when after surgical extirpation and subsequent application of peroral proteases there was a significant improvement of their clinical state and laboratory results. The patients have been disease-free from 10 to 18 months. In the authors' experience, the adjuvant enzymotherapy seems to be a suitable replacement of the supplementary treatment in larynx papillomatosis, and it promises to decrease the recurrence rate as well.

Enzymes in the News

Research links enzyme to SARS virus - Breakthrough may result in treatment for lung failure. The Associated Press.
WASHINGTON - An enzyme that regulates blood pressure also is involved in infection by the SARS virus, a discovery that may lead to new treatment for diseases that cause lung failure.

Learning how SARS (severe acute respiratory syndrome) became a deadly threat possibly teaches us a lesson on how to actively fight so diverse and dreadful diseases as SARS, avian flu or the effects of such biotech weapons as anthrax, said Josef Penninger of the Institute of Molecular Biotechnology of the Austrian Academy of Sciences.

The research might have wider implications for a type of lung failure known as acute respiratory distress syndrome, Penninger reported in a communication to the journal Nature. It can occur in cases such as sepsis, aspiration of gastric contents, pneumonia and avian and human influenza.

What those diseases have in common is a type of lung failure.

Penninger and colleagues report in today's issue of Nature Medicine that, working in mice, they found that angiotensin-converting enzyme 2 (ACE2) is a crucial receptor for the SARS virus.

The result is disruption of the body’s protective renin-angiotensin system, leading to respiratory distress syndrome as fluids seep into the air sacks. The renin-angiotensin system uses enzymes to regulate sodium balance, fluid volume and blood pressure.

First, ACE2 combined with the virus and prevented it from binding to normal cells. Also, the enzyme protected the mice from acute lung failure.


 

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