DNAse

A deoxyribonuclease (DNase, for short) is any enzyme that catalyzes the hydrolytic cleavage of phosphodiester linkages in the DNA backbone, thus degrading DNA. Deoxyribonucleases are one type of nuclease, a generic term for enzymes capable of hydrolyzing phosphodiester bonds that link nucleotides. A wide variety of deoxyribonucleases are known, which differ in their substrate specificities, chemical mechanisms, and biological functions.

Some DNases cut, or "cleave", only residues at the ends of DNA molecules (exodeoxyribonucleases, a type of exonuclease). Others cleave anywhere along the chain (endodeoxyribonucleases, a subset of endonucleases).

Some are fairly indiscriminate about the DNA sequence at which they cut, while others, including restriction enzymes, are very sequence-specific.

Some cleave only double-stranded DNA; others are specific for single-stranded molecules; and still others are active toward both.

DNase enzymes can be inhaled using a nebuliser by cystic fibrosis sufferers. DNase enzymes help because white blood cells accumulate in the mucus, and, when they break down, they release DNA, which adds to the 'stickiness' of the mucus. DNase enzymes break down the DNA, and the mucus is much easier to clear from the lungs.

Intrapleural tissue plasminogen activator (tPA) combined with deoxyribonuclease has been shown to increase pleural drainage, decrease hospital length of stay, and decrease need for surgery in parapneumonic effusions and empyema.

The studied protocol used a dose of DNase (Pulmozyme, Roche) of 5 mg, and a dose of t-PA (Actilyse, Boehringer Ingelheim) of 10 mg. Intrapleural medications are each given twice daily for 3 days, and each administration was followed by clamping of the drain to permit the drug to remain in the pleural space for 1 hour. Treatment with DNase alone or t-PA alone was ineffective.

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