Bromelain monograph

Alternative Medicine Review

Volumn 15, Issue 4, 2010, Pages 361-368

[No Author Info available]

Author keywords

Ananas; Angina; Anti inflammatory; Antibiotic; Antimicrobial; Arthritis; Blood thinner; Bromelain; Cancer; Cardiovascular; Circulation; Diarrhea; Digestion; Fibrinolytic; IBD; Inflammation; Injury; Intestinal pathogens; Kidney; Pineapple; Platelet aggregation; Prostatitis; Protease; Proteolytic; Renal; Sinusitis; Surgery; Wound

Indexed keywords

ALGINIC ACID; ANALGESIC AGENT; ANTIBIOTIC AGENT; BICARBONATE; BROMELAIN; CYCLOSPORIN; DICLOFENAC; ETODOLAC; FLUOROURACIL; INDOMETACIN; KETOPROFEN; NAPROXEN; OROTATE MAGNESIUM; PAPAIN; PHLOGENZYM; PIROXICAM; QUERCETIN; VINCRISTINE; ANTIINFLAMMATORY AGENT; ANTIOXIDANT;

ACUPUNCTURE; ADJUVANT THERAPY; ANGINA PECTORIS; ANKLE SPRAIN; ANTHELMINTIC ACTIVITY; ANTIINFLAMMATORY ACTIVITY; ANTINEOPLASTIC ACTIVITY; ASTHMA; BREAST ADENOCARCINOMA; BRONCHITIS; CANCER INHIBITION; CANDIDA ALBICANS; CARCINOGENESIS; CD25+ T LYMPHOCYTE; CD4+ CD25+ T LYMPHOCYTE; CELLULITIS; CHRONIC PROSTATITIS; DEBRIDEMENT; DIARRHEA; DOSE RESPONSE; DRUG EFFICACY; DRUG POTENTIATION; DRUG SAFETY; DYSPEPSIA; EDEMA; ESCHERICHIA COLI; FIBRINOLYSIS; HEART INFARCTION; HIP OSTEOARTHRITIS; HUMAN; HYPERTENSION; INFLAMMATION; INTESTINE MOTILITY; INTRACELLULAR SIGNALING; JOINT SWELLING; KIDNEY FIBROSIS; KNEE OSTEOARTHRITIS; LETHAL DOSE; LUNG CARCINOMA; LUNG METASTASIS; MULTIPLE SCLEROSIS; NATURAL KILLER CELL; NONHUMAN; PAIN; PANCREAS RESECTION; PELVIS PAIN SYNDROME; PERIANAL ABSCESS; PERIRENAL ABSCESS; PITYRIASIS LICHENOIDES; PNEUMONIA; POSTOPERATIVE EDEMA; PYELONEPHRITIS; REPERFUSION INJURY; REVIEW; RHEUMATOID ARTHRITIS; SEPSIS; SHOULDER IMPINGEMENT SYNDROME; SIGNAL TRANSDUCTION; SINUSITIS; SKIN CANCER; SOFT TISSUE INJURY; STAPHYLOCOCCUS INFECTION; TACHYCARDIA; THROMBOCYTE AGGREGATION; THROMBOPHLEBITIS; THROMBOSIS; TREATMENT OUTCOME; TRICHURIS; ULCERATIVE COLITIS; URINARY TRACT INFECTION; VIBRIO CHOLERAE; WOUND HEALING; ANIMAL; CHEMISTRY; DRUG EFFECT; IMMUNITY; INFECTION; PHYTOTHERAPY; PINEAPPLE;

ANANAS; ANIMALS; ANTI-INFLAMMATORY AGENTS; ANTIOXIDANTS; BROMELAINS; HUMANS; IMMUNITY; INFECTION; INFLAMMATION; PHYTOTHERAPY;

EID: 79952261556     PISSN: 10895159     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (105)

1. Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol 2005;5:783-793. (Pubitemid 40248332)
2. White RR, Crawley FE, Vellini M, et al. Bioavailability of 1251 bromelain after oral administration to rats. Biopharm Drug Dispos 1988;9:397-403.
3. Kumakura S, Yamashita M, Tsurufuji S. Effect of bromelain on kaolin-induced inflammation in rats. Eur J Pharmacol 1988;150:295-301.
4. Uchida Y, Katori M. Independent consumption of high and low molecular weight kininogens in vivo. Adv Exp Med Biol 1986;198:113118.
5. Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.
6. Fitzhugh DJ, Shan S, Dewhirst MW, Hale LP. Bromelain treatment decreases neutrophil migration to sites of inflammation. Clin Immunol 2008;128:66-74.
7. Bhui K, Prasad S, George J, Shukla Y. Bromelain inhibits COX-2 expression by blocking the activation of MAPK regulated NF-kappa B against skin tumor initiation triggering mitochondrial death pathway. Cancer Lett 2009;282:167-176.
8. Huang JR, WuCC, Hou RC, Jeng KC. Bromelain inhibits lipopolysaccharide- induced cytokine production in human THP-1 monocytes via the removal of CD14. Immunol Invest 2008;37:263-277.
9. Gaspani L, Limiroli E, Ferrario P, Bianchi M. In vivo and in vitro effects of bromelain on PGE(2) and SP concentrations in the inflammatory exudate in rats. Pharmacology 2002;65:83-86. (Pubitemid 34298010)
10. Desser L, Rehberger A, Paukovits W. Proteolytic enzymes and amylase induce cytokine production in human peripheral blood mononuclear cells in vitro. Cancer Biother 1994;9:253-263
11. Engwerda CR, Andrew D, Murphy M, Mynott TL. Bromelain activates murine macrophages and natural killer cells in vitro. Cell Immunol 2001;210:5-10. (Pubitemid 32756936)
12. Engwerda CR, Andrew D, Ladhams A, Mynott TL. Bromelain modulates T cell and B cell immune responses in vitro and in vivo. Cell Immunol 2001;210:66-75. (Pubitemid 32756943)
13. Barth II, Guseo A, Klein R. In vitro study on the immunological effect of bromelain and trypsin on mononuclear cells from humans. Eur J Med Res 2005;10:325-331. (Pubitemid 41226978)
14. Secor ER Jr, Singh A, Guernsey LA, et al. Bromelain treatment reduces CD25 expression on activated CD4+ T cells in vitro. Int Immunopharmacol 2009;9:340-346.
15. Eckert K, Grabowska E, Stange R, et al. Effects of oral bromelain administration on the impaired immunocytotoxicity of mononuclear cells from mammary tumor patients. Oncol Rep 1999;6:1191-1199.
16. Reddy VB, Lerner EA. Plant cysteine proteases that evoke itch activate protease-activated receptors. Br J Dermatol 2010 May 20. [Epub ahead of print]
17. Bhui K, Prasad S. George J, Shukla Y. Bromelain inhibits COX-2 expression by blocking the activation of MAPK regulated NF-kappa B against skin tumor-initiation triggering mitochondrial death pathway. Cancer Lett 2009;282:167-176.
18. Kalra N, Bhui K, Roy P, et al. Regulation of p53, nuclear factor kappaB and cyclooxygen ase-2 expression by bromelain through targeting mitogen-activated protein kinase pathway in mouse skin. Toxicol Appl Pharmacol 2008;226:30-37. (Pubitemid 350235577)
19. Mynott TL, Ladhams A, Scarmato P, Engwerda CR. Bromelain, from pineapple steins, proteolytically blocks activation of extracellular regulated kinase-2 in T cells. J Immunol 1999;163:2568-2575. (Pubitemid 29399179)
20. Juhasz B, Thirunavukkarasu M, Pant R, et al. Bromelain induces cardioprotection against ischemia-reperfusion injury through Akt/FOXO pathway in rat myocardium. Am J Physiol Heart Circ Physiol 2008;294:H1365-H1370. (Pubitemid 351468735)
21. Wen S, Huang TH, Li GQ, et al. Bromelain improves decrease in defecation in postoperative rats: modulation of colonic gene expression of inducible nitric oxide synthase. Life Sci 2006;78:995-1002. (Pubitemid 43112538)
22. Mynott TL, Guanddini S, Raimondi F, Fasano A. Bromelain prevents secretion caused by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro. Gastroenterology 1997;113:175-184. (Pubitemid 27281772)
23. Chandler DS, Mynott TL. Bromelain protects piglets from diarrhoea caused by oral challenge with K88 positive enterotoxigenic Escherichia coli. Gut 1998;43:196-202. (Pubitemid 28348321)
