Bromelain is an enzyme found in pineapple, classified as a protease, which breaks down proteins by cleaving amino acid chains. It selectively inhibits the biosynthesis of pro-inflammatory prostaglandins through indirect intervention. Bromelain has been noted in various epidemiological studies for its immunomodulatory effects, as it has the ability to both activate and suppress the immune system. Endogenous proteases, which are associated with trauma or repeated exposure to excessive stress, significantly increase the relative proportions of prostaglandins linked to inflammatory symptoms. Inflammation, as a complex biological mechanism, is primarily related to the regulation of tissue homeostasis disruptions. It plays a crucial role in cancer development, particularly in the stages of cellular transformation, reproduction, angiogenesis, invasion, and metastasis. Thus, inhibiting chronic inflammation can reduce cancer incidence and inhibit its progression. As a bioactive enzyme, bromelain may serve this purpose at a low cost, making it highly valuable in medical sciences.
In the United States, osteoarthritis is the most common joint-related disease, with a prevalence ranging between 3.2% and 33% of the population, depending on the joint type. Bromelain can be an effective solution for this disease due to its analgesic properties. Analgesic effects refer to the ability of a substance or drug to provide pain relief. This therapeutic property is crucial as it helps alleviate pain and improve quality of life. Because of these properties, bromelain is widely used to treat muscle and perineal pain, joint pain, and episiotomy recovery.
Researchers have found significant efficacy in using bromelain for arthritis treatment. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for managing arthritis pain. A clinical study compared the effects of bromelain, rutin, and trypsin to diclofenac in 103 patients with knee arthritis, and the results showed equivalent pain-relieving outcomes for both treatments. Bromelain has also been shown to act as an antioxidant, stimulating the secretion of antioxidant enzymes such as catalase, superoxide dismutase, and reduced glutathione. Bromelain reduces the expression of nitric oxide synthase, thereby inhibiting the production of nitric oxide and reactive nitrogen species. Its administration can help reduce post-surgical inflammation, shortening the average recovery time. Clinical trials indicate that bromelain administration postpartum reduces bruising, pain, and swelling during recovery from episiotomy. Sports injuries and acute inflammations can also be successfully managed with bromelain therapy.
The anthelmintic potential of a substance refers to its ability to destroy or inhibit the growth or survival of parasites, particularly intestinal worms. Bromelain exhibits this capability and may be effective in combating gastrointestinal nematodes such as Heligmosomoides polygyrus, Trichoderma viride, and Trichuris muris. This suggests that bromelain may be suitable for treating and preventing infections caused by intestinal worms. Its therapeutic efficacy has also been demonstrated in research against gastric ulcers. In a comprehensive study examining the effects of bromelain on the gastric mucosa, radioactive sulfur uptake increased by 50%, while glucosamine uptake rose from 30% to 90%. In cases of gastric ulcers, the enhanced absorption of these substances may accelerate mucosal healing.
