3rd Annual BMRP Investigator Meeting - Abstract
Bromelain Treatment of Inflammatory Bowel Disease
Laura P. Hale1,a, Marcia R. Gottfried1, Jane E. Onken2 and Alexander Swidsinski3
1Departments of Pathology and 2Medicine, Duke University Medical Center (Durham, North Carolina, U.S.A.); 3Innere Klinik, Gastroenterologie, Charité Humboldt Universität (Berlin, Germany)
Bromelain is a mixture of proteinases derived from pineapple stem that is sold in health food stores as a “digestive aid.” Self-treatment with oral bromelain was anecdotally reported to induce clinical and endoscopic remission of ulcerative colitis in two patients whose disease was refractory to multi-agent conventional medical therapy. We and others previously showed that bromelain removes cell surface molecules that affect lymphocyte adhesion and activation and also decreases lymphocyte production of pro-inflammatory cytokines in vitro.
The purpose of these studies was to determine the potential of bromelain for treatment of inflammatory bowel disease (IBD), using in vivo murine colitis models and in vitro treatment of human colon biopsies. We found that bromelain remained proteolytically active within the gastrointestinal tract of mice when administered orally in antacid. Daily treatment with oral bromelain beginning at age five weeks decreased the incidence and severity of spontaneous colitis in C57BL/6 IL-10-/- mice. Bromelain also significantly decreased the clinical and histologic severity of colonic inflammation when administered to piroxicam-exposed IL-10-/- mice with established colitis. Proteolytically active bromelain was required for anti-inflammatory effects in vivo. In vitro bromelain treatment of colon biopsies from IBD patients significantly decreased secretion of IFN-g, granulocyte colony stimulating factor (G-CSF), macrophage inhibitory protein (MIP)-1b, and macrophage chemoattractant protein (MCP)-1. Although the exact mechanisms by which bromelain decreases bowel inflammation have not yet been determined, the results justify additional studies of this complementary biologically-based approach to treatment of IBD.
aPrincipal Investigator