Introduction
Bromelain is an aqueous enzyme extract obtained from both the stem and fruit of the pineapple plant and it’s the cause of why your tongue may become irritated or hurt when eating pineapple. Bromelain contains a number of proteolytic enzymes, otherwise known as digestive proteins, and as many people often say, as you’re eating pineapple, it ‘eats’ you too. Despite this, it has been proven to be quite functional within medicine, demonstrating, in vitro and in vivo, anti-edematous, anti-inflammatory, anti-thrombotic, and fibrinolytic activities. This article will briefly explore bromelain’s uses within treating inflammatory diseases, specifically osteoarthritis.
Why Bromelain?
Although not a licensed medical product, having reviewed the mechanisms of action, bromelain has been shown to have a number of beneficial properties that include anti-inflammatory and analgesic actions, anti-oedematous, anti-thrombotic, and fibrinolytic effects [1].
In Central and South America, pineapple has been used for centuries to treat indigestion and inflammation. And in the late 1800s, bromelain was first isolated from the pineapple and more recently, bromelain has been approved to treat swelling and inflammation after surgery, particularly sinus surgery in Germany. Hence many scientists and physicians have pondered the efficacy and potential uses of bromelain within future therapeutics and treatments for other inflammatory conditions and diseases. From an economic standpoint, bromelain being overtly found within pineapples can easily be accessed and extracted, minimizing any complex costs to produce any bromelain based products for the pharmaceutical market.
Bromelain for Inflammatory Disease
Bromelain, an extract from the pineapple plant, has been demonstrated to show anti-inflammatory and analgesic properties and was first reported to be of value to provide a safer alternative or adjunctive treatment for both rheumatoid arthritis and osteoarthritis patients in 1964 [2, 6].
Some studies suggest that bromelain as an anti-inflammatory agent works by increasing serum fibrinolytic activity which reduces plasma fibrinogen levels and decreases bradykinin levels which all result in reduced vascular permeability and thus reducing pain [2-4]. Thus is often used to reduce inflammation from tendonitis, sprains and strains, and other minor muscle injuries as well as reducing inflammation and pain after dental, nasal, and foot surgeries or trauma. In addition, it controls prostaglandin levels and through modulation of certain immune cell surface adhesion molecules which play a role in the pathogenesis of arthritis [5]. However, further data is needed to clarify definitive mechanisms of its action.
Typically in modern-day medicine, knee pain from osteoarthritis is relieved through drugs like rutosid and trypsin as well as nonsteroidal anti-inflammatory drugs (NSAIDs), which are commonly used pain relievers, including ibuprofen, naproxen and diclofenac. However, bromelain is a food supplement that may provide an alternative treatment to NSAIDs for patients with osteoarthritis that is found to be just as effective [2, 7,8].
Conclusion:
The active factors involved can be biochemically characterized only in part. However, due to its safety, efficacy and it is freely available to the general public in health food stores and pharmacies in the USA and Europe, and most obviously found in pineapples directly, bromelain is gaining acceptance among some as a phytotherapeutic drug. The future for bromelain in medicine seems to be a promising one, but much more work is needed and many more clinical trials need to be done to administer it properly in an upscale setting, but bromelain, for now, will be easily accessible even without a prescription.
Nara Ito, Youth Medical Journal 2020
References
[1] Cooreman, W. M., Scharpé, S., Demeester, J., & Lauwers, A. (1976). Bromelain, biochemical and pharmacological properties. Pharmaceutica acta Helvetiae, 51(4), 73–97.
[2] Brien, S., Lewith, G., Walker, A., Hicks, S. M., & Middleton, D. (2004). Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies. Evidence-based complementary and alternative medicine : eCAM, 1(3), 251–257. https://doi.org/10.1093/ecam/neh035
[3] Kumakura, S., Yamashita, M., & Tsurufuji, S. (1988). Effect of bromelain on kaolin-induced inflammation in rats. European journal of pharmacology, 150(3), 295–301. https://doi.org/10.1016/0014-2999(88)90010-6
[4] Maurer H. R. (2001). Bromelain: biochemistry, pharmacology and medical use. Cellular and molecular life sciences : CMLS, 58(9), 1234–1245. https://doi.org/10.1007/PL00000936
[5] Taussig, S. J., & Batkin, S. (1988). Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. Journal of ethnopharmacology, 22(2), 191–203. https://doi.org/10.1016/0378-8741(88)90127-4
[6] COHEN, A., & GOLDMAN, J. (1964). BROMELAINS THERAPY IN RHEUMATOID ARTHRITIS. Pennsylvania medical journal (1928), 67, 27–30.
[7]Cooreman, W. M., Scharpé, S., Demeester, J., & Lauwers, A. (1976). Bromelain, biochemical and pharmacological properties. Pharmaceutica acta Helvetiae, 51(4), 73–97.
[8]Walker, A. F., Bundy, R., Hicks, S. M., & Middleton, R. W. (2002). Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine : international journal of phytotherapy and phytopharmacology, 9(8), 681–686. https://doi.org/10.1078/094471102321621269
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