Carica papaya / Papaja

Papaja, vrucht voor een lang leven
Vele vruchten van over de hele wereld zijn niet alleen in de keuken als lekkernij in gebruik, maar hebben terzelfdertijd ook een gezondheidsbevorderende en geneeskrachtige waarde. Lekker is dan ook gezond en zo zou het altijd moeten zijn.

Het woord papaya is afkomstig van het woord papayana, dat hameren, breken betekent. Het hangt samen met het woord payana, aardkluiten breken. De vrucht kreeg die naam omdat de bladeren vlees kunnen mals maken. De eerste naam die de Spanjaarden aan de papaja gaven was higo de mastuerzo (waterkersvijg), omdat de zaden dezelfde pikante smaak als waterkers hebben. In Cuba heet dezelfde vrucht fruta bomba (bom-fruit), om de term papaya te vermijden waarmee het volk de vrouwelijke pubis aanduidt. Andere namen: papaya de los pajaros (vogelpapaja) voor de wilde vruchten in Yucatan; en in andere delen van het land papaya, papayero en melon chapote of melon zapote (zapoteken-meloen).

De plant Carica papaya
De papajaboom is een snel groeiende boom. Het hout is zacht. Op de holle stam staan een aantal grote, ingesneden bladeren. De bladstelen zijn zeer lang (tot 1m) en hol. Op de stam zijn overal grote bladlittekens te zien. De plant bevat een wit melksap (latex) in alle onderdelen. De papajaboom is tweehuizig : er zijn mannelijke bomen, waar nooit vruchten aan komen, en vrouwelijke planten waar natuurlijk wel vruchten aan komen. Tegenwoordig worden er echter ook rassen met tweeslachtige bloemen geteeld. Hier is een kruisbevruchting niet meer noodzakelijk. De gelig-groene bloemen ontwikkelen zich rechtstreeks op de stam. De mannelijke bloemen komen steeds in grote schermen voor, de vrouwelijke bloemen staan solitair of in kleine groepjes. Papajabomen worden uit zaad opgekweekt. Ze worden ongeveer 25 jaar oud. De productiviteit van de planten loopt echter na 3 jaar al terug.




Uit Pharmacotherapeutisch Vademecum 1979/ PAPAYOTINUM, tegenwoordig meestal als papaïne aangeduid, is het gedroogde melksap, verkregen door insnijden van de nog niet geheel rijpe vruchten van Carica Papaya. Het produkt is ook uit andere delen van de plant te winnen. Het bevat een proteolytisch ferment, dat kristallijn is verkregen en eveneens papaïne wordt genoemd.
De optimum pH is afhankelijk van het iso-elektrisch punt van het substraat; het werkt dus zowel in zuur en neutraal als in zwak alkalisch milieu. De ongezuiverde handelspreparaten kunnen het 30-40 voudige van hun gewicht aan eiwit hydrolyseren ; door zuivering met alcohol kan men preparaten verkrijgen, die het 200-300 voudige van hun gewicht omzetten. De werkzaamheid is gebonden aan vrije SH-groepen ; in overeenstemming daarmede wordt papaïne geactiveerd door reducerende stoffen (HCN, H 2 S, etc.) en geïnactiveerd door oxydantia en zware metalen. In tegenstelling tot de meeste andere fermenten is papaïne nog werkzaam bij relatief hoge temperaturen (bv. 70° C). Het handelspreparaat is een grijswit tot geelbruin poeder, dat niet geheel in water oplosbaar is.

Gebruik: Papaïne is aanbevolen ter ondersteuning der spijsvertering, gelijk pepsine ; hiertoe 0,1-1 g met 2-3 g Natrii Bicarbonas na het
eten. Verder ter oplossing van diftherische pseudomembranen, door elk kwartier te penselen of te bestuiven met 5 pCt.'s oplossing. De
belangstelling voor papaïne is toegenomen sinds een aantal fabrikanten gebruik maakte van het reeds lang bekende feit, dat het produkt
ingewandsparasieten kan aantasten en papaïne bevattende middelen als wormmiddel in de handel brachten o.a. tegen ascariden, oxyuren
en trichocephalus.


Papain monograph 
Natural Standard Bottom Line Monograph, 

Related Terms
Actinidin, aleurain, bromelain, Carica papaya, caricain, cathepsin B, cathepsin C, cathepsin H, cathepsin K, cathepsin L, cathepsin S, chymopapain, ficin, human cysteine proteases, meat tenderizer, papain-like enzyme, papaya, papaya enzyme, proteolytic enzymes.
Combination product examples: Prosta-Q (quercetin, saw palmetto, cranberry, bromelain, papain, zinc), Wobenzym® (pancreatin, bromelain, papain, lipase, amylase, trypsin, alpha chymotrypsin, rutin).

