Potential Significance of Proteases
Hafiz Ansar Rasul Suleria, Megh R. Goyal, Masood Sadiq Butt in Phytochemicals from Medicinal Plants, 2019
Bromelain is a protein hydrolyzing enzyme and is present in the stems and immature fruit of pineapple as a crude and aqueous extract. Stem bromelain had been utilized in different processes of food industries, for example, baking processes, tenderization of meat, beer clarification, prevention from fruit juice browning, and production of hydrolysates of protein. Likewise, bromelain has been used for softening and pretanning of skin in leather industries. It is used for the treatment of acute inflammation and sports injuries and is also easily available for the pharmacies of USA and Europe as well as for food stores concerned with public health.18 This plant enzyme is also used for treating few malignant diseases, inflammatory, and blood coagulation related diseases.81
Catalog of Herbs
James A. Duke in Handbook of Medicinal Herbs, 2018
Toxicity — Workers who cut up pineapples have their fingerprints almost completely obliterated by pressure and the keratolytic effect of bromelain (calcium oxalate crystals and citric acid were excluded as the cause). The recurved hooks on the leaf margins can painfully injure one. Mitchell and Rook also restated earlier work on “pineapple estate pyosis” occurring in workers who gather the fruits, probably on acarus infestation with secondary bacterial infection. Angular stomatitis can result from eating the fruit. Ethyl acrylate, found in the fruits, produced sensitisation in 10 of 24 subjects “by a maximisation test.” Ethyl acrylate is used in creams, detergents, food, lotions, perfumes, and soaps.6 In “therapeutic doses”, bromelain may cause nausea, vomiting, diarrhea, skin rash, and menorrhagia.29 Watt and Breyer-Brandwijk3 restate a report, unavailable to me, of unusual toxic symptoms following ingestion of the fruit, heart failure with cyanosis and ecchymoses, followed by collapse and coma and sometimes death.1 Morton adds that unripe pineapple is poisonous, causing violent purgation.17
Metabolic Approaches to the Treatment of Back Pain
Kohlstadt Ingrid, Cintron Kenneth in Metabolic Therapies in Orthopedics, Second Edition, 2018
Bromelain is derived from both the stem and the pineapple fruit. In Europe, it is approved for both oral and topical use. In the US, however, it is not FDA approved and is classified as a supplement. The mechanism of action is through the kallikrein–kinin pathway-lowering plasmakinin (bradykinin) at inflammatory sites and lowers prostaglandin E2. Via the arachidonic acid (AA) pathway, it increases platelet-derived cyclic adenosine monophosphate (cAMP). It has immunomodulatory effects on T cells by inhibiting T cell signal transduction. It was shown at a dosage of 90 mg in long bone fractures to significantly reduce pain and swelling and accelerate healing compared to treatment with standard NSAIDs [65].
Green isolation and physical modification of pineapple stem waste starch as pharmaceutical excipient
Published in Drug Development and Industrial Pharmacy, 2019
Annisa Rahma, Melissa Adriani, Puji Rahayu, Raymond R. Tjandrawinata, Heni Rachmawati
Pineapple stem waste has been utilized as a source of chemicals including ehthanol, citric acid, hydrogen gas, antidying agent, antioxidant compound, antimicrobial compound, and bromelain [3]. Pineapple stem waste has been known mainly as a source of bromelain, a protein-digesting enzyme. Isolation of bromelain from pineapple stem has been reported in a number of studies [3–5]. After bromelain extraction from pineapple stem waste, more than 98% of the residue can be utilized [5]. In addition to bromelain, pineapple stem also contains starch, a material that has drawn considerable interest in pharmaceutical formulation. Furthermore, similar to bromelain, the starch in pineapple plant is mainly deposited within the stem [6]. Since bromelain and starch are both used in pharmaceutical dosage form, the waste management can be more efficient. However, pineapple stem starch is still under-explored. Nakhtong et al. [7] has reported physical characteristics of native pineapple stem starch, including gelatinization behavior and pasting properties. Until recently, pineapple stem starch has not been explored in solid drug dosage forms.
Enzymatic debridement: past, present, and future
Published in Acta Chirurgica Belgica, 2022
Ignace De Decker, Liesl De Graeve, Henk Hoeksema, Stan Monstrey, Jozef Verbelen, Petra De Coninck, Els Vanlerberghe, Karel E. Y. Claes
Selective and fast enzymatic debridement—performed before the development of the prolonged inflammatory/infectious processes—preserves the still vital tissue, in particular the dermis with its collagen matrix and epithelial cellular elements. Enzymatic debridement optimally prepares the dermal wound bed for epithelial proliferation and migration, which can usually take several weeks, nevertheless often with good functional and aesthetic results. Some authors, therefore, allowed mixed depth burns to maximize their spontaneous epithelialization potential, but areas that were not closed in ∼3 weeks were subsequently grafted anyway [19,27]. Since spontaneous epithelialization in a highly inflammatory wound bed is different from epithelialization in a moderately inflammatory wound bed, future research should focus on questioning the 21 day golden rule of wound closure after enzymatic debridement [95]. This was also reflected in the German consensus meeting [20], where it was stated that, if re-epithelization of the wound cannot be achieved within 21 days, small residual defects can be treated using the continuous conservative application of topical corticosteroids. Larger residual defects, however, should in their opinion still be treated using a secondary split-skin graft to reduce the risk of instable scar formation during healing. More data from different sources and a basic study on bromelain inflammation modulation potential are needed.
Provider-directed analgesia for dental pain
Published in Expert Review of Clinical Pharmacology, 2023
For decades, phytotherapies have been used for treating inflammatory diseases and postsurgical conditions [148]. In a single-center, randomized controlled clinical trial, patients received ibuprofen (600 mg), Lenidase (a phytotherapeutic compound composed of baicalin, bromelain, and escin) or placebo twice daily for 5 days following third molar extraction [149]. Although the mean reduction of swelling and trismus was similar between ibuprofen and phytotherapy groups, patients receiving phytotherapy exhibited a significant reduction in postoperative pain score at 12 h, 24 h, and 48 h after surgery [149]. Numerous studies have shown that bromelain, a component of Lenidase, used as a single-agent or in combination with another agent, provides significant pain relief compared to control post-operatively in the mandibular third molar surgery setting [150–152]. However, a prospective double-blind clinical trial showed no postoperative benefit of bromelain compared to placebo [153]. Three independent systemic reviews with meta-analyses all concluded that bromelain improves postoperative discomfort (e.g. reduction of pain and swelling) following third molar extractions, but higher levels of evidence are required before implementation of this alternative therapeutic into mainstream clinical guidelines [154–156].
Related Knowledge Centers
- Bromelain
- Burn
- Clinical Significance
- Cosmetics
- Enzyme
- Pineapple
- Protease
- Proteolysis
- Traditional Medicine
- Topical Medication