Bromelain (Bromelin)

Bromelain is a pineapple extract derived from the pineapple juice and stem. The term “bromelain” refers to the proteolytic enzymes extracted from the plants belonging to the family, Bromeliaceae, or the combination of these enzymes. As it contains proteolytic enzymes, so it is used as supplement for improving protein digestion. Furthermore, it has anti-inflammatory, immunomodulatory and decongestant properties. Therefore, it is used in inflammatory conditions as well.

Bromelain has been used as a medication owing to the numerous health benefits it provides. It has been used for centuries in the South and Central America to treat indigestion and inflammatory conditions. It helps in the management of several disorders by reducing swelling and inflammation, especially in the sinuses and nose. The anti-inflammatory action of Bromelain helps in treating allergic conditions like hay fever, bowel conditions like ulcerative colitis, and lung conditions such as pulmonary edema.

Bromelain Benefits

Bromelain is a proteolytic enzyme that helps in the digestion of proteins. It helps in removing the dead and damaged tissues after burns, preventing the retention of water in the body cavities like peritoneal and pleural cavity, relaxing muscles, stimulating muscle contractions, slowing down the clotting, and improving the absorption of antibiotics. It also helps in preventing cancer, easing labor, and stimulating the burning of fats. The different health benefits of Bromelain are discussed beneath:

Prevents clot formation

It was found that the bromelain obtained from the pineapple fruit and stem has different properties and contains different enzymatic composition. The Bromelain obtained from the stem contains a mixture of thiol endopeptidases and some other components including phosphatase, peroxidase, glucosidase, escharase, cellulase, as well as several protease inhibitors. (1)

Research studies have demonstrated that bromelain exhibits an antithrombotic activity that helps in preventing an abnormal formation of clots in the blood vessels.

This property of Bromelain is beneficial for the people who are at a risk of developing stroke, myocardial infarction, or deep vein thrombosis that occur due to the loss of blood supply to the vital organs as a result of clot formation. The anticoagulant property of Bromelain also helps in the prevention of pulmonary thrombosis, and thrombophlebitis.

It works by inhibiting the platelet aggregation. The benefit of using bromelain over the use of antiplatelet drugs is the process of platelet aggregation inhibited by Bromelain is reversible, which means the risks associated with the lack of blood clotting that results in excessive bleeding following surgery or trauma can be avoided by stopping the use of this enzyme.

Fibrinolytic activity

In vitro and in vivo studies have found that Bromelain acts as a natural fibrinolytic agent. Fibrinolysis is a normal body process that involves the breakdown of clots. It results in the disintegration of a fibrin clot, which is the product of coagulation. The fibrinolytic activities of bromelain have led to the use of this enzyme in the management of angina pectoris, stroke, and other disorders that are caused by the clot formation in the blood vessels. The biochemical experiments have indicated that this pharmacological property of bromelain can be attributed to the proteolytic action produced by it (2).

Cancer

The results from recent pharmacological and preclinical studies have proved the anti-cancer benefits of bromelain. It can be given orally to complement the conventional treatments for cancer such as radiation or chemotherapy. It acts as an immunomodulator by enhancing the immuno-cytotoxicity of the monocytes against the cancer cells, which stimulates the recognition of the cancer cells as abnormal by the monocytes. This leads to the destruction of the cancer cells by the monocytes, which helps to control the growth and spread of the tumor. Bromelain also works by increasing the production of some cytokines like interleukin (IL)-1beta, IL-6, and IL-8 and tumor necrosis factor-a.

These findings were confirmed in clinical research with the patients diagnosed with breast cancer. Several animal experiments have also advocated the anti-metastatic efficacy of bromelain. It has been proved to prevent the spread of cancer and inhibit the metastasis-associated aggregation of platelets. It also reduces the invasiveness of the tumor cells and interferes with the growth of the malignant cells.

The anti-invasive activity of bromelain is attributed more to its effect on the modulation of immune functions rather than its proteolytic activity. (2)

Bromelain also has the potential to eliminate the toxic products from the body and accelerate wound healing. These properties help in hastening the recovery of cancer patients and increase their life expectancy.

Osteoarthritis

Bromelain has been demonstrated to possess strong anti-inflammatory properties. (3)

It offers a safe and effective alternative for the patients with osteoarthritis. Osteoarthrosis is an age-related degenerative condition affecting the bones that results in pain, and gradual restriction of movements. It is a chronic progressive condition, which causes significant loss of joint, and affects the quality of patient’s life.

