By Dr. Rita Fabbri
The pharmacological activity of the Pineapple is linked to the Bromelain contained above all in the stem; proteolytic, anti-inflammatory soft tissue, analgesic, anti-edematous and fibrinolytic properties are attributed to this substance; Bromelain also has mucolytic, immunomodulating and gastroprotective activity; moreover it seems able to relax the smooth muscles; it is capable of draining liquids and for this reason it is included in over-the-counter slimming products.
For topical use it is used in the treatment of ulcers and burns.
In supplements formulated for dyspepsia, Bromelain is often associated with other proteolytic enzymes (such as trypsin and papain).
Thanks to its proteolytic activity, Bromelain is also used in the food industry in order to soften canned meat.
Pineapple contains organic acids (citric, malic and oxalic acids) which give the fruit a diuretic action.
Bromelain comprises a group of sulfhydric proteolytic (or proteinase) enzymes. The Bromelin contained in the pineapple stem is a mixture of at least 8 proteinases and small amounts of non-proteolytic enzymes. In the stem, there are also two cysteine proteinases, comosain and ananaine, enzymatically related to bromelain.
Bromelain is unstable to heat, so its pharmacological activity can be reduced by inappropriate treatments or poor storage.
Being sulfhydric proteinases (such as papain and ficin), the bromeline extracted from the stem of the pineapple or from the fruit are inactivated by oxidizing agents (such as hydrogen peroxide or methyl bromide) and by certain metal ions (for example lead, copper and iron) . Human serum also inhibits the digestive activity of Bromelain; Magnesium and cysteine, on the other hand, are activators of Bromelain on the market.
As an enzyme, the concentration of Bromelain is expressed in enzyme units, which indicate the ability of the enzyme to digest a certain amount of protein.
The Food Chemistry Codex (FCC) officially recognizes MCUs as enzyme units (milk clotting units). Even the gdu (gelatin digesting units) are accepted and are equivalent to MCUs.
By varying the mcu, the activity of Bromelain varies; therefore it is not easy to establish a priori what the effective dosage can be. Normally, Bromelain has an activity between 1200 and 1800 mcu and the typical dosages oscillate between 250-500 mg three times per day away from meals (6-7).
Very high doses of Bromelain (around 2 g) were administered without side effects (LD 50> 10g / kg of body weight); even long-term use appears to be well tolerated.
Bromelain can be administered orally, parenterally or by intravenous infusion and it has been established that up to 40% of bromelain administered orally can be absorbed as such (9-11).
Bromelain has been known chemically since 1876, but only in 1957 was it introduced as a therapeutic substance; Since then, numerous scientific studies on its therapeutic applications have been published. The most significant are listed below.
Digestive activity
Bromelain is very effective in dyspepsia due to gastric and pancreatic enzyme deficiency, it can in fact be considered an excellent substitute for trypsin or pepsin (12-13). Bromelain is active both in an acidic environment - therefore at the gastric level - and in a neutral environment, therefore in the enteric district.
- In a double-blind study, administration of Bromelain together with pancreatin and bovine bile was found to be effective in the treatment of patients with pancreatic insufficiency.
For this digestive activity, pineapple can also be taken after large meals; in fact, Bromelain is able to mitigate the symptoms of gastric disorders or heartburn, particularly when used in association with other enzymes such as amylases and lipases.
Anti-inflammatory and anti-edematous activity
Bromelain is indicated in all cases of inflammation and / or edema of the soft tissues.
The anti-inflammatory effect may be due to the proteolytic activity of Bromelain on the site
inflammation, a hypothesis to be confirmed also because the proteolytic action is inhibited by factors present in the serum. Much more probably Bromelain, by interaction with lipoxygenase, determines an increase in the formation of plasmin, which has fibrinolytic activity, that is, it is capable of breaking down fibrin, preventing or reducing the formation of localized edema; plasmin also reduces the synthesis of pro-inflammatory prostaglandins and stimulates the formation of prostaglandin E1, an inhibitory factor of inflammation (15-18).
Bromelain has also been shown to reduce plasma levels of kininogen, thus inhibiting the formation of kinins (19-20): kinins generate vasoactive peptides, thus causing inflammation, edema and pain.
All these factors contribute to an improvement in circulation, in cellular metabolism, in skin trophism and in the reabsorption of edema, exudates, hematomas, necrotic substances and inflammatory agents.
The anti-inflammatory activity of Bromelain is certainly the most significant, also because it intervenes on many aspects of inflammation; it is confirmed in various experimental models (such as edema induced by albumin or carrageenan) and finds various clinical applications in man. The most important are listed below.
Arthritis
Bromelain can be useful in both rheumatoid arthritis and osteoarthritis. In particular in rheumatoid arthritis it has allowed the reduction of the use of corticosteroids (such as prednisone).
- In one study, Bromelain was administered to some patients: 25 with severe rheumatoid arthritis, 1 with rheumatoid arthritis and osteoarthritis, 2 with osteoarthritis, 1 with gout and joint edema. Corticosteroid doses were reduced to minimal maintenance doses with concomitant administration of gastro-resistant bromelain (20-40 mg three or four times a day). A significant reduction in joint edema and an increase in joint motility were noted in most patients shortly after starting treatment. In the observation period from 3 weeks to 13 months, 8 out of 29 patients (28%) found excellent effects, 13 (45%) good, 4 (14%) fair and 4 (14%) poor, as in the patient's case. with gout.
In a clinical study, the effect of Bromelain in patients with osteoarthritis of the knee was evaluated with the result that it was not effective. Perhaps better results could have been obtained by administering Bromelain in a non-gastro-resistant form.
Surgical interventions
Bromelain administered orally has given positive results in reducing edema, ecchymoses, healing time and post-operative pain. In particular, in the case of interventions at the oral cavity, a treatment with Bromelain is recommended before and after the surgery.
- In a double-blind study in patients undergoing oral surgery, the effect of Bromelain was found to be significantly greater than that of placebo. Edema was reduced in 3/4 days with Bromelain compared to 7 days with placebo; pain duration was 5 days in the bromelain group compared to 8 days in the placebo group.
Similar observations have been confirmed in case studies of episiotomy (surgical incision of the perineum, lateral to the vagina, during childbirth): Bromelain reduces edema, inflammation, pain and administration before surgery enhances its effects. (26-27).
In a double-blind study, Bromelain promoted the reduction of edema and bruising in patients undergoing rhinoplasty surgery.
Other articles on "Pineapple and Bromelain - Therapeutic Indications"
- Pineapple
- Bromelain - Therapeutic indications
- Pineapple: Contraindications and Bibliography
