Bromelain Clinical Evidence

Alternative Medicine Review
Helms S and Miller A. Natural treatment of chronic rhinosinusitis. 2006 11(3): 200. 

Topic: 
What mainstream and alternative treatments are effective at relieving the symptoms of chronic rhinosinusitis?

Background:

Chronic rhinosinusistis is a widespread condition, affecting 14% of the population. Its causes are complex and poorly understood, making it challenging to treat. Bromelain, an enzyme found in pineapples, has been the subject of several studies on sinusitis. What does the research say?

Study Type:

Review paper

Dosage:

Varied by study: 500-2,000 mg/day

Results:

The authors found that:

  • In one study, children with acute sinusitis treated with bromelain recovered from their symptoms more quickly than those administered standard treatment. (This study replicated previous findings.)
  • 85% of subjects treated with bromelain in another study experienced complete relief from nasal inflammation, compared to 40% of subjects in the placebo group.
  • Bromelain is thought to work by inhibiting the synthesis and accumulation of prostaglandins (fatty acids that promote inflammation).

In Vivo 
Braun J, Schneider B, and Beuth H. Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. 2005 Mar-Apr;19(2):417-21. 

Topic: 
How effective and safe is bromelain as a treatment for acute sinusitis in children?

Background:
Bromelain is a common treatment for German children diagnosed with acute sinusitis. Is it a beneficial treatment?

Study Type:
Human clinical intervention trial.

Study Design:
Subjects were treated with bromelain alone, a combination of bromelain and standard therapies, or standard therapies alone.

Subjects:
116 subjects under the age of 11, diagnosed with acute sinusitis

Results:
Patients treated with bromelain alone had a statistically significant faster recovery from their symptoms than the other treatment groups. The bromelain group recovered in 6.66 days, the standard therapy group in 7.95 days, and the combination group in 9.06 days. The only side effect of bromelain ingestion was a mild allergic reaction in a patient with a known pineapple allergy.

Conclusion:
This trial documents that the proteolytic pineapple enzyme Bromelain-POS is widely used in the treatment of young children diagnosed with acute sinusitis in Germany and that the use of proteolytic enzymes can benefit such patients.

Bromelain Mechanism of Action:

Bromelain, an enzyme found in pineapple, reduces inflammation of the nasal mucosa, and thins and clears nasal mucus. It works by breaking down protein found in inflamed tissue. This action inhibits the production of pro-inflammatory prostaglandins, hormone-like substances that cause inflammation and tissue damage. 

Bromelain also supports respiratory health by reducing the number of leukocytes (a kind of white blood cell) and cytokines (signaling molecules of the immune system) in the lungs. Bromelain improves the health of cells and tissues in the lungs, lessens oversensitivity of the airways, and reduces levels of immune cells involved in asthma attacks.