Official Full Name
Chymopapain
Background
Chymopapain is a proteolytic enzyme isolated from the latex of papaya (Carica papaya). It is a medication used to treat herniated lower lumbar discs in the spine. Chymopapain injections are normally given under local, Rather than general, anaesthesia. The dose for a single intervertebral disc is 2 to 4 nanokatals, with a maximum dose per patient of 8 nanokatals. The procedure is referred to as chemonucleolysis.
Synonyms
chymopapain A; chymopapain B; chymopapain S; EC 3.4.22.6; 9001-09-6; Chymodiactin
Chymotrypsin is a proteolytic enzyme secreted by the pancreas, which can rapidly decompose denatured protein. Its function and use are similar to trypsin, and it has stronger decomposing ability than trypsin, lower toxicity, and less adverse reactions. Chymotrypsin has a wide range of uses, and can still be used for the treatment of sprains, otitis media, rhinitis, sinusitis, pharyngitis, lung abscess, etc. It can be used for surgical inflammation, trauma, hematoma and abscess, and can also be used for tracheotomy. Chymotrypsin has a better effect on patients with excessive sputum, making it easier to cough up sputum.
Figure 1. Protein structure of chymotrypsin.
Structure
Chymopapain's zymogen is made up of a total of 352 residues, and it has a weight of approximately 23.78kDa. Three different regions can be distinguished inside the precursor's chain. The first 18 amino acids act as a sorting signal by indicating the final destination of chymopapain inside the cell when being sorted by the Golgi apparatus. Although this final destination is not fully studied yet, other PLCPs are contained in lysosomes and other acidified vesicles and chymopapain is believed to be in these same vesicles as well. Chymopapain is also known to be secreted outside the cell. The second region is constituted by residues 19 to 134, which conform a propeptide that will be removed upon activation once chymopapain reaches its final destination inside the cell. This region allows the protein to be properly folded in the endoplasmatic reticulum and to stabilize the chain in different acidity conditions, as its optimum pH varies from 3,5 to 10 depending on the substrate. Therefore, the ability to work in low pH conditions supports the idea that chymopapain can be found in lysosomes. The propeptide is folded in a way that prevents substrates from entering into the active site, thus blocking proteolytic activity until it is cleaved. The rest of the protein -residues 135 to 352- conform chymopapain's mature chain. Three amino acids can be highlighted in this region, which are Cys159, His293 and Asn313, as they constitute the catalytic tryad of the enzyme.
Function
As well as all the other enzymes in the PLCPs group, chymopapain is a cysteine protease. Proteases are enzymes that hydrolyse peptide bonds between the residues that conform a protein. In every hydrolysis a water molecule is released. Specifically, a cysteine protease is an enzyme which breaks the peptide bond by using the thiol group of a cysteine residue as the nucleophile. In order to hydrolyse, the whole catalytic triad of the enzyme must be used. This is constituted by a cysteine, the Cys159 residue, a histidine, the His203 residue, and a third residue, which tends to be an asparagine, specifically the Asn313 residue. The functional groups used in the reaction are the thiol group of the cysteine and the imidazolium ring of a histidine. The asparagine residue works orientating the imidazolium ring of the histidine.
Applications
Chymopapain is one of the substracts used in chemonucleolysis (a type of percutaneous discectomy). This method was a new proposal to treat primary lumbar intervertebral disc disease using a nonsurgical method. As a matter of fact, the treatment consists on an injection of proteolytic enzymes to dissolve the herniated nucleus pulposus of the intervertebral discs. Purified chymopapain is the main component of the injection, composed basically of 20 mg in five millilitres. It is provided in vials containing 10.000 units of the lyophilized agent with 0.37 mg of disodium edetate, 3.5 mg of cysteine hydrochloride monohydrate and 1.0 mg of bisulfide. All of them work as stabilisers and activators. Sodium hydroxide is in charge of adjusting the PH of the solution. Then, the injection is rehydrated with 5 milillitres of steril water.
References
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Groleau D.; et al. Enzymatic hydrolysis of agar:purification and characterization of beta neoagarotetraose hydrolase from Pseudomonas atlantica. Can J Microbiol, 1977, 23(6): 672-697.
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Bibb M J.; et al. The Chymopapain gene(dag A) of Streptomyces coelicolor A3(2): affinity purification and characterization of the cloned gene product. J Gen Microbiol, 1987, 133(Pt 8):2 089-2 096.