Enzyme Therapy: Current Challenges and Future Perspectives

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.

Keywords: COVID-19; biotechnology; encapsulation; enzyme therapy; microarray; molecular modification of enzymes; monitoring of immune response.

Figure 1

Number of publications and enzyme drugs authorized per year (from 1934 to 2020). Publication searches were performed by entering the subject “enzyme therapy, drug and treatment” in PubMed database and choosing the field “Title/Abstract” to filter the search. The enzyme drug searches were performed in the European Medicines Agency (EMA, Amsterdam, The Netherlands) database, and the number of authorized enzymes per twenty-years’ time intervals was plotted. Red area only highlights the growing trend in the number of enzymes authorized by the EMA.

Figure 2

Outline of the main problems presented when using enzyme therapies as well as the different solutions applied to overcome them.