Bromelain Research
37 peer-reviewed studies · Evidence score: 7/10
Interventions for reducing bleeding and swelling in eyelid and periocular surgeries: a systematic review of randomized controlled trials
Alamoudi A et al. • Orbit (Amsterdam, Netherlands) (2025)
Tranexamic acid, vessel-preserving surgical methods, and magnesium sulfate dressings are among the most effective strategies for minimizing ecchymosis and edema in eyelid and periocular surgery.
- Vessel-preserving surgical techniques significantly reduced edema and hematoma, while skin-only excision led to less swelling than combined skin and muscle excision.
- Tranexamic acid, vessel-preserving surgical methods, and magnesium sulfate dressings are among the most effective strategies for minimizing ecchymosis and edema in eyelid and periocular surgery.
- Further RCTs should explore optimized combinations of these interventions and assess long-term patient-reported outcomes.
Bromelain supplementation and inflammatory markers: A systematic review of clinical trials
Pereira IC et al. • Clinical nutrition ESPEN (2023)
The general effect of bromelain supplementation on inflammation is inconsistent because of population heterogeneity, doses used, treatment duration, and parameters evaluated.
- The general effect of bromelain supplementation on inflammation is inconsistent because of population heterogeneity, doses used, treatment duration, and parameters evaluated.
- The observed effects are punctual and isolated, and further standardization is needed to establish doses, supplementation time, and which type of inflammatory condition is indicated.
- Further research warranted to confirm findings
Proteolytic Enzyme Therapy in Complementary Oncology: A Systematic Review
Gremmler L et al. • Anticancer research (2021)
On the basis of existing evidence, there is no clear therapeutic benefit of enzymes neither as supportive therapy nor as part of antineoplastic therapy.
- On the basis of existing evidence, there is no clear therapeutic benefit of enzymes neither as supportive therapy nor as part of antineoplastic therapy.
- Published in Anticancer research (2021)
- Further research warranted to confirm findings
Bromelain-Based Enzymatic Debridement Versus Standard of Care in Deep Burn Injuries: A Systematic Review and Meta-Analysis
De Freitas LR et al. • Journal of burn care & research : official publication of the American Burn Association (2025)
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- We included 7 studies, comprising 484 participants, of whom 238 (49%) were treated with enzymatic debridement.
- Bromelain significantly reduced time to eschar removal (MD -7.60 days 95% CI [-9.76, -5.44]; I2 = 70%) in comparison with standard care.
- Additionally, bromelain group presented a significant reduction in the risk of surgical excision (RR 0.17; 95% CI [0.06, 0.47]; I2 = 79%) and need for autografts (RR 0.40; 95% CI [0.18, 0.93]; I2 = 76%) in comparison with standard group.
Supplementation Containing Bromelain on the Side Effects of Oncological Treatment: Systematic Review
Pereira IC et al. • Journal of medicinal food (2025)
In general, it was possible to observe that supplementation was able to reduce side effects of adjuvant hormone therapy and chemotherapy, such as mucosal dryness, arthralgia, and peripheral neuropathy induced by chemotherapy.
- Bromelain is an enzyme complex that regulates pathways associated with inflammation.
- This review aims to evaluate the use of bromelain-containing supplements to improve the side effects of cancer treatment.
- This systematic review was developed in PubMed, Web of Science, and Cochrane Library, using the terms: Cancer AND Bromelain. 239 studies were retrieved, and only three met our objective.
Bromelain as a natural anti-inflammatory drug: a systematic review
Alves Nobre T et al. • Natural product research (2025)
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.
- 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 and liver health: A comprehensive systematic review of preclinical studies
Pereira IC et al. • Clinical nutrition ESPEN (2025)
Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism.
- Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism.
- In summary, bromelain demonstrates a capacity to enhance liver function across a range of injury types.
- Further research warranted to confirm findings
The role of Bromelain and Liposomal Vitamin C in the treatment of chronic venous disease
Buso G et al. • VASA. Zeitschrift fur Gefasskrankheiten (2025)
Dedicated clinical studies are needed to clarify the efficacy and safety of a combination of these molecules in CVD management.
- No studies have evaluated the effects of bromelain and vitamin C alone or in combination, whereas both molecules were administered in combination with other nutritional supplements.
- Overall, CVD-related symptoms and edema seem to improve with dietary supplement containing these two compounds, with no major safety issues reported.
- Bromelain and vitamin C may thus represent attractive options in the management of patients with symptomatic CVD and/or presence of venous edema, provided optimal conservative treatment is in place.
Evaluating the role of bromelain in diabetes management: a systematic review of research evidence and mechanisms of action
Mohammed JS et al. • The Journal of pharmacy and pharmacology (2025)
Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes.
- Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes.
- However, further research is needed to clarify the underlying mechanisms, including bromelain's potential interaction with the incretin system and its role in modulating insulin resistance through various pathways.
- Further research warranted to confirm findings
Burn Wounds and Enzymatic Debridement (ED)-Past, Present, and Future
Atiyeh B et al. • Journal of burn care & research : official publication of the American Burn Association (2024)
Though available evidence is not entirely in favor of replacing the current surgical SOC with BBD, it certainly presents ED as a highly advantageous modality for the management of burn wounds.
- Though available evidence is not entirely in favor of replacing the current surgical SOC with BBD, it certainly presents ED as a highly advantageous modality for the management of burn wounds.
- Newly described keratinase and SN514 also are promising new products.
- They both still await further investigation before being clinically adopted.
Exploring the Therapeutic Potential of Bromelain: Applications, Benefits, and Mechanisms
Kansakar U et al. • Nutrients (2024)
Since then, bromelain has gained recognition in both traditional and modern medicine for its potential therapeutic effects.
