Abstract
In recent years, enzymes have risen as promising therapeutic tools for different pathologies, from metabolic deficiencies, such as fibrosis conditions, ocular pathologies or joint problems, to cancer or cardiovascular diseases. Treatments based on the catalytic activity of enzymes are able to convert a wide range of target molecules to restore the correct physiological metabolism. These treatments present several advantages compared to established therapeutic approaches thanks to their affinity and specificity properties. However, enzymes present some challenges, such as short in vivo half-life, lack of targeted action and, in particular, patient immune system reaction against the enzyme. For this reason, it is important to monitor serum immune response during treatment. This can be achieved by conventional techniques (ELISA) but also by new promising tools such as microarrays. These assays have gained popularity due to their high-throughput analysis capacity, their simplicity, and their potential to monitor the immune response of patients during enzyme therapies. In this growing field, research is still ongoing to solve current health problems such as COVID-19. Currently, promising therapeutic alternatives using the angiotensin-converting enzyme 2 (ACE2) are being studied to treat COVID-19.
Highlights
Enzymes are chemical catalysts of biological systems
The aim of this review is to approach the field of enzyme therapy from another perspective, which it integrates treatment examples, and their current challenges, as well as new trouble-solving strategies
The different uses of therapeutic enzymes were obtained from the drug database of the EMA, using the anatomical therapeutic chemical (ATC) index as search criteria
Summary
Enzymes are chemical catalysts of biological systems. They allow organisms to selfreplicate and catalyze, in a selective and efficient manner, essential biochemical reactions. Except for ribozymes, which are a small group of RNA molecules with a catalytic activity [1]. These proteins have a high specificity that allows them to discriminate between substrates with similar structures [2]. They possess an extraordinary catalytic power that accelerates the targeted chemical reactions. The process of catalyzing biochemical reactions takes place in aqueous solutions under very mild conditions of temperature and pH [3]
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