The Anti-Inflammatory Benefits of Bromelain

The digestive enzyme commonly known as Bromelain is derived from pineapples and is used for many different health reasons that one would never suspect from a digestive enzyme. This extract that is derived from pineapples is an excellent therapeutic enzyme that closely resembles proteinases with many anti-inflammatory abilities present. Bromelain has earned growing acceptance and compliance among patients as a phytotherapeutical drug. A wide range of therapeutic benefits has been claimed for bromelain, such as reversible inhibition of platelet aggregation, angina pectoris, bronchitis, sinusitis, surgical traumas, thrombophlebitis, pyelonephritis and enhanced absorption of drugs, particularly of antibiotics. There is also much promise with bromelain from pineapples and its potential to fight tumors.

Bromelain acts as an immunomodulator by raising the impaired immunocytotoxicity of monocytes against tumor cells from patients and by inducing the production of distinct cytokines such as tumor necrosis factor-a, interleukin (Il)-1beta, Il-6, and Il-8. In a recent clinical study with mammary tumor patients, these findings could be partially confirmed. Especially promising are reports on animal experiments claiming an antimetastatic efficacy and inhibition of metastasis-associated platelet aggregation as well as inhibition of growth and invasiveness of tumor cells. In addition to fighting and preventing tumors, bromelain has also shown much promise with treating osteoarthritis.

Bromelain is a food supplement that may provide an alternative treatment to NSAIDs for patients with osteoarthritis. Bromelain is a crude, aqueous extract obtained from both the stem and fruit of the pineapple plant, which contains a number of proteolytic enzymes (10,11) and has shown potentially beneficial effects due to its anti-inflammatory and analgesic properties. Currently, bromelain is used for acute inflammation and sports injuries. It is not a licensed medical product and is freely available to the general public in health food stores and pharmacies in the USA and Europe.

Experimental evidence suggests that bromelain’s action as an anti-inflammatory is mediated via the following factors: (i) by increasing serum fibrinolytic activity (13), reducing plasma fibrinogen levels (14) and decreasing bradykinin levels (which results in reduced vascular permeability) and hence reducing oedema and pain (15); (ii) by mediating prostaglandin levels (by decreasing levels of PGE₂ and thromboxane A₂); and (iii) through modulation of certain immune cell surface adhesion molecules (16–20), which play a role in the pathogenesis of arthritis (21). However, many of these studies are of poor quality and further data is needed to clarify definitive mechanisms of its action

In regard to clinical studies Bromelain was first reported to be of value as an analgesic/anti-inflammatory for use in both rheumatoid arthritis and osteoarthritic patients in 1964 (24). Clinical trials have assessed the effectiveness of bromelain most frequently using preparations containing differing complexes of proteolytic enzymes and differing concentrations of bromelain. Three complexes have been used: (i) Phlogenzyme^TM (PHL), which contains the proteolytic enzymes bromelain (90 mg/tab), trypsin and rutin; (ii) Wobenzyme^TM (WOB) which contains bromelain (45 mg/tab), papain, trypsin, chymotrypsin, pancreatin, lipase and amylase; and (iii) Wobenzym N^TM (WOB-N) which contains bromelain (45 mg/tab), trypsin, papain, chymotrypsin, pancreatin and rutin. Bromelain has been assessed in the treatment of osteoarthritis of two joints, i.e. the knee (24–30) and the shoulder (as assessed under the global term periarthritis humeroscapularis) (31,32). Tables 1 and ​and22 summarise those studies that have investigated the effect of bromelain in knee and shoulder osteoarthritis.

The common dosage for Bromelain has been recommended between 200-2000 mg per day. The most therapeutic has been reported at 160mg per day. Higher amounts have been used depending upon tolerability of patients as well as the stages of osteoarthritis. In essence the dosage needed really depends upon the chronic conditions of the patient taking the enzyme.

Resources:

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2. Aichele K, Bubel M, Deubel G, Pohlemann T, Oberringer M. Bromelain down-regulates myofibroblast differentiation in an in vitro wound healing assay.Naunyn Schmiedebergs Arch Pharmacol. 2013; 386(10):853-863.
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5. Brien, Sarah et al. “Bromelain as a Treatment for Osteoarthritis: A Review of Clinical Studies.”Evidence-based Complementary and Alternative Medicine 3 (2004): 251–257. PMC. Web. 19 May 2017.
6. R. Maurer. “Bromelain: biochemistry, pharmacology and medical use.” Cell Mol Life Sci.2001 Aug; 58(9): 1234–1245.