- It has a long history of traditional medicinal use in various cultures, particularly in Central and South America, where pineapple is native.
- This systematic review will delve into the history, structure, chemical properties, and medical indications of bromelain.
- Bromelain was first isolated and described in the late 19th century by researchers in Europe, who identified its proteolytic properties.
Efficacy and safety of bromelain: A systematic review and meta-analysis
Leelakanok N et al. • Nutrition and health (2023)
Major health risks were not reported during the treatment with bromelain.
- Pain reduction from oral bromelain was slightly but significantly better than controls (mean difference in pain score = -0.27; 95% CI: -0.45, -0.08; n = 9; I2 = 29%).
- Topical bromelain significantly reduced the time to complete debridement (mean difference in time = -6.89 days; 95% CI: -7.94, -5.83; n = 4; I2 = 2%).
- Adverse events may be irrelevant and include burning sensation, pain, fever, and sepsis.
Bromelain-based enzymatic burn debridement: A systematic review of clinical studies on patient safety, efficacy and long-term outcomes
Shoham Y et al. • International wound journal (2023)
International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.
- NexoBrid® is a safe, selective, non-surgical eschar removal treatment modality.
- The benefits of Bromelain-based debridement are faster debridement and healing times, reduced operations, length of stay, cases of sepsis, blood transfusions, and prevention of compartment syndrome.
- Existing evidence suggests that the indications and the role of Bromelain-based debridement are expanding to cover "off-label" cases with significant benefits to the global healthcare economy.© 2023 The Authors.
Is bromelain an effective drug for the control of pain and inflammation associated with impacted third molar surgery? Systematic review and meta-analysis
de A C Almeida R et al. • International journal of oral and maxillofacial surgery (2019)
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- A meta-analysis was performed for the outcomes pain and trismus and was based on the inverse variance method for continuous outcomes, considering the mean difference (MD) and corresponding 95% confidence interval (CI).
- After the different stages of the selection process, five articles reporting data for a total 252 patients remained and were included in the review.
- Published by Elsevier Ltd.
Collagen-depletion strategies in dentin as alternatives to the hybrid layer concept and their effect on bond strength: a systematic review
H S Delgado A et al. • Scientific reports (2022)
This systematic-review examined the effects of Bromelain.
- Some specific collagen-depletion strategies seem to play a favorable role in improving immediate bond strengths to dentin.
- Further research with sound methodology is required to consolidate these findings, since limitations in RoB and a low number of studies were found.
- The assessment of further proteolytic agents and long-term outcomes is also required.© 2022.
Medicinal Plants as Efficacious Agents for Diabetic Foot Ulcers: A Systematic Review of Clinical Studies
Ahmadian R et al. • Wounds : a compendium of clinical research and practice (2021)
Per the studies included in this review, medicinal plants can be recommended as promising adjuvant therapies to conventional wound care to accelerate wound healing in patients with DFUs.
- A diabetic foot ulcer (DFU) is a chronic, nonhealing wound that occurs in approximately 15% to 25% of patients with diabetes, and amputation is necessary in approximately 5% to 24% of these patients.
- Parameters such as ulcer width and depth, phagocytic function, tumor necrosis factor α level, epithelialization, vascularization, and wound closure were evaluated in clinical trials, several of which were significantly improved in patients compared with their baseline values or control group.
- Fourteen studies were included in the present review.
Efficacy of natural, peroxide-free tooth-bleaching agents: A systematic review, meta-analysis, and technological prospecting
Ribeiro JS et al. • Phytotherapy research : PTR (2020)
Therefore, the current literature does not support the use of natural agents as dental bleaching.© 2019 John Wiley & Sons, Ltd.
- The addition of non-peroxide agents into peroxide showed improvement in bleaching effect with the incorporation of these non-peroxide agents (p < .05).
- The evidence in literature suggested that natural bleaching agents incorporated to peroxide may improve the bleaching.
- Therefore, the current literature does not support the use of natural agents as dental bleaching.© 2019 John Wiley & Sons, Ltd.
Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis
de Souza GM et al. • Phytotherapy research : PTR (2019)
The results suggest that the bromelain appears to be effective in the control of pain, edema, and trismus after lower third molar surgeries; however, further high-quality studies are needed to confirm this finding.© 2018 John Wiley & Sons, Ltd.
- Following the selection process, seven studies were included in the systematic review and four in the meta-analysis.
- In terms of the risk of bias analysis, all the evaluated studies were classified as low or unclear risk of bias in the following criteria: selection bias, detection bias, and reporting bias.
- The results suggest that the bromelain appears to be effective in the control of pain, edema, and trismus after lower third molar surgeries; however, further high-quality studies are needed to confirm this finding.© 2018 John Wiley & Sons, Ltd.
Perioperative Homeopathic Arnica and Bromelain: Current Results and Future Directions
Knackstedt R et al. • Annals of plastic surgery (2020)
However, there was no effect demonstrated when evaluating topical arnica following blepharoplasty procedures.
- Systematic review examining Bromelain efficacy
- Published in Annals of plastic surgery (2020)
- Further research warranted to confirm findings
Alternative therapies for sinusitis and rhinitis: a systematic review utilizing a modified Delphi method
Wu AW et al. • International forum of allergy & rhinology (2020)
Some alternative therapies show promise as potential treatments for sinusitis and rhinitis, mostly compared to placebo.
- Some alternative therapies show promise as potential treatments for sinusitis and rhinitis, mostly compared to placebo.
- Comparisons to traditional therapies are lacking.
- For other alternative therapies, many websites included unsubstantiated claims of benefit and ignored potential side effects for which patients should be warned appropriately.