24. Mynott TL, Luke RK, Chandler DS. Oral administration of protease inhibits enterotoxigenic Escherichia coli receptor activity in piglet small intestine. Gut 1996;38:28-32.
25. Munzig E, Eckert K, Harrach T, et al. Bromelain protease F9 reduces the CD44 mediated adhesion of human peripheral blood lymphocytes to human umbilical vein endothelial cells. FEBS Lett 1995;351:215-218. (Pubitemid 24277272)
26. Heinicke RM, Van der Wal M, Yokoyama MM. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844-845.
27. Glaser D, Hilberg T. The influence of bromelain on platelet count and platelet activity in vitro. Platelets 2006;17:37-41. (Pubitemid 41759239)
28. Metzig C, Grabowska E, Eckert K, et al. Bromelain proteases reduce human platelet aggregation in vitro, adhesion to bovine endothelial cells and thrombus formation in rat vessels in vivo. In Vivo 1999;13:7-12. (Pubitemid 29168196)
29. De-Giuli M, Pirotta F. Bromelain: interaction with some protease inhibitors and rabbit specific antiserum. Drugs Exp Clin Res 1978;4:21-23.
30. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exp Clin Res 1978;4:39-44.
31. Luerti M, Vignali ML. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res 1978;4:45-48
32. Renzini G, Varengo M. Absorption of tetracycline in presence of bromelain after oral administration. Arzneimittelforschung 1972;22:410-412. [Article in German]
33. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143-160.
34. Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7:13-17.
35. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn 1972;19:147-153.
36. Shahid SK, Turakhia NH, Kundra M, et al. Efficacy and safety of phlogenzym - a protease formulation, in sepsis in children. J Assoc Physicians India 2002;50:527-531.
37. Stepek G, Lowe AE, Buttle DJ, et al. In vitro and in vivo anthelmintic efficacy of plant cysteine proteinases against the rodent gastrointestinal nematode, Trichuris muris. Parasitology 2006;132:681-689.
38. Stepek G, Buttle DJ, Duce IR, et al. Assessment of the anthelmintic effect of natural plant cysteine proteinases against the gastrointestinal nematode, Heligmosomoides polygyrus, in vitro. Parasitology 2005;130:203-211. (Pubitemid 40260722)
39. Brakebusch M, Wintergerst U, Petropoulou T, et al. Bromelain is an accelerator of phagocytosis, respiratory burst and killing of Candida albicans by human granulocytes and monocytes. Eur J Med Res 2001;6:193-200.
40. Massimiliano R, Pietro R, Paolo S, et al. Role of bromelain in the treatment of patients with pityriasis lichenoides chronica. J Dermatolog Treat 2007;18:219-222. (Pubitemid 47206998)
41. Gerard G. Anti-cancer therapy with bromelain. Agressologic 1972;13:261-274.
42. Taussig SJ, Szekerezes J, Batkin S. Inhibition of tumor growth in vitro by bromelain, an extract of the pineapple plant (Ananas comosus). Planta Med 1985;6:538-539. (Pubitemid 16176666)
43. Batkin S, Taussig SJ, Szekerezes J. Antimetastatic effect of bromelain with or without its proteolytic and anticoagulant activity. J Cancer Res Clin Oncol 1988;114:507-508.
44. Nieper HA. A program for the treatment of cancer. Krebs 1974;6:124-127.
45. Chobotova K, Vernallis AB, Majid FA. Bromelain's activity and potential as an anti-cancer agent: Current evidence and perspectives. Cancer Lett 2010;290:148-156.
46. Beuth J, Braun JM. Modulation of murine tumor growth and colonization by bromelain, an extract of the pineapple plant (Ananas comosum L.). In Vivo 2005;19:483-485.
47. Báez R, Lopes MT, Salas CE, Hernández M. In vivo antitumoral activity of stem pineapple (Ananas comosus) bromelain. Planta Med 2007;73:1377-1383.
48. Juhasz B, Thirunavukkarasu M, Pant R, et al. Bromelain induces cardioprotection against ischemia-reperfusion injury through Akt/FOXO pathway in rat myocardium. Am J Physiol Heart Circ Physiol 2008;294:H1365-H1370. (Pubitemid 351468735)
49. Bahde R, Palmes D, Minin E, et al. Bromelain ameliorates hepatic microcirculation after warm ischemia. J Surg Res 2007;139:88-96. (Pubitemid 46482574)
50. Neumayer C, Fugl A, Nanobashvili J, et al. Combined enzymatic and antioxidative treatment reduces ischemia-reperfusion injury in rabbit skeletal muscle. J Surg Res 2006;133:150-158. (Pubitemid 43765754)
