Bromelain as a natural anti-inflammatory drug: a systematic review

Abstract

Inflammation is a complex and necessary mechanism of an organ’s response to biological, chemical and/or physical stimuli. In recent years, investigations on natural compounds with therapeutic actions for the treatment of different diseases have increased. Among these compounds, bromelain is highlighted, as a cysteine protease isolated from the Ananas comosus (pineapple) stem. This review aimed to evaluate the anti-inflammatory activity of bromelain, as well as its pathways on inflammatory mediators, through a systematic review with in vitro studies on different cell lines. The search was performed in PubMed, Science Direct, Scopus, Cochrane Library and Web of Science databases. Bromelain reduced IL-1β, IL-6 and TNF-α secretion when immune cells were already stimulated in an overproduction condition by proinflammatory cytokines, generating a modulation in the inflammatory response through prostaglandins reduction and activation of a cascade reactions that trigger neutrophils and macrophages, in addition to accelerating the healing process.

Graphical Abstract

Keywords:

• Bromelain
• bioactive compounds
• immunologic factors
• inflammation

Authors’ contributions

T.A.N. and A.A.S. conducted the literature review, database search, data extraction and edited drafts of the manuscript as well as the final version. I.C.P. and H.A.S.E. conducted the text review, database search, data extraction, graphic formatting and contributed to the final revision. A.M.C.P.S., M.T.I. conducted database search and data extraction. L.O.L., M.E., N.D., M.T.I. provided content input into draft versions, conducted the translation and edited drafts of the manuscript. J.M.C.S. and F.L.T.L.S. guided the research, contributed to the data extraction, provided intellectual input into draft versions and reviewed the drafts and final version.

Disclosure statement

The authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Additional information

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Finance Code 001.