Abstract
- Background
Bromelain represents a well-characterized group of crude, naturally occurring protein-digesting proteolytic enzymes commercially isolated from the fruit or stem tissues of the pineapple plant (Ananas comosus). While both fruit bromelain and stem bromelain are derived from the same botanical source, they are prepared through distinct extraction methodologies and possess uniquely differing enzymatic compositions. In scientific and clinical literature, the designation "bromelain" predominantly refers to stem bromelain. Chemically, it is a complex, multi-component biological mixture comprising diverse thiol endopeptidases alongside various non-enzymatic constituents, such as phosphatases, glucosidases, peroxidases, cellulases, escharase, and multiple endogenous protease inhibitors. This comprehensive review aims to evaluate the biochemical properties, systemic absorption profiles, pharmacological mechanisms, and broad therapeutic applications of bromelain in clinical medicine.
- Methods
A structured literature evaluation was performed across major scientific databases—including PubMed, Scopus, Web of Science, and Embase—focusing on peer-reviewed pharmacological studies, biochemical analyses, in vitro and in vivo animal investigations, and human clinical trials evaluating oral and topical bromelain preparations. Data extraction prioritized examining enzyme mechanisms, pharmacokinetic absorption metrics, clinical efficacy endpoints in inflammatory, cardiovascular, and oncological conditions, and overall safety and toxicity profiles.
- Results
Biochemical and pharmacological evaluations confirm that bromelain exerts substantial therapeutic benefits across a wide spectrum of medical domains, driven by its unique ability to be absorbed intact into the human body without losing proteolytic activity and without inducing major adverse side effects:
Anti-Inflammatory & Analgesic Efficacy: Bromelain significantly modulates inflammatory cascades, reduces swelling, and effectively alleviates symptoms associated with surgical trauma, sinusitis, bronchitis, and osteoarthritis.
Cardiovascular & Fibrinolytic Actions: Preclinical and clinical studies demonstrate that bromelain exhibits robust fibrinolytic, antithrombotic, and anti-edematous properties, contributing to the management of cardiovascular disorders, angina pectoris, and thrombophlebitis.
Wound Debridement & Drug Enhancement: Topical applications facilitate effective eschar and wound debridement, while oral co-administration significantly enhances the systemic absorption and bioavailability of co-administered therapeutic drugs, particularly antibiotics.
Oncological Potential & Gastrointestinal Support: Emerging evidence indicates that bromelain possesses notable anticancer activities, actively promoting apoptotic cell death in various malignant cell lines, alongside supporting digestive health and alleviating diarrhea. The reviewed studies consistently highlight bromelain's exceptional safety profile and high tolerability.
- Conclusions
Bromelain is a versatile, naturally derived enzyme complex possessing scientifically validated anti-inflammatory, fibrinolytic, antithrombotic, and anticancer properties. Its significant absorbability and multi-targeted mode of action underscore its considerable therapeutic utility in modern clinical practice, warranting further large-scale clinical investigations to optimize its evidence-based applications.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3529416/