Pineapple enzyme Bromelain and its medicinal properties

WHAT IS BROMELAIN?

Bromelain is basically an enzyme that is present in fresh pineapples. This fruit is native to tropical and subtropical countries like Philippines, Thailand, Indonesia, Malaysia, Kenya, India, and China. Although it is present in all of its parts, Bromelain is usually obtained from the stems of the pineapples. The enzyme performs the function of proteolysis, that is, protein breakdown.  Bromelain has been used since the late 1800s as a medicinal supplement due to its myriad of beneficial properties. A lot of data exists to support the advantageous role of Bromelain extracts in medicine, especially its fibrinolytic, anti-edematous, antithrombotic, and anti-inflammatory effects that make it a valuable remedy for a variety of diseases. Presently, Bromelain is extracted from the pineapple by means of centrifugation, ultrafiltration, and lyophilization techniques.

COMPOSITION

The fruit and stem Bromelain extracts are different in composition as they are composed of two different proteolytic enzymes (containing sulfhydryl groups) and several other minor constituents. “Bromelain” usually refers to the stem Bromelain. It consists of several thiol endopeptidases, phosphatase, glucosidase, peroxidase, cellulase, escharase, and protease inhibitors. 

DOSAGE INFORMATION

Most of the Bromelain products contain 2000 MCU (milk clotting units) per gram. The daily dose of Bromelain, as recommended by the doctors, is 3,000 MCU, thrice daily for a few days and then reduction of its amount to 2000MCU at a twice daily basis. The maximal potency level of Bromelain has not been established as yet.

USES OF BROMELAIN

The anti-cancer potential of Bromelain comes from its property to induce apoptotic cell death in the rapidly growing cancerous cells. It is also due to its ability to alter the key pathways that lead to malignancy. Also, it reduces the concentration of substances that mediate the survival of cancerous cells. In a study carried out on mice, Bromelain was observed to cause apoptosis in Papilloma (a skin tumor) and reduced the tumor development and tumor volume (Beez et al; 2007). Another study carried out on glioblastoma revealed its ability to attenuate the invasiveness associated with cancer cells (Tysnes et al.; 2001). It also checks the cancerous growth by inhibiting the cyclooxygenase pathway that leads to formation of prostaglandin E2 from arachidonic acid that is responsible for angiogenesis (Hussain S.P.; 2007). Bromelain has marked in vivo cytotoxic potential against P-388 leukemia, sarcoma, Ehrlich ascetic tumour, Lewis lung carcinoma, and ADC-755 mammary adenocarcinoma. (Beez et al; 2007)

Owing to its fibrinolytic and thrombolytic properties, it can cause the breakdown of the plaque and is beneficial in preventing angina pectoris and transient ischemic attacks (TIA) and other cardiovascular disorders. The full range of ischemic cardiac disorders that can be prevented with Bromelain include stable and unstable angina and coronary heart diseases. (Pavan et al., 2012). This is mainly because it prevents the blockage of the blood vessels supplying the heart by preventing the formation of thrombi. It may also do so by preventing the ischemic-reperfusion injury in the cardiac myocytes (Juhasz et al.; 2008).

It can also be administered for relieving the symptoms of diabetes, hypertension and hypercholesterolemia (King et al.; 2009).

Its anti-coagulant and thrombolytic action makes it quite useful for the treatment and prevention of thromboembolism. This property makes it an effective remedy for diseases like Deep Venous Thrombosis (DVT), Portal Vein Thrombosis, Pulmonary embolism, cardiac embolism etc. The anti-coagulant property leads to prolongation of the prothrombin time (PT) and activated partial thromboplastin time (APTT). It does so by inhibiting the formation of fibrin from fibrinogen and by enhancing the fibrinolytic activity.

It is used in the prevention of ischemia/reperfusion injury in skeletal muscles. 

It helps in the treatment of asthma by causing thinning of mucus. Mucus production and viscosity is increased during asthma. Another recent research suggests that Bromelain also relives asthma symptoms by causing the modifications in the CD4+ and CD8+ T lymphocyte cell populations thus reducing the allergic symptoms (Secor Jr. et al.; 2005).

Topical preparations of Bromelain are used for the debridement of necrotic tissues and to speed up the healing process in wounds. It is especially beneficial in healing burns. One study revealed these effects to be due to increased delivery of oxygen to the wounds by Bromelain and due to attenuation in the levels of Tumor Necrosis Factor, TNF (Wu,S.Y. et al.; 2012).

The anti-inflammatory and analgesic characteristics of Bromelain make it quite useful in postoperative healing.   

By neutralizing the endotoxins of certain alimentary tract pathogens like Vibrio cholera and Escherichia coli, Bromelain prevents diarrhea. It may do so by interfering with the signaling pathways (Mynott et al.; 1997) or by inhibiting the adhesive property of the endotoxin (Chandler et al.; 1998). 

It is used as an adjuvant therapy in the treatment of Rheumatoid Arthritis (RA) which is partly due to its anti-inflammatory and partly due to its immune modulation effects (Secor Jr et al.; 2009). 

It is extremely beneficial for relieving pain and inflammation associated with osteoarthritis (OA). In a study, 103 individuals were given Bromelain and its effects were compared to that of diclofenac. After the 6 week period, their effects were found to be equal (Akhtar et al.; 2004). It has been deemed as an effective alternative to the use of NSAIDs in the treatment of OA. The analgesic effect of Bromelain is thought to be due to its ability to modulate the levels of Bradykinin, a pain mediator.

SIDE EFFECTS

Allergic reactions may develop in people who are allergic to pineapple constituents.

In people with pre-existing gastric or duodenal ulcers, Bromelain extracts may lead to exacerbation of the condition.

DRUG INTERACTIONS

In patients who are on warfarin therapy, Bromelain should be avoided as both of them have an additive effect that can lead to excessive anti-coagulation.

BOTTOM LINE

Further researches are being carried out to discover the full oncologic potential and other uses of Bromelain and also to fully understand the mechanisms by which Bromelain exerts its many effects. No teratogenic and fetotoxic effects of Bromelain have been discovered as yet and it has been rendered completely safe for use during pregnancy. Being natural in composition, extremely beneficial and due to its minimal side effects, the use of Bromelain is steadily increasing.  

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