Classically, the Bromelain used in the world of nutritional supplementation is extracted from the stem of this fruit.
In addition to the digestive effects, evidently related to the proteolytic activity of these enzymes, Bromelain is also known for numerous other systemic effects.
The anti-inflammatory, antioxidant, anti-edema, antithrombotic, anticoagulant and immunomodulating activities of Bromelain are today the most used in the clinical and preventive field.
For this reason, in addition to its use in sports, Bromelain would be useful in the course of rhinitis, phlebitis, rheumatoid arthritis and other inflammatory pathologies, cellulite, varicose veins and pathologies on an oxidative or inflammatory basis.
The aforementioned biological effects would be attributable to the ability of Bromelain to modulate the gene expression of factors involved in the activation and maintenance of inflammatory and oxidative processes.
Among the registered medicinal specialties based on Bromelain, Ananase ® and Nexobrid ® are mentioned.
) and indirect trauma (contractures, strains and tears).It is important to note that the demonstrated pain-reducing effect is most likely due to Bromelain's ability to reduce tissue inflammation and edema, rather than a direct analgesic effect.
The best known study dates back to 1960 and concerns boxing:
- 58 out of 74 boxers treated with Bromelain reported that the bruising had disappeared within 4-5 days; in the remaining 16, the disappearance had occurred in 8-10 days.
Bromelain also appears to be effective in improving muscle function after intense physical activity.
Bromelain and Respiratory Disorders
Bromelain is a good mucolytic, useful in respiratory tract disorders; in particular, it has proved to be an excellent decongestant of the mucous membranes in case of acute catarrhal inflammation.
- Patients examined with a spirometer to determine respiratory function before and after treatment with Bromelain showed an increase in lung capacity and function. These effects, consequent to the improvement of respiratory congestion, are due to the ability of Bromelain to thin and reduce bronchial secretions.
Promising results were obtained in an experimental model of acute allergic asthma induced by ovalbumin.
Acute sinusitis also responds to bromelain therapy.
- The efficacy of Bromelain in children with sinusitis was evaluated in a clinical study. 116 children (aged less than 11 years) were enrolled, partly treated with bromelain alone, partly treated with bromelain combined with standard therapy for this. disease, and partly treated with standard therapy alone. The evaluation parameter was the duration of symptoms. It was seen that Bromelain alone led to the disappearance of symptoms after about 6 days compared to 7-8 days in patients treated with standard therapy and compared to 9 days in patients treated with bromelain combined with standard therapy.
One patient developed a Bromelain allergy and dropped out of the study. No other adverse effects were recorded.
Bromelain and Thrombophlebitis
Oral administration of Bromelain is effective on Thrombophlebitis.
- In a double-blind study conducted on 73 patients with acute thrombophlebitis, bromelain, combined with analgesics, was shown to reduce symptoms of inflammation, such as pain, edema, redness, elevated skin temperature and difficulty in movement.
In this and other studies, the mean daily dose ranged from 60 to 160 mg of 1,200 mcu Bromelian.
According to some authors, doses of 400 to 800 mg would be necessary to obtain consistent results in patients suffering from thrombophlebitis and, more generally, in all the clinical applications mentioned.
Bromelain and varicose veins
Varicose veins (or varices) are dilations of the leg veins, characterized by a reduced fibrinolytic activity following a reduced level of the plasminogen activator: this can lead to the deposition of fibrin causing hardening and prominences in the surrounding tissues.
Bromelain acts in a similar way to the plasminogen activator by causing fibrin to break down.
Bromelain should be used before and after varicose vein surgery.
- In a study that looked at a series of 180 varicose vein operations, Bromelain was given to 90 patients
- at doses of 40 mg four times a day, from the first to the third postoperative day,
- at a dose of 20 mg four times a day from the fourth to the seventh day
Bromelain and dysmenorrhea
Bromelain and papain have been used successfully in the treatment of dysmenorrhea (painful menstruation).
Bromelain is thought to be a smooth muscle relaxant, as there was a reduction in spasms of the contracted cervix in treated patients.
