How Do Mucolytic Enzymes Work?

Mucolytic enzymes are medications used in the management of cystic fibrosis, an inherited genetic disorder that affects the water balance in body fluids such as mucus, sweat, and tears, making them more viscous. Mucolytic enzymes break up the mucus in the airway and lungs, and reduce its viscoelasticity, making it easier to cough it up.

Cystic fibrosis affects the free movement of chloride ions through cells, which is essential for attracting water to maintain the right consistency of mucus and other body fluids. With insufficient water, the mucus in the respiratory system becomes thick and sticky, clogs the airways, and traps germs, leading to persistent infections, inflammation, and lung damage.

Infections attract immune cells known as neutrophils, which attack the bacteria and induce inflammation. The DNA material from dead neutrophils accumulates and further thickens the mucus, leading to repeated infections and irreversible lung damage.

The mucolytic enzyme approved by FDA to treat cystic fibrosis is a recombinant human DNase 1, an enzyme that cuts up the DNA released by the dead neutrophils into small fragments, reducing the viscosity of the mucus and facilitating its easy expectoration.

Mucolytic enzymes are typically used in conjunction with standard therapies for cystic fibrosis. Mucolytic enzymes prevent the clogging up of lungs, break the cycle of repeated infections, inflammations, and resultant lung damage, and improve overall pulmonary function.

Mucolytic enzymes are solutions that are orally inhaled using a nebulizer which turns the solution into a fine mist. Mucolytic enzymes are used to thin the mucus and improve pulmonary function in patients with cystic fibrosis, in conjunction with standard treatment.

Mucolytic enzymes also have an orphan designation for the treatment of sarcoidosis, a condition in which inflammatory cells form clumps known as granulomas in many organs including the lungs, causing inflammation and damage.

Side effects of mucolytic enzymes may include the following:

• Chest pain
• Pharyngitis (throat inflammation)
• Rash
• Voice alteration
• Rhinitis (inflammation of the nasal passage)
• Fever
• Dyspepsia (indigestion)
• Conjunctivitis (inflammation of the conjunctiva, the membrane on the whites of the eyes and the inner surface of eyelids)
• Formation of serum antibodies to the mucolytic enzyme
• Laryngitis (inflammation of the larynx)
• Headache
• Urticaria

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of the FDA-approved mucolytic enzyme are:

• dornase alfa
• Pulmozyme