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Nattokinase is a serine protease enzyme produced by the bacterium *Bacillus subtilis* during the fermentation of boiled or steamed soybeans to make the traditional Japanese food natto. It is available as a dietary supplement and is primarily promoted for its fibrinolytic (blood clot-dissolving) and antithrombotic properties. Nattokinase acts by directly degrading fibrin (the main protein component of blood clots), stimulating tissue plasminogen activator (tPA) production to enhance endogenous clot breakdown, inhibiting platelet aggregation, hydrolyzing thrombin in the coagulation cascade, and reducing levels of plasminogen activator inhibitor-1 (PAI-1), thereby increasing tPA activity[3][4][5][6][7]. Preliminary studies suggest potential benefits in cardiovascular health such as prevention of deep vein thrombosis and reduction of high blood pressure; however, robust clinical evidence supporting these uses remains lacking[1][2][3]. Nattokinase also exhibits some anti-inflammatory and antioxidant effects[7].
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