Preparation Wobenzym in the treatment of gonorrhea aiming to improve the results of antibacterial therapy

Chartmane I.1, Mikazans I.2

1Clinical Center of Skin and Sexually Transmitted Diseases, Riga; 2Department of Dermathovenerology, Lithuanian Medical Academy

A lot of investigations showed that disfunctions of immune system and nonspecific factors of organism resistence play a significant role in pathogenity of gonorrhea (1, 3, 4, 5, 6, 7, 9). Antibacterial therapy is not always able to prevent deflections of immune system when process of gonorrhea proceeds fast, with complications, becomes chronic,or in the case of relapses of the disease (2, 6, 7, 8, 9, 10). This fully supports the use of enzyme therapy in the treatment of gonorrhea.

Our aim was to investigate and compare basic factors of cell and humoral immunity in patients suffering from gonorrhea treated with antibacterial agents together with enzyme preparations.

According to several authors enzymes increase the effect of antibacterial agents in blood when administered concomitantly. Systemic enzyme therapy significantly influences immune system - ensures homeostasis, antiedematic and analgetic effects, and fybrinolytic processes. Wobenzym effects cell and humoral immunity. Enzymes contribute to normalization of fagocytary activity, lymphokinins production, activity of macrophages and natural killers, regulation of cytokines, function of T lymphocytes subpopulations, decomposition of immune complexes, activation of complement, and synthesis of IL-1 and IL-6 (11).

We determined:

  1. Content of T lymphocytes OKT3+ and their subpopulations of T helpers (OKT4+), T suppressors (OKT8+), and (OKT4+/OKT8+) ratio in peripheral blood
  2. Content of important factors of humoral immunity - immunoglobulins A, G, M and circulating immune complexes (CIC) in peripheral blood

Material and methods

In our Center two groups of 15 patients suffering from gonorrhea were treated. 6 cases with accute form of the disease and 9 cases with chronic form were included in the first (control) group. 7 cases with accute form and 8 cases with chronic form were included in the second (enzyme) group. All patients were men at the age of 15-36 years. Concomitantly with gonorrhea trichomoniasis was diagnosed in 4 patients, chlamydiosis in 4 patients, ureaplasmosis in 2 cases, and candidosis in 7 patients in the first group. In the second group trichomoniasis was diagnosed in 6 patients, chlamydiosis in 4 patients, ureaplasmosis in 3 cases, and candidosis in 6 patients. All patients were immunologically examined before and after treatment. Using monoclonal antibodies (Reinherz et al., 1979) the content of T lymphocytes OKT3+ and their subpopulations of T helpers (OKT4+), T suppressors (OKT8+), and (OKT4+/OKT8+) ratio in peripheral blood were determined during the treatment. Content of immunoglobulins A, G, M was determined (method of radial immunodifusion in the gel by Mancini et al. (1978), Baranovskis, Rudiks (1982)) using 3.75% solution of polyethylenglycol with spectrophotometric method.

All patients were divided into two groups:

  1. First group obtained antibacterial treatment* (* Accute gonorrhea - patients obtained a single dose of 250 mg of Rocephin at the beginning of therapy followed by administration of Norfloxacin - 400 mg two times a day for 5 days, Chronic gonorrhea - with relapses - patients obtained the same antibiotics, Norfloxacin was administered for 10 days, without relapses - patients obtained only Norfloxacin - dosage 400 mg two times a day for 14 days) and 0.5g of natrium nucleinate and 0.5g of methyluracil as a immunostimulator 3 times a day for 14 days.
  2. Second group was administered with the same antibiotics as the first group and with Wobenzym 5 tablets 3 times a day.

Control group included 15 healthy volunteers

Results

In both observed group significant deflections were observed before treatment. Inhibition of the cell immunity were found in 13 patients of the first group and in 12 patients of the second group. Average level of OKT4+ was decreased (36.7 + 1.7 and 37.6 + 0.3 p< 0.01), OKT8+ level was increased (26.8 + 2.8 and 28.4 + 3.1 p< 0.05), and coefficient OKT4+/OKT8+ was decreased (1.36 + 0.18 and 1.32 + 0.2 p< 0.00).

A significant increase in average factors IgA (4.13 + 0.82 and 3.9 + 1.2 p< 0.01, in the control 2.5 + 0.03) was also found in both groups, whereas factors IgG and IgM remained within the norm.

Before treatment the CIC value was determined in the serum. In both groups of patients with gonorrhea an increase of CIC was found (30.1 + 0.7 and 31.2 + 1.6 p< 0.001) compared to control (10.8 + 0.4). Increase of IgA and CIC in peripheral blood reflected the disturbances of humoral immunity in 11 patients. This was a reason for the application of systemic enzyme therapy. Repeated examination after the treatment showed significant dynamics in immunologic processes. In the second (enzyme) group the coefficient OKT4+/OKT8+ reached the normal level (1.7 + 0.2 p< 0.01). IgA level remained statistically significantly increased (3.14 + 0.36 and 3.9 + 1.2 p< 0.01).

Determinations of CIC content showed a tendency to decrease in enzyme group (15.6 + 1.2 p< 0.001).

Normalization of immune parameters during the enzyme treatment was reached in 12 cases out of 15.

Conclusions

  1. Significant disturbances of the cell and humoral immunity were found in gonorrhea patients.
  2. Systemic enzyme therrapy (Wobenzym) normalized immune status of gonorrhea patients.
  3. Wobenzym can be successfully used to increase the efficacy of gonorrhea therapy.

Enclosures

1. Changes of the ratio OKT4+/OKT8+ as a result of the treatment of patients with gonorrhea

Group Number OKT3+ p OKT4+ p OKT8+ p OKT4+/OKT8 p
Control 15 63.6+0.3 46.2+0.7 25.7+0.4 1.82+0.5
1. group
before treat. 15 52.5+3.7< 0.02 36.7+1.7< 0.01 26.8+2.8< 0.05 1.36+1.8< 0.001
after treat. 15 59.9+1.2< 0.01 36.9+1.9 25.0+0.8 1.4+0.1
Wobenzym group
before treat. 15 53.9+2.1 37.6+0.3< 0.01 28.4+3.1< 0.05 1.32+0.2< 0.001
after treat. 15 61.1+1.0 45.1+2.0 26.3+1.2 1.7+0.2< 0.01

p - compared to control

2. Changes of immunoglobulins A, G, M and CIC in blood of patients with gonorrhea as a result of the treatment

Group Number CICrel. units p IgA g/l p IgG g/l p IgM g/l p
Control 15 10.8+0.4 2.5+0.03 13.8+0.29 1.43+0.29
1. group
before treat. 15 30.1+2.7< 0.001 4.13+0.82< 0.01 15.7+1.6 1.67+0.12
after treat. 15 26.8+2.9< 0.001 3.14+0.36< 0.01 16.1+3.0 1.52+0.8
Wobenzym group
before treat. 15 31.2+1.6< 0.09 3.9+1.2< 0.01 14.8+1.8 1.7+1.2
after treat. 15 15.6+1.2< 0.001 3.9+1.2< 0.01 14.0+3.7< 0.01 1.37+0.23

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