Bromelain and antitumor activity
Bromelain can potentiate standard chemotherapy treatment.
- In a study conducted in Germany, oral administration of bromelain, sometimes given with sub-acute doses of chemotherapy drugs, such as 5-fluorouracil and vincristine, induced tumor regression. It has also been shown that doses of less than 100 mg per day of Bromelain are inactive; it seems that doses up to 2.4 g / day are needed to have optimal effects and that the most effective preparations are those that are not gastro-resistant. According to some authors, the therapeutic effect is due to the ability of Bromelain to "deconstruct" the fibrin barrier of tumor cells, facilitating the intervention of the immune system.
- In a study conducted in France, 12 patients with different types of cancer were treated with 600mg per day of Bromelain for periods from six months to several years: in women with tumors in the ovaries and breast the tumor masses regressed compared to patients. treated with standard therapy.
These results, confirmed by studies conducted at the Cancer Research Center (University of Honolulu), suggest that bromelain - in addition to increasing the effectiveness of chemotherapy - could also exert a direct antitumor activity.
Bromelain and Antibiotic Activity
Bromelain appears to exert antibiotic effects; in fact it has proved effective in the treatment of various infectious processes, such as pneumonia, perirectal abscesses, pyelonephritis, staphylococcal skin infections.
Bromelain and cellulite and overweight
The stem of the pineapple is traditionally used in the treatment of cellulite.
Generally, when we talk about cellulite we think of a "simple" skin blemish, ignoring the underlying inflammatory process that leads to the stagnation of liquids in the interstitial spaces; this phenomenon - associated with the deposition of fats in the subcutaneous tissue - causes the morphological alterations characteristic of cellulite (orange peel skin and painful cellulite nodules).
As we know, cellulite manifests itself in various ways, in various parts of the body and for multiple causes; we also know that Bromelain - by stimulating diuresis, restoring cell trophism and normalizing the structure of skin and subcutaneous tissue - can help in the prevention and treatment of cellulite.
Precisely for these reasons, Bromelain is recommended for obese or overweight subjects, especially when water retention is the cause of the increase in body weight.
Bromelain, wounds and burns
It has been shown that the treatment with Bromelain, in addition to a thorough cleaning of the lesion, also promotes the reduction of pain in wounds and burns in humans.
- In a study conducted on 130 patients with second and third stage burns, a preparation containing Bromelain was applied for 4 hours in occlusion by means of a patch. The percentage of necrotic tissue removal - which could compromise wound healing - was 89% after each single application, 77% after two applications and 62% after the third.
Other clinical applications
Bromelain has shown excellent results in chronic lichenoid pityriasis.
Lichenoid Pityriasis is not a frequent disease (one case in 1,000-1,500 patients) and often affects the "pediatric age. It is a dermatitis that is not easily codified due to its often different clinical aspects, for the very variable duration (from a few weeks to a few year) and for the unpredictable trend.
The lesion starts from a small hard purpuric papule, which evolves by widening, flattening and becoming darker; finally, above it, a scaly-crust appears; the lesions are almost asymptomatic and generally not itchy. The etiology of the disease is obscure.
As for treatment, attempts have been made with oral tetracyclines and erythromycin, but have yielded inconsistent results; the application of local cortisone is generally not very effective.
- The efficacy of oral bromelain was evaluated in eight patients with chronic pityriasis lichenoid in a small clinical trial. Complete clinical resolution occurred after three months of treatment.
Bromelain seems to exert a cardioprotective effect but the data is still only experimental.
The research project on the applicative potential of Bromelain in the case of autistic syndrome is particularly interesting.
, vomiting, cramping abdominal pain and diarrhea.
More rarely, metrorrhagia and menorrhagia have been observed.
such as Warfarin, rather than antithrombotic agents such as aspirin, could enhance the pharmacological activity of these active ingredients.
Likewise, Bromelain could increase the serum half-life and thus the concentrations of antibiotics such as Amoxicillin and Tetracyclines.
It is therefore recommended to avoid the simultaneous use of these active ingredients and Bromelain.
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