51. Nieper HA. Effect of bromelain on coronary heart disease and angina pectoris. Acta Med Empirica 1978;5:274-278.
52. Taussig SJ, Nieper HA. Bromelain: its use in prevention and treatment of cardiovascular disease, present status. J IAPM 1979;6:139-151.
53. Nieper HA. Decrease of the incidence of coronary heart infarct by Mg- and K-orotate and bromelain. Acta Med Empirica 1977;12:614-618.
54. Seligman B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology 1969;20:22-26.
55. Knill-Jones RP, Pearce H, Batten J, et al. Comparative trial of Nutrizym in chronic pancreatic insufficiency. Brit Med J 1970;4:21-24.
56. Balakrishnan V, Hareendran A, Sukumaran NC. Double-blind cross-over trial of an enzyme preparation in pancreatic steatorrhea. J Assn Phys Ind 1981;29:207-209.
57. Glade MJ, Kendra D, Kaminski MV Jr. Improvement in protein utilization in nursing-home patients on tube feeding supplemented with an enzyme product derived from Aspergillus niger and bromelain. Nutrition 2001;17:348-350. (Pubitemid 32454990)
58. Pellicano R, Strona S, Simondi D, et al. Benefit of dietary integrators for treating functional dyspepsia: a prospective pilot study. Minerva Gastroenterol Dietol 2009;55:227-235.
59. Hale LP, Greer PK, Trinh CT, Gottfried MR. Treatment with oral bromelain decreases colonic inflammation in the IL-10-deficient murine model of inflammatory bowel disease. Clin Immunol 2005;116:135-142. (Pubitemid 40910239)
60. Onken JE, Greer PK, Calingaert B, Hale LP. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clin Immunol 2008;126:345-352.
61. Kane S, Goldberg MJ. Use of bromelain for mild ulcerative colitis. Ann Intern Med 2000;132:680. (Pubitemid 30217572)
62. Baumhackl U, Kappos L, Radue EW, et al. A randomized, double-blind, placebo-controlled study of oral hydrolytic enzymes in relapsing multiple sclerosis. Mult Scler 2005;11:166-168. (Pubitemid 40403254)
63. Aiyegbusi AI, Duru FI, Anunobi CC, et al. Bromelain in the early phase of healing in acute crush Achilles tendon injury. Phytother Res 2010 Jul 7. [Epub ahead of print]
64. Blonstein JL. Control of swelling in boxing injuries. Practitioner 1960;185:78.
65. Masson M. Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice. Fortschr Med 1995;113:303-306.
66. Kerkhoffs GM, Struijs PA, de Wit C, et al. A double blind, randomised, parallel group study on the efficacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med 2004;38:431-435. (Pubitemid 39044023)
67. Szczurko O, Cooley K, Mills EJ, et al. Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers: a randomized controlled trial. Arthritis Rheum 2009;61:1037-1045.
68. Buford TW, Cooke MB, Redd LL, et al. Protease supplementation improves muscle function after eccentric exercise. Med Sci Sports Exerc 2009 Sep 2. [Epub ahead of print]
69. Miller PC, Bailey SP, Barnes ME, et al. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. J Sports Sci 2004;22:365-372. (Pubitemid 38461141)
70. Stone MB, Merrick MA, Ingersoll CD, Edwards JE. Preliminary comparison of bromelain and ibuprofen for delayed onset musde soreness management. Clin J Sport Med 2002;12:373-378. (Pubitemid 35477437)
71. Walker AF, Bundy R, Hicks SM, Middleton RW. Bromelain reduces mild acute knee pain and improves well being in a dose dependant fashion in an open study of otherwise healthy adults. Phytomedicine 2002;9:681-686 (Pubitemid 36152125)
72. Akhtar NM, Naseer R, Farooqi AZ, et al. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee - a double-blind prospective randomized study. Clin Rheumatol 2004;23:410-415. (Pubitemid 39386436)
73. Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol 2006;24:25-30.
74. Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM 2006;99:841-850. (Pubitemid 46024095)
75. Shoskes DA, Zeidin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999;54:960-963.
76. Sebeková K, Dämmrich J, Krivosíková Z, Heidland A. The effect of oral protease administration in the rat remnant kidney model. Res Exp Med (Berl) 1999;199:177-188. (Pubitemid 30077031)
77. Secor ER, Carson WF, Singh A, et al. Oral bromelain attenuates inflammation in an ovalbumin-induced murine model of asthma. Evid Based Complement Alternat Med 2008;5:61-69. (Pubitemid 351301948)
