{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:20:32Z","timestamp":1793215232047,"version":"4.5.0"},"reference-count":18,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"MucPharm"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_pp-2025-0026_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Pseudomyxoma peritonei (PMP) is a rare peritoneal malignancy. BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      is a novel therapeutic agent which has been developed to dissolve and facilitate the drainage of mucin as a palliative treatment for PMP; however, its effect is significantly reduced in patients with hard mucin. This study aimed to assess whether combining collagenase or cysteamine with BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      would be more effective in dissolving hard\u00a0mucin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2025-0026_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This preclinical human\n                      <jats:italic>in\u00a0vitro<\/jats:italic>\n                      study examined the effect of adding collagenase to BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      on hard mucin samples when incubated at 37\u202f\u00b0C over 24\u202fh. The effect of cysteamine alone and in combination with collagenase and BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      was also examined as a supplementary arm of this study. Five experiments were conducted with appropriate controls. Human hard mucin samples were sliced into equal fractions using a sterile surgical scalpel, weighed and noted. The leftover solid mucin was weighed at 0, 1, 3, 5, and 24\u202fh post-treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2025-0026_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 24\u202fh post-treatment, all combinations with collagenase demonstrated almost 100\u202f% dissolution of hard mucin. At 3 and 5\u202fh post-treatment, only BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      with collagenase at 250\u202f\u03bcg\/mL was found to be superior to BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      alone. Combinations with cysteamine were not found to be effective.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2025-0026_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study provides promising evidence of the efficacy and synergistic effect of combining BromAc\n                      <jats:sup>\n                        <jats:bold>\u00ae<\/jats:bold>\n                      <\/jats:sup>\n                      with collagenase to dissolve hard mucin. Further preclinical and clinical research should be undertaken to assess its safety and efficacy in the clinical setting.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/pp-2025-0026","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:56:43Z","timestamp":1761796603000},"page":"185-192","source":"Crossref","is-referenced-by-count":2,"title":["The addition of collagenase to BromAc\n                    <sup>\n                      <b>\u00ae<\/b>\n                    <\/sup>\n                    for the management of inoperable pseudomyxoma peritonei\u00a0\u2013\u00a0\n                    <i>in\u00a0vitro<\/i>\n                    results"],"prefix":"10.1515","volume":"10","author":[{"given":"Carissa","family":"Vici","sequence":"first","affiliation":[{"name":"2989 Peritonectomy Unit, St George Hospital, South Eastern Sydney Local Health District , Kogarah , NSW , Australia"},{"name":"University of New South Wales Saint George and Sutherland Clinical Campuses , Kogarah , NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Eapen","sequence":"additional","affiliation":[{"name":"Mucpharm Pty. Ltd. , Kogarah , NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Narang","sequence":"additional","affiliation":[{"name":"Mucpharm Pty. Ltd. , Kogarah , NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Morris","sequence":"additional","affiliation":[{"name":"2989 Peritonectomy Unit, St George Hospital, South Eastern Sydney Local Health District , Kogarah , NSW , Australia"},{"name":"University of New South Wales Saint George and Sutherland Clinical Campuses , Kogarah , NSW , Australia"},{"name":"Mucpharm Pty. Ltd. , Kogarah , NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"2025121816430084518_j_pp-2025-0026_ref_001","doi-asserted-by":"crossref","unstructured":"Pillai, K, Akhter, J, Mekkawy, A, Chua, TC, Morris, DL. Physical and chemical characteristics of mucin secreted by pseudomyxoma peritonei (PMP). Int J Med Sci 2017;14:18\u201328. https:\/\/doi.org\/10.7150\/ijms.16422.","DOI":"10.7150\/ijms.16422"},{"key":"2025121816430084518_j_pp-2025-0026_ref_002","doi-asserted-by":"crossref","unstructured":"Yang, J, Glenn, D, Lodh, S, Valle, S, Morris, DL. Long-term treatment of unresectable pseudomyxoma peritonei with multiple treatments of intratumoural bromelain and acetylcysteine (BromAc(\u00ae)): a case report. Case Rep Oncol 2023;16:1551\u20136. https:\/\/doi.org\/10.1159\/000534202.","DOI":"10.1159\/000534202"},{"key":"2025121816430084518_j_pp-2025-0026_ref_003","doi-asserted-by":"crossref","unstructured":"Lin, Y-L, Xu, D-Z, Li, X-B, Yan, F-C, Xu, H-B, Peng, Z, et al.. Consensuses and controversies on pseudomyxoma peritonei: a review of the published consensus statements and guidelines. 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