Bromelain: A Multifunctional Proteolytic Enzyme Complex with Therapeut

By: Laria de Mestral

Bromelain is a complex mixture of proteolytic enzymes extracted from the pineapple plant. It comprises stem bromelain, fruit bromelain, and ananain. Notably, research has shown that the proteolytic enzymes in bromelain can be absorbed through the gastrointestinal tract, to then enter the bloodstream, enabling systemic effects after oral intake.

Bromelain exhibits therapeutic potential through multiple complementary mechanisms, including proteolytic activity, anti-inflammatory, immunomodulatory, fibrinolytic, antioxidant, and cell-signaling modulatory actions. These overlapping mechanisms are thought to underlie its analgesic, anti-inflammatory, anti-edematous, antiangiogenic, and antioxidant properties, supporting its use in a variety of inflammatory and oxidative stress-related conditions.

Key Biological Effects and Mechanisms of Action :

1) Anti-Inflammatory and Anti-Edematous Activity

Preclinical studies have shown that bromelain downregulates pro-inflammatory cytokines by inhibiting key signaling pathways such as NF-κB and MAPK. This results in decreased levels of TNF-α, IL-1β, and IL-6. Bromelain also reduces levels of bradykinin, a peptide involved in increasing vascular permeability and pain, thereby contributing to its anti-edematous and anti-inflammatory effects. In clinical settings, a meta-analysis of oral surgery patients demonstrated that bromelain significantly reduced postoperative pain and swelling compared to placebo or standard care.

2) Analgesic Action

Beyond its anti-inflammatory effects, bromelain exhibits direct analgesic properties. It has shown pain-relieving effects comparable to NSAIDs in managing osteoarthritis-related pain, indicating its potential as a safer alternative for long-term pain relief.

3) Fibrinolytic and Circulatory Effects

Bromelain possesses fibrinolytic properties by supporting the breakdown of fibrin, a protein formed during blood coagulation that creates the fibrous scaffold, which stabilizes blood clots. By promoting fibrin degradation, bromelain may improve blood fluidity, reduce blood viscosity, and potentially lower the risk of thrombosis, thereby supporting overall vascular health.

4) Immunomodulation

Bromelain promotes an healthy and regulated immune response by stimulating the phagocytic activity of macrophage, by enhancing natural killer (NK) cell function, and by modulating T-cells and cytokines activity. In experimental models of inflammatory bowel disease, bromelain reduced pro-inflammatory markers in colonic tissues, suggesting possible applications in gastrointestinal inflammation.

5) Clinical Application in Wound Debridement

Additionally, NexoBrid®, a topical treatment made from bromelain, is approved in both the EU and the United States for the removal of eschar in patients with deep partial- and full-thickness burns. Clinical studies have shown that it allows for fast and precise removal of damaged tissue, which can reduce the need for surgery, accelerate wound healing, minimize blood loss, and improve skin appearance in both adults and children.

Sources :

https://pmc.ncbi.nlm.nih.gov/articles/PMC11243481/