78. Secor ER, Carson WF, Cloutier MM, et al. Bromelain exerts anti-inflammatory effects in an ovalbumin-induced murine model of allergic airway disease. Cell Immunol 2005;237:68-75. (Pubitemid 41821083)
79. Taub SJ. The use of ananase in sinusitis: a study of 60 patients. Eye Ear Nose Throat Mon 1966;45:96.98.
80. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon 1967;46:1281-1288.
81. Braun JM, Schneider B, Beuth HJ. Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. In Vivo 2005;19:417-421.
82. Rovenská E, Svík K, Stancíková M, Rovenský J. Inhibitory effect of enzyme therapy and combination therapy with cyclosporin A on collagen-induced arthritis. Clin Exp Rheumatol 2001;19:303-309. (Pubitemid 32529824)
83. Rovenska E, Svík K, Stancíková M, Rovenský J. Enzyme and combination therapy with cyclosporin A in the rat developing adjuvant arthritis. Int J Tissue React 1999;21:105-111. (Pubitemid 30186541)
84. Cohen A, Goldman J. Bromelains therapy in rheumatoid arthritis. Penn Med J 1964;67:27-30.
85. Klein G, Kullich W. Reducing pain by oral enzyme therapy in rheumatic diseases. Wien Med Wochenschr 1999;149:577-580. [Article in German] (Pubitemid 30030079)
86. Inoue K, Motonaga A, Nishimura T, et al. Mechanism of anti-inflammatory action of etodolac. Arzneimittelforschung 1991;41:235-239.
87. Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant proteolytic enzyme for the control of inflammation and pain. J Dent Med 1964;19:73-77.
88. Tassman GC, Zafran JN, Zayon GM. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20:51-54.
89. Seltzer AP Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain). EENT Monthly 1962;41:813-817.
90. Howat RCL, Lewis GD. The effect of bromelain therapy on episiotomy wounds - a double blind controlled clinical trial. J Obstet Gynaecol Br Commonwealth 1972;79:951-953.
91. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol 1967;29:275-278.
92. Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci 2001;58:1234-1245. (Pubitemid 32850918)
93. Rowan AD, Christopher CW, Kelley SF, et al. Debridement of experimental full-thickness skin burns of rats with enzyme fractions derived from pineapple stem. Burns 1990;16:243-246. (Pubitemid 20267490)
94. Gurfinkel R, Lavon I, Cagnano E, et al. Combined ultrasonic and enzymatic debridement of necrotic eschars in an animal model. J Burn Care Res 2009;3:505-513.
95. Krieger Y, Rosenberg L, Lapid O, et al. Escharotomy using an enzymatic debridement agent for treating experimental burn-induced compartment syndrome in an animal model. J Trauma 2005;58:1259-1264. (Pubitemid 41020115)
96. Singer AJ, McClain SA, Taira BR, et al. Rapid and selective enzymatic debridement of porcine comb burns with bromelain-derived Debrase: acute-phase preservation of noninjured tissue and zone of stasis. J Burn Care Res 2010;31:304-309.
97. Koller J, Bukovcan P, Orság M, et al. Enzymatic necrolysis of acute deep burns - report of preliminary results with 22 patients. Acta Chir Plast 2008;50:109-114.
98. Levensen S. Supportive therapy in burn care. Debriding agents. J Trauma 1979;19:8-30.
99. Rosenberg L, Lapid O, Bogdanov-Berezovsky A, et al. Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report. Burns 2004;30:843-850. (Pubitemid 39536054)
100. Ahle NW, Hamlet MP. Enzymatic frostbite eschar debridement by bromelain. Ann Emerg Med 1987;16:1063-1065. (Pubitemid 17122210)
101. Taussig SJ, Yokoyama MM, Chinen N, et al. Bromelain: a proteolytic enzyme and its clinical application. Hiroshima J Med Sci 1975;24:185-193.
102. Gutfreund A, Taussig S, Morris A. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients. Hawaii Med J 1978;37:143-146. (Pubitemid 8376301)
103. Hale LP. Proteolytic activity and immunogenicity of oral bromelain within the gastrointestinal tract of mice. Jnt Immunopharmacol 2004;4:255-264. (Pubitemid 38296354)
104. Hale LP, Fitzhugh DJ, Staats HF. Oral immunogenicity of the plant proteinase bromelain. Int Immunopharmacol 2006;6:2038-2046. (Pubitemid 44855702)
105. Gailhofer G, Wilders-Truschnig M, Smolle J, Ludvan M. Asthma caused by bromelain: an occupational allergy. Clin Allergy 1988;18:445-450.