Bromelain, derived from the pineapple plant, is one of a group of proteolytic enzymes (enzymes capable of digesting protein). Bromelain is the name of a group of powerful protein-digesting, or proteolytic, enzymes that are found in the pineapple plant (Ananas comosus). The pineapple is a tropical fruit native to Central and South America.

Bromelain supplements are promoted as an alternative remedy for various health problems including joint inflammation and cancer. Bromelain is the collective term for enzymes (principally proteolytic enzymes) derived from the ripe and unripe fruit, as well as the stem and leaves, of the pineapple plant, Ananas comosus, a member of the Bromeliaceae family. Commercial bromelain is typically stem bromelain. Bromelain is mainly comprised of cysteine proteases, with smaller amounts of acid phosphatase, peroxidase, amylase and cellulase. Bromelain contains at least four distinct cysteine proteases. The principal stem protease is called stem bromelain or stem bromelain protease. Two additional proteases found in the stem are called ananain and comosain. Fruit bromelain is the name given to the principal protease found in the fruit.

Bromelain is a natural blood thinner because it prevents excessive blood platelet stickiness. This may explain, in part, the positive reports in a few clinical trials of bromelain to decrease symptoms of angina and thrombophlebitis. In addition, bromelain reduces the thickness of mucus, which may benefit patients with asthma or chronic bronchitis. Bromelain helps to inhibit pro-inflammatory compounds, similar to non-steroidal, anti-inflammatory drugs reducing swelling & pain without side effects. And unlike aspirin, bromelain doesn't inhibit the production of prostaglandins which can have undesirable side effects.

It is widely believed that most orally ingested enzymes are destroyed by the digestive juices prior to being absorbed. However, there is evidence that significant amounts of bromelain can be absorbed intact.1 Proteolytic enzymes other than bromelain are often used with people who suffer from malabsorption. Although bromelain in combination with other enzymes and ox bile has been reported to help digest food, it is generally not used for this purpose. However, bromelain does contribute to the digestion of protein, and may therefore be used as a digestive aid. Although many doctors assume that other proteolytic enzymes, such as those found in pancreatin, are more effective than bromelain in helping digestion and absorption, almost no research compares the relative effects of these enzymes.

Bromelain is an anti-inflammatory agent and for this reason is helpful in healing minor injuries, particularly sprains and strains, muscle injuries, and the pain, swelling, and tenderness that accompany sports injuries. Topically applied bromelain in the form of a cream may be beneficial for frostbite, possibly enhancing the rate of healing. and for cleaning debris from burns. These uses of bromelain should be supervised by a doctor. Also as a result of its anti-inflammatory effect, bromelain has been found to dramatically reduce postoperative swelling in controlled human research. Double-blind research has found bromelain effective in reducing swelling, bruising, and pain, for women having minor surgery in conjunction with giving birth (episiotomy). The anti-inflammatory effect of bromelain is the probable reason this enzyme has been found effective for people suffering from sinusitis. Some of the evidence supporting bromelain in the treatment of sinusitis comes from double-blind research.

Bromelain, in combination with trypsin (another enzyme), may enhance the effect of antibiotics in people with a urinary tract infection (UTI). In a double-blind study, 100% of people who received bromelain/trypsin in combination with antibiotics had a resolution of their UTIs, compared to only 46% of those who received antibiotics alone. Due to its anti-inflammatory action, bromelain was reported to help patients with rheumatoid arthritis in preliminary research. In that trial, in which bromelain was given for varying (3-week to 13-month) periods, 73% had good to excellent results.

Bromelain is useful in the treatment of a wide range of conditions, but it is particularly effective in relieving inflammation associated with infection and physical injuries. Studies have shown that bromelain may help in the treatment of the following:

Surgical Procedures and Sports Injuries
Although studies show mixed results, bromelain supplements may reduce swelling, bruising, healing time, and pain following surgery and physical injuries. In fact an authoritative body in Germany called the Commission E (similar to the U.S. Food and Drug Administration) approved the use of bromelain for these purposes.

Wounds and Burns
Some studies of animals indicate that bromelain (applied to the surface of the skin) may be useful in removing dead tissue from third-degree burns (particularly burns that go through all layers of the skin). This application has not yet been tested on people, but traditional and current day practices in Japan, Hawaii and Taiwan include use of topical bromelain to clean wounds and burns. Similarly, some clinicians may recommend this topical agent to reduce swelling from insect bites or stings.

Nasal and Sinus Congestion
Although not all experts agree, bromelain supplements may help suppress cough, reduce nasal mucus associated with sinusitis, and relieve the swelling and inflammation caused by hay fever. Bromelain is approved by the German Commission E for the treatment of sinus and nasal swelling following ear, nose, and throat surgery or trauma.

The protein-digesting enzymes found in bromelain help promote and maintain proper digestion and may relieve symptoms of stomach upset or heartburn, particularly when used in conjunction with other enzymes such as amylase (which digests starch) and lipase (which digests fat). Similarly, an animal study suggests that the antibacterial effects of bromelain may help to control diarrhea caused by bacteria. Studies in people are needed.

Arthritis and other Inflammatory Conditions
Bromelain supplements may be as effective as some commonly used nonsteroidal anti-inflammatory (NSAID) medications (such as ibuprofen and diclofenac) for reducing pain associated with osteoarthritis. Similarly, preliminary studies suggest that bromelain may also help reduce the pain associated with rheumatoid arthritis. Plus, long-standing use of bromelain suggests that this enzyme may be helpful as part of the treatment for other connective tissue disorders including scleroderma (build up of tough scar-like tissue in the skin and, at times, internal organs), bursitis, and tendinitis.

Some scientific evidence from test tubes and animals suggests that bromelain can fight against infectious agents such as viruses and bacteria. Therefore, bromelain may prove a useful addition to conventional treatment of bronchitis, pneumonia, and urinary tract infections. More research is needed.

Amyloid is a protein-like substance that can build up and cause damage to many organs in the body such as the kidneys, liver, or heart. This build-up of amyloid is called amyloidosis. In one laboratory study, researchers examined the tissue of one person with a strong family history of amyloidosis. They found that bromelain may help breakdown amyloid deposits in kidney tissue. This very preliminary finding does not indicate how this information will translate to treatment or prevention of amyloidosis for people in general. Much more research is needed.

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