Original Articles
16 May 2023
Vol. 17 No. 1 (2023)
https://doi.org/10.4081/itjm.2023.1583

Nattokinase historical sketch on experimental and clinical evidence

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nattokinase, fibrinolysis, thrombolysis, subtilisin, serin proteases
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Authors

Pierpaolo Di Micco
pdimicco@libero.it
AFO Medicina, ASL Napoli 2 nord, Pozzuoli, Naples, Italy.
Francesca Futura Bernardi
Department of Experimental Medicine, Università degli studi della Campania “Luigi Vanvitelli”, Naples, Italy.
Giuseppe Camporese
Department of Internal Medicine, General Medicine Unit, Thrombotic and Haemorrhagic Disorders Unit, University Hospital of Padua, Padua, Italy.
Mario Biglietto
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Alessandro Perrella
Department of Infectious Disease, PO Cotugno, AO dei Colli, Naples, Italy.
Tiziana Ciarambino
Department of Internal Medicine, Hospital of Marcianise, Caserta, Italy.
Vincenzo Russo
University Vanvitelly, Department of Translational Science, Caserta, Italy.
Egidio Imbalzano
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Nattokinase (NK) is a protease derived from food used mainly in the Japanese diet that has several properties. The main activity is related to improving fibrinolytic activities. Other activities have been demonstrated in the regulation of blood pressure by the action toward angiotensin proteases and in the antiplatelet activities. NK can be given orally and reaches its maximal concentration after 12 hours. In addition, an antithrombotic activity based on various NK activities has been proposed. First, increased fibrinolytic activity increases thrombus dissolution and/or the formation of atherosclerotic plaques; second, its enhanced antiplatelet action adds to clot dissolution. All activities have been studied in animals and humans in vitro and in vivo. Relevant adverse effects of NK therapy have not been described, however clinical experience is restricted to case series and volunteers and is not based on clinical studies, thus clinical trials are required to confirm.

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Nattokinase historical sketch on experimental and clinical evidence. (2023). Italian Journal of Medicine, 17(1). https://doi.org/10.4081/itjm.2023.1583
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