Bromelain offers a natural remedy for treating this condition by reducing the swelling and damage in the joints caused by the inflammation. It also acts as an analgesic and helps reduce joint pains. It also prevents damage to the cartilage within the joints thus slowing down the progress of the disease. Bromelain is found to be as efficacious as the Non-Steroidal Anti-Inflammatory Drugs that are commonly used to treat osteoarthritis. These drugs relieve the pain; however, they cause serious side effects and can even damage the kidneys and the liver over a period of time. Since the chronic nature of the disease necessitates taking medications for several years, it is advisable to use the safe and natural remedies like Bromelain as it, unlike the Non-Steroidal Anti-Inflammatory drugs, does not produce side effects or have any harmful effect on the vital organs of the body.

Sprains, Strains & Tendinitis

Bromelain can be used to treat other joint disorders like sprains, strains, and tendinitis. It reduces swelling, bruising, and pain in the affected tissues and hastens the healing.

Burns

Bromelain is known to possess skin debridement properties. (4)

Debridement is the process of removal of unhealthy tissues from the parts affected by burns, and wounds to promote healing. Bromelain offers an effective and non-toxic method for the rapid chemical enzymatic debridement for the patients with third-degree burns. It dramatically reduces the risk of morbidity and mortality of the severely burned patients.

Sepsis, which is the major cause of death in the patients with deep burns, can be prevented using Bromelain. It allows for the removal of tissues devitalized due to burns without causing damage to the healthy skin. This helps in preventing the buildup of toxic substances in the body, which can otherwise lead to sepsis.

The skin debridement achieved by Bromelain permits immediate skin grafting and lessens the risk of infection thus speeding up the convalescence and the return of the affected individuals to a normal life.

Chemical debridement by bromelain has the potential advantage over the surgical excision of the devitalized tissues, as it does not require anesthesia or the need to undergo the procedure both of which have their own complications.

The experimental studies have indicated that bromelain can help in achieving rapid debridement, with minimal systemic and local toxicity. (5)

Chemotherapeutic agents can be combined with Bromelain to complement its action. The combined use of bromelain for chemical debriding and the chemotherapeutic agents can obviate the risk of infection in the affected part.

Post-surgical therapeutic uses

Research has been conducted to understand the therapeutic benefits of Bromelain in the field of surgery. The research has been particularly of interest for the plastic surgeons, who can improve the results of the cosmetic procedures using this enzyme. Bromelain has the ability to reduce pain, swelling, platelet aggregation, and inflammation in the treated part with its anti-inflammatory and analgesic properties. It also improves the response of the body to the antibiotics, thus increasing their effectiveness at preventing an infection at the surgical site. Bromelain can promote the healing of the surgical wound and hasten the recovery.

It also promotes reperfusion of the grafted tissues, which helps restore the blood supply to the tissues. (6)

This increases the chances of successful acceptance of the graft by the body. Studies have shown that Bromelain can improve the recovery period of the patients who have undergone nasal, dental, and foot surgeries.

Ulcerative colitis

Dietary supplementation with bromelain can decrease inflammation in the colon. It works by decreasing the production of cytokines and leukocyte that promote inflammation. During research, a state of colitis was triggered in mice with the help of exposure to the NSAIDs like piroxicam. Later, the mice with colitis were administered bromelain purified from the pineapple stem for up to 6 months, while the control group of mice was administered boiled juice that contained inactive enzymes. The flow cytometric analysis of the splenocytes in the mice that were exposed to bromelain demonstrated proteolytic removal of the cell surface molecules, which could affect the leukocyte trafficking and activation and prevent the worsening of the inflammation in the colon. (7)

This study points to the effectiveness of Bromelain in the treatment and prevention of ulcerative colitis. It is specifically recommended for the patients who have to use the Non-Steroidal Anti-Inflammatory drugs for a prolonged period to obtain relief from the chronic painful disorders like arthritis. It can help minimize the damage to the colon mucosa by these medicines and prevent Colitis.

Colonic Neoplasia

Bromelain has been found to be useful in several forms of cancer, particularly the colon cancer. This mixture of proteolytic enzymes helps decrease the production of pro-inflammatory cytokines, which promote the inflammation and cause damage to the healthy tissues. This form of damage leads to the genetic mutations and changes in the DNA of the normal cells thereby initiating the cancerous changes in the colon. Bromelain helps to prevent this and maintains the DNA integrity by reducing the inflammation by blocking the production of pro-inflammatory substances.

Bromelain also reduces the production of leukocytes that accumulate at the site of inflammation and worsen the condition. This compliments the cytokines-blocking action of bromelain and helps in reducing the risk of colon cancer.

These findings have been proved during research in which experimental mice were treated with fresh pineapple juice that induced the proteolytic activities, while the control group received a juice containing inactive enzymes. A rise in the survival rate of the group that received fresh pineapple juice was observed. This group also had a lower histologic colon inflammation score and a reduced incidence of inflammation-linked colon cancer. It was also observed that the experimental group of mice had fewer neoplastic lesions caused by the spread of colon cancer as compared to the control group.

