Bromelain

Bromelain is a water extract from pineapple stem that contains cysteine proteinases that have several purported therapeutic effects, including antimetastatic, antithrombotic, anti-edematous, fibrolytic, and immunomodulatory actions.

Efficacy

In vitro and in vivo studies have shown that bromelain inhibits metastasis, stimulate both innate and adaptive aspects of immune function in macrophages and natural killer cells, reduced inflammatory cytokine release in rats injected intraperitoneally with lipopolysaccharide, and inhibited growth of lung tumors in mice inoculated with tumor cells.

Ex vivo human clinical trials of bromelain have shown that oral doses of bromelain (3000 IF.I.P. units) in breast cancer patients for ten days enhanced monocyte cytotoxicity against breast cancer cell lines.

Bromelain in doses of 3000 mg have been found useful in preventing postsurgical adhesions and is used, often in combination with other plant enzymes in the treatment of lymphedema.

Safety

Doses are often expressed in terms of milk clotting units (MCU) or F.I. P. or sometimes in simple milligram weights. Adult safe oral doses range from 400- 4000 mg/day.

Recommendations

Bromelain is routinely used in naturopathic oncology to prevent post-radiation fibrosis and to reduce risk of lymphedema. This practice is based on a small number of clinical studies in post-traumatic and postsurgical edema using Phlogenzym™ a German-manufactured combination enzyme formula containing bromelain

Use of bromelain in prevention of post-radiotherapy fibrosis is supported by a Ukranian paper reporting on the use of bromelain in preventing lymphogranulomatosis in cancer patients receiving radiation therapy.

Because bromelain has been shown to be generally safe in oral doses, integrative oncologists often use it for a variety of cancer-related conditions including post-radiotherapy fibrosis, post-surgical edema ileus, lymphedema, immunomodulation, and inflammatory bowel disorders.

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• Eckert, K., E. Grabowska, et al. (1999). "Effects of oral bromelain administration on the impaired immunocytotoxicity of mononuclear cells from mammary tumor patients." Oncol Rep 6(6): 1191-9.
• Glaser, D. and T. Hilberg (2006). "The influence of bromelain on platelet count and platelet activity in vitro." Platelets 17(1): 37-41.
• Engwerda, C. R., D. Andrew, et al. (2001). "Bromelain activates murine macrophages and natural killer cells in vitro." Cell Immunol 210(1): 5-10.
• Hou, R. C., Y. S. Chen, et al. (2006). "Cross-linked bromelain inhibits lipopolysaccharide-induced cytokine production involving cellular signaling suppression in rats." J Agric Food Chem 54(6): 2193-8.
• Beuth, J. and J. M. Braun (2005). "Modulation of murine tumor growth and colonization by bromelaine, an extract of the pineapple plant (Ananas comosum L.)." In Vivo 19(2): 483-5.
• Tysnes, B. B., H. R. Maurer, et al. (2001). "Bromelain reversibly inhibits invasive properties of glioma cells." Neoplasia 3(6): 469-79.
• Hubarieva, H. O., L. P. Kindzel's'kyi, et al. (2000). "[Systemic enzymotherapy as a method of prophylaxis of postradiation complications in oncological patients]." Lik Sprava(7-8): 94-100.
• Kamenicek, V., P. Holan, et al. (2001). "[Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling]." Acta Chir Orthop Traumatol Cech 68(1): 45-9.