Background
Papain is an enzyme (a molecule that speeds up a chemical reaction) found in the latex produced by the fruit of the papaya plant (Carica papaya). The release of this enzyme-rich latex may be part of the plant's defense mechanism and aids in cleaning and sealing the damaged areas of the plant.
In some parts of Africa, papain is used to treat burn wounds, especially in children, and to stimulate healing. In standard Western medical care, papain-containing agents are commonly used to remove dead tissue from burns and many types of wounds and skin ulcers. Traditionally, papain has also been used as digestive aid. Today, papain remains a popular after-meal supplement.
Allergic sensitivity to papain may cause symptoms ranging from itchiness to abdominal cramps, diarrhea, and excessive sweating. Papain is used as a meat tenderizer and in processing beer, so symptoms may occur after ingestion of foods seemingly unrelated to papain.

Scientific Evidence
Uses
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.


Exercise recovery
Research suggests that a combination product containing papain may speed muscle recovery and reduce soreness in runners. Additional research on the effects of papain alone is needed. C

Gastrointestinal disorders (phytobezoar)
Papain may be useful in the treatment of phytobezoars (masses of partially digested or undigested plant material in the gastrointestinal tract). Papain treatment may also damage the esophagus and stomach. More research is needed to determine if papain can be useful while avoiding these adverse effects. C

Jellyfish stings
Limited research has investigated the treatment of jellyfish stings with papain. Additional research is needed in this area.C

Lung conditions (lung abscess)
Research suggests that papain may be useful in the treatment of lung abscesses when used together with other therapies. Additional research is needed in this area.C

Radiation therapy side effects
Limited research on the use of papain to reduce the negative side effects of radiation therapy has shown mixed results. Additional research is needed before a conclusion can be made.C

Recovery from surgery (prevention of postoperative adhesion formation)
Papain and other enzymes have been used to prevent postoperative adhesions. Additional research is needed in this area.C

Rheumatic disorders
Limited research suggests that papain and other protein-digesting enzymes may reduce pain and inflammation in rheumatic disorders.C

Skin conditions (xerotic skin)
Papain has shown some benefits in reducing scaling of xerotic (excessively dry) skin. More high-quality studies are needed in this area before a conclusion can be made.C

Sore throat
Papain has shown some benefits in reducing the symptoms of pharyngitis and tonsillitis. More high-quality studies are needed before a conclusion can be made.C

Wound healing
Studies suggest that papain may be very useful for removing dead tissue from wounds and stimulating healing. More high-quality research is needed in this area.C

Insect bites (fire ants)
Limited research exploring the treatment of fire ant bites with papain found a lack of benefit. Additional research is needed in this area.D

*Key to grades:
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use; 
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

Tradition
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Antiviral, arthritis, bile duct disorders (bile duct stones), cancer, chronic prostatitis (chronic prostate inflammation), eye diseases, food uses, heart disease, immune system regulation, malaria, mouth and throat inflammation, osteochondrosis (bone disease of children), osteoporosis, parasites, recovery from surgery (reducing mucus production after urinary reconstruction), rheumatoid arthritis, SARS (severe acute respiratory syndrome), tuberculosis.

Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)
There is no proven safe or effective dose for papain in adults.

Children (under 18 years old)
There is no proven safe or effective dose for papain in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Avoid with known allergy or hypersensitivity to papain, papaya (Carica papaya), or other plants or foods that may contain papain.
Papain is used as a meat tenderizer and to process beer, so symptoms may occur after ingestion of foods seemingly unrelated to papain.
Upon exposure to papain, people sensitive to papain experienced symptoms including specific airway sensitization, itching in the mouth, watering itchy eyes, sneezing, "runny nose," abdominal cramps, diarrhea, and excessive sweating.
The commercial papain supplement Caroid, sold during the early to mid-20th Century, was noted to cause allergic symptoms, including severe coughing attacks, rhinitis ("stuffy nose" and watery eyes), shortness of breath, swelling under the skin, and asthma.

