Fig 41 10 Tongue Sphincter Salivary glands Oral

Fig. 41 -10 Tongue Sphincter Salivary glands Oral cavity Salivary glands Mouth Pharynx Esophagus Sphincter Liver Stomach Ascending portion of large intestine Gallbladder Duodenum of small intestine Pancreas Small intestine Large intestine Rectum Appendix Cecum Anus Gallbladder Liver Pancreas Stomach Small intestine Large intestine Rectum Anus A schematic diagram of the human digestive system

Fig. 41 -13 Carbohydrate digestion Oral cavity, pharynx, esophagus Protein digestion Nucleic acid digestion Fat digestion Polysaccharides Disaccharides (starch, glycogen) (sucrose, lactose) Salivary amylase Smaller polysaccharides, maltose Stomach Proteins Pepsin Small polypeptides Lumen of small intestine Polysaccharides Pancreatic amylases Polypeptides Pancreatic trypsin and chymotrypsin DNA, RNA Fat globules Pancreatic nucleases Bile salts Maltose and other disaccharides Nucleotides Fat droplets Smaller polypeptides Pancreatic lipase Pancreatic carboxypeptidase Glycerol, fatty acids, monoglycerides Amino acids Epithelium of small intestine (brush border) Small peptides Disaccharidases Monosaccharides Dipeptidases, carboxypeptidase, and aminopeptidase Amino acids Nucleotidases Nucleosidases and phosphatases Nitrogenous bases, sugars, phosphates

鳳梨酵素 ( Bromelain )

發炎反應 Skin surface Swelling Pin Phagocytes Bacteria Chemical signals Phagocytes and fluid move into area White blood cell 1 Tissue injury; release of chemical signals such as histamine 2 Dilation and increased leakiness of local blood vessels; migration of phagocytes to the area 紅、腫、熱、痛 3 Phagocytes (macrophages and neutrophils) consume bacteria and cell debris; tissue heals

發炎性腸道疾病之動物試驗 l C 57 BL/6 IL-10 -/- 小鼠 l 一組 10~20隻 l 利用Piroxicam誘導結腸發炎 l 鳳梨酵素： 5 mg/天 l 降低出血的情形 l 明顯減緩發炎的程度 From: Clinical Immunology 2005, 116, 135 -142 (Department of Pathology, Duke University Medical Center, CN, USA)

鳳梨酵素應用於發炎性腸道疾病 A: control C: piroxicam + water A B C D B: piroxocam D: piroxicam + bromelain

調節免疫系統 l 降低CD 44(附屬分子)在T細胞上的表現 (FEBS Lett 1994, 351(2), 215 -218, Munzig at Institut fur Pharmazie der Freien, Universistat Berlin, Germany) l 降低CD 44在T細胞上的表現，但提高CD 11的表 現 (Pathobiology 1996, 64(6), 339 -346, Kleef at Memorial Sloan-Kettering Cancer Center, NY, USA) l 鳳梨酵素、木瓜酵素和澱粉水解酵素可以激發人 體單核細胞分泌腫瘤壞死因子α、第一型介白質 以及第六型介白質 (Cancer Biother 1994, 9(3), 253 -263, Desser at Institute of Experimental and Applied Oncology, University of Vienna, Austria)

抑制血小板凝集 l 在 1971由Sano和Yokoyama發現 l 20位有心臟病、中風及高血小板凝集值 病史的患者 l 口服鳳梨酵素有效減緩血小板凝集 From: Experientia 1972, 28, 844 -845 (Kuakini Medical Research Institute, Hawaii, USA)

心絞痛 l 1978： ¡ 14位心絞痛患者 ¡ 400~1000 mg/day ¡ 症狀在 4~90天內消除 l 1979： ¡ 500~700 mg/day ¡ 一但停止服用，心絞痛會因為壓力或刺激再 度復發 From: Acta Med Empirica 1978, 5, 274 -278 and J IAPM 1979, 6, 139 -151

圖 1. The sequence of nattokinase. （ Zhong-liang Zhenh et. al. , 2004 ）

凝血過程 血管受傷 prothrombin 凝血活酶 、 Ca＋2 thrombin 血栓 fibrinogen （ Yoshinori Mine et. al. , 2004 ） fibrin

纖維蛋白溶解系統 tissue-type plasminogen activator plasminigen plasmin nattokinase fibrin degradation Products （ Yoshinori Mine et. al. , 2004 ）

Nattokinase、plasmin對於fibrinogen及cross－ linked fibrin之降解作用

Monacolin K (莫那可林 K) Lovastatin (Mevacor, 史他汀)