For Patients & Caregivers
How It Works
Bromelain has anti-inflammatory properties but it has not been shown to treat or prevent cancer.
Bromelain, obtained from the stem of the pineapple, is an enzyme that breaks down protein molecules. In laboratory experiments, bromelain prevented several steps of blood clotting and decreased some substances that cause inflammation. Bromelain increases the absorption of antibiotics and when used topically, helps remove dead and damaged tissue from burns. Bromelain can help digestion and absorption in patients with digestive tract cancers. Anticancer activity has not been studied in humans.
To treat arthritis
Laboratory studies show that bromelain reduces the levels of some substances that cause inflammation, but results from clinical trials are mixed.
To treat burns of the skin
Studies support this use.
To prevent and treat cancer
Laboratory studies suggested bromelain has anticancer activities. But these effects have not been confirmed in humans.
To treat circulatory disorders
Laboratory studies show that bromelain can prevent the formation of blood clots, but there is no proof from clinical trials that it can treat circulatory disorders.
To reduce swelling
Small clinical studies show that bromelain helps reduce swelling.
Do Not Take If
For Healthcare Professionals
An enzyme obtained from the stem of pineapple, bromelain is a proteolytic enzyme, and has a wide range of applications. Preclinical data show that it has anti-inflammatory (15) (16) properties, reduces serum fibrinogen levels, supports fibrinolysis and has also been investigated for its debriding effects on burn wounds (1). A review of clinical findings reported safety and effectiveness of a bromelain based product for burn debridement (28). Small studies also suggest it may be useful for treating skin conditions such as pityriasis lichenoides chronica (PLC) (2); for reducing mild, acute knee pain (3); and for alleviating post-operative pain and swelling (27) (29) (30). But data on bromelain’s pain relieving effects in arthritic patients are mixed (4) (5) (6). A randomized study did not find any benefit in reducing fibrinogen or in influencing other risk factors of cardiovascular disease (31).
Bromelain has been investigated for its anticancer potential as well. It was shown to have chemopreventive (19) (25) and antitumorigenic effects (20) (26), and increased the survival indices of animals bearing leukemia, sarcoma, lung, breast, and ascetic tumors (10). It may be useful as an adjuvant in cancer treatments (7) (8) (9).
Mechanism of Action
Proteolytic removal of cell surface molecules by bromelain may account for some of its activities. Studies show that it prevents platelet aggregation and adhesion of platelets to blood vessel endothelial cells, as well as improving ischemia-reperfusion injury (13). It can act as an anti-inflammatory agent by reducing levels of prostaglandin E2 and thromboxane A2 (9). In addition, bromelain inhibits neutrophil migration in response to IL-8 during inflammation (14) and decreases pro-inflammatory chemokine and cytokine secretion (15) (16). Topical application of bromelain may be used for the skin debridement of burns (1).
Oral enzymes such as bromelain have been proposed as additive agents for cancer therapy (8). Proposed mechanisms include down-regulation of the immunosuppressive cytokine, TGF-beta (7), direct inhibition of tumor cell growth, modulation of immune cell function, modulation of cell adhesion molecules (CAMs), and the effects on platelet aggregation and thrombosis mentioned above (8) (9). Experiments with murine models showed that bromelain induced apoptosis-related proteins along with inhibiting NF-kappaB-driven Cox-2 expression by blocking the MAPK and Akt/protein kinase B signaling in DMBA-TPA-induced skin tumors (20). Bromelain also induced the expression of autophagy-related proteins, light chain 3 protein B II (LC3BII), and beclin-1 thereby facilitating apoptosis in mammary carcinoma cells (26).