Side Effects and Warnings
Use cautiously in people being treated for prostatitis (prostate inflammation), as papain may reduce prostatitis symptoms.
Use cautiously in combination with radiation therapy, as papain may cause some symptoms to worsen. Diarrhea, fatigue, and destruction of epithelial tissue have been reported as side effects with the use of a combination product containing papain and other enzymes.
Avoid the combination product Wobenzym®, which contains papain, in people with bleeding disorders, or those taking anticoagulants, antiplatelet agents, or other drugs, herbs, or supplements that may increase the risk of bleeding. Symptoms of Coumadin® overdose (increased bleeding) have been reported in a person taking Coumadin® and Wobenzym® that was possibly contaminated with Coumadin®.
Avoid in people with gastroesophageal reflux disease or gastrointestinal ulcers, as papain may cause gastric ulcer and esophageal perforation.
Avoid in people using therapy that suppresses the immune system, as papain may stimulate the immune system.
Avoid in people sensitive to papain or with known allergy or hypersensitivity to papain, papaya (Carica papaya), or other plants or foods that may contain papain. Papain is used as a meat tenderizer and to process beer, so symptoms may occur after ingestion of foods seemingly unrelated to papain. People sensitive to papain may have itching in the mouth, watering itchy eyes, sneezing, runny nose, abdominal cramps, diarrhea, and excessive sweating.

Interactions
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
Papain may further increase the risk of bleeding when taken with drugs that increase the risk of bleeding. The combination product Wobenzym®, which contains papain, may have been contaminated with the anticoagulant warfarin (Coumadin®) and may also further increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Papain may also interact with agents that affect the immune system, agents used to treat diarrhea, agents used to treat ulcers, dry skin treatments, or hormonal agents.

Interactions with Herbs and Dietary Supplements
Papain may further increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. The combination product Wobenzym®, which contains papain, may have been contaminated with the anticoagulant warfarin (Coumadin®) and may also further increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Papain may also interact with alpha-chymotrypsin, amylase, bromelain, dry skin treatments, herbs and supplements that affect the immune system, herbs and supplements used to treat diarrhea, herbs and supplements used to treat ulcers, hormonal herbs and supplements, lipase, pancreatin, rutin, sodium, or trypsin.

Author Information
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  • Bromme D, Nallaseth FS, Turk B. Production and activation of recombinant papain-like cysteine proteases. Methods 2004;32(2):199-206. View Abstract
  • De Clercq E. Potential antivirals and antiviral strategies against SARS coronavirus infections. Expert Rev Anti Infect Ther 2006;4(2):291-302. View Abstract
  • Glenn J. Managing a traumatic wound in a geriatric patient. Ostomy Wound Manage 2006;52(4):94-98. View Abstract
  • Jedeszko C, Sloane BF. Cysteine cathepsins in human cancer. Biol Chem 2004;385(11):1017-1027. View Abstract
  • Jose Cazzulo J, Stoka V, Turk V. The major cysteine proteinase of Trypanosoma cruzi: a valid target for chemotherapy of Chagas disease. Curr Pharm Des 2001;7(12):1143-1156. View Abstract
  • Leipner J, Iten F, Saller R. Therapy with proteolytic enzymes in rheumatic disorders. BioDrugs 2001;15(12):779-789. View Abstract
  • Martin T, Uhder K, Kurek R, et al. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? Results of a double-blind randomized trial. Radiother Oncol 2002;65(1):17-22. View Abstract
  • N'Dow J, Robson CN, Matthews JN, et al. Reducing mucus production after urinary reconstruction: a prospective randomized trial. J Urol 2001;165(5):1433-1440.View Abstract
  • Pereira AL, Bachion MM. [Wound treatment: scientific production analysis published in the Revista Brasileira de Enfermagem from 1970-2003]. Rev Bras Enferm 2005;58(2):208-213. View Abstract
  • Pieper B, Caliri MH. Nontraditional wound care: A review of the evidence for the use of sugar, papaya/papain, and fatty acids. J Wound Ostomy Continence Nurs 2003;30(4):175-183. View Abstract
  • Rosenthal PJ, Sijwali PS, Singh A, et al. Cysteine proteases of malaria parasites: targets for chemotherapy. Curr Pharm Des 2002;8(18):1659-1672. View Abstract
  • Steverding D, Caffrey CR, Sajid M. Cysteine proteinase inhibitors as therapy for parasitic diseases: advances in inhibitor design. Mini Rev Med Chem 2006;6(9):1025-1032. View Abstract
  • Taylor SL, Hefle SL. Ingredient and labeling issues associated with allergenic foods. Allergy 2001;56 Suppl 67:64-69. View Abstract
  • van Kampen V, Merget R, Brüning T. [Occupational allergies to papain]. Pneumologie 2005;59(6):405-410. View Abstract
  • Yasuda Y, Kaleta J, Bromme D. The role of cathepsins in osteoporosis and arthritis: rationale for the design of new therapeutics. Adv Drug Deliv Rev 5-25-2005;57(7):973-993. View Abstract
Comments