These results demonstrated that dietary supplementation with the proteolytically active bromelain can decrease the inflammation in colon and the incidence of colonic neoplasia. (8)

Cardiovascular diseases

A study conducted to identify the potential effect of bromelain on the risk factors associated with coronary vascular diseases showed favorable results. The research proved that bromelain could be used for preventing cardiovascular diseases like myocardial infarction and acute thrombophlebitis. It helps by inhibiting the aggregation of platelets, and the abnormal clot formation in the blood vessels thus preventing the narrowing of arteries and the resultant loss of blood supply to the organs.

It also produces a cardio-protective effect and enhances the functions of the heart. It protects the heart from the damage caused by toxins. It ameliorates the rejection-induced remodeling of the arterial walls and prevents thrombus formation by inhibiting the thrombin-induced platelet aggregation. (9)

Hence, the patients belonging to the high-risk category for heart diseases are advised to use Bromelain on a regular basis.

Asthma

Bromelain can provide significant relief from the allergic diseases such as asthma and allergic rhinitis. Asthma is a multifactorial condition having an allergic, genetic, environmental, and dietary origin.

Bromelain can work as an effective natural treatment for managing this condition by limiting the airway inflammation, which helps prevent the swelling of the bronchi and bronchioles. It also reduces the production of mucus in the air passages. These actions prevent obstruction to the airflow through the respiratory passages. Thus, it helps to reduce the intensity and frequency of asthma attacks.

A research was designed to study the effects of bromelain extract in the control group of mice that was administered phosphate buffered saline (PBS) while the intervention group was administered bromelain in PBS. The outcomes of the study showed significant anti-inflammatory activity in the respiratory passages of the interventional group indicated by a lower eosinophil, leukocyte, and cellular infiltrate counts. (10)

In addition, bromelain also reduced BAL CD8+ T and CD4+ cells significantly without affecting the normal cells in the hilar lymph nodes and spleen. The study found a decrease in the number of interleukins IL-4, IL-12, IL-17, and IFN-α in the serum of the bromelain-treated mice.

These results point to the beneficial therapeutic effect of bromelain in the management of asthma.

Digestive Disorders

Bromelain is basically an enzyme that digests proteins. It assists the digestive functions by promoting the breakdown and absorption of proteins. It also increases the absorption of vitamins and minerals thus improving the nutritional status of the body. It is extremely effective at healing the tissues in the digestive tract. These actions of bromelain can help in the treatment of dyspepsia, constipation, and Crohn’s Disease.

Allergic diseases

Bromelain helps to treat allergic disorders by modulating the response of the immune system. It was also observed that bromelain helps block DC44 antigen-presenting cells and the CD11c (+) dendritic cells. This proves that bromelain has the ability to mask the primary immune response that exhibits in the form of symptoms like nasal congestion, running nose, itching in the eyes and skin rashes. It can prevent the allergies by tackling the root cause of the disease, which is an over-sensitive and hyperactive immune system.

Sinusitis

A study conducted at the University of Cologne by the Germany researchers showed that bromelain could help in the management of chronic sinusitis by preventing inflammation of the sinuses. The research involved 12 patients who had undergone surgery for sinusitis. The patients were treated with bromelain for 3 months. At the end of the research, a remarkable improvement in the symptoms was observed together with a better rhinoscopy score and an enhanced quality of life.

Insect Bites & Stings

Topical application of Bromelain can help in reducing swelling and discomfort caused by insect bites and stings. It can also be taken orally to reduce pain and promote healing. It also decreases the burning sensation caused by stings.

Varicose Veins

Varicosity is a condition affecting the veins in the lower extremities and the anorectal region. Varicosity in the anorectal region is called hemorrhoids. Varicose veins occur due to the laxity of the walls of the veins in these regions resulting in their enlargement and protrusion.  Bromelain is an effective remedy to manage this problem. It helps prevent damage to the veins and maintains their elasticity thus preventing laxity.

Bromelain Dosage

Bromelain Side Effects

(What are the side effects of Bromelain Supplements?)

Bromelain is safe when used in appropriate amounts. It may cause a few mild side effects such as loose motions and abdominal discomfort. Some rare cases of an allergic reaction to Bromelain have been reported resulting in skin rashes, itching, hives, breathing difficulties, and swelling of face and throat. The incidence of allergies is higher in the individuals who have other allergies.

Bromelain can increase the risk of bleeding during surgery. Hence, people must stop using bromelain 2 weeks before the scheduled procedure.