Therapeutic Applications and Benefits from Postsurgical Use of the Phytotherapeutic Bromelain in Otorhinolaryngology: A Non- Interventional Study

Background: Bromelain is a phytotherapeutic drug that is well established in medicinal use for the treatment of injuries and postoperative swelling. It is frequently recommended in otorhinolaryngological indications. However, there is lack of recent clinical data on its use in this setting. Methods: We conducted a non-interventional study including 102 patients to evaluate postsurgical clinical (pain, edema, hematoma, signs of inflammation) and specific nasal symptoms (hindrance of nasal breathing, impairment of sleep, impairment of food intake, impairment of smell, impairment of taste). The participating physicians furthermore assessed the potential additional benefits of bromelain therapy.Results: Clinical and specific nasal symptoms improved significantly during postoperative recovery and an additional benefit was assigned by the physicians given ratings in more than fifty percent of the documented cases. According to the physicians, the consumption of analgesics was “low” in seventy percent of the patients during adjunctive therapy with bromelain. Conclusion: Given the good tolerability of bromelain treatment, this study substantiates its safe and efficacious use in otorhinolaryngological practice.

[1]  N. Gellrich,et al.  Perioperative Bromelain Therapy after Wisdom Teeth Extraction – A Randomized, Placebo‐Controlled, Double‐Blinded, Three‐Armed, Cross‐Over Dose‐Finding Study , 2016, Phytotherapy research : PTR.

[2]  C. Shing,et al.  Acute protease supplementation effects on muscle damage and recovery across consecutive days of cycle racing , 2016, European journal of sport science.

[3]  M. Schmolz,et al.  Placebo‐controlled Randomized Clinical Trial on the Immunomodulating Activities of Low‐ and High‐Dose Bromelain after Oral Administration – New Evidence on the Antiinflammatory Mode of Action of Bromelain , 2013, Phytotherapy research : PTR.

[4]  Shraddha,et al.  Properties and Therapeutic Application of Bromelain: A Review , 2012, Biotechnology research international.

[5]  E. Secor,et al.  Bromelain limits airway inflammation in an ovalbumin-induced murine model of established asthma. , 2012, Alternative therapies in health and medicine.

[6]  Amit Kumar Srivastava,et al.  Bromelain inhibits nuclear factor kappa‐B translocation, driving human epidermoid carcinoma A431 and melanoma A375 cells through G2/M arrest to apoptosis , 2012, Molecular carcinogenesis.

[7]  Y. Shukla,et al.  Bromelain inhibits COX-2 expression by blocking the activation of MAPK regulated NF-kappa B against skin tumor-initiation triggering mitochondrial death pathway. , 2009, Cancer letters.

[8]  R. Seymour,et al.  An Evidence-Based Update on Nonsteroidal Anti-Inflammatory Drugs , 2007, Clinical Medicine & Research.

[9]  H. Kehlet,et al.  Predicting postoperative analgesia outcomes: NNT league tables or procedure-specific evidence? , 2005, British journal of anaesthesia.

[10]  Mauro Bianchi,et al.  In vivo and in vitro Effects of Bromelain on PGE2 and SP Concentrations in the Inflammatory Exudate in Rats , 2002, Pharmacology.

[11]  H. R. Maurer,et al.  Bromelain: biochemistry, pharmacology and medical use , 2001, Cellular and Molecular Life Sciences CMLS.

[12]  J. Seifert,et al.  [The effect of proteolytic enzymes (traumanase) on posttraumatic edema]. , 1981, Fortschritte der Medizin.

[13]  T. Shigei,et al.  Protective effect of stem bromelain against adrenaline pulmonary edema, and its dependence on the proteolytic activity. , 1968, Japanese journal of pharmacology.

[14]  A. Sakuma,et al.  A Study on the Protective Effect of Bromelain, Crude Pineapple Proteases, against Adrenaline Pulmonary Edema in Rats , 1967 .

[15]  Martin Gj,et al.  BROMELAINS. THE PHARMACOLOGY OF THE ENZYMES. , 1963 .

[16]  G. Martin,et al.  Systemic biochemical changes following the oral administration of a proteolytic enzyme, bromelain. , 1962, Archives internationales de pharmacodynamie et de therapie.

[17]  G. Kirsch,et al.  Systemic Enzyme Therapy: Fact or Fiction? A Review with Focus on Bromelains, Proteolytic Enzymes from the Pineapple Plant , 2014 .

[18]  M. Wahlqvist,et al.  Natural products and anti-inflammatory activity. , 2006, Asia Pacific journal of clinical nutrition.

[19]  M. Katori,et al.  Bromelain, a thilprotease from pineapple stem, depletes high molecular weight kininogen by activation of Hageman factor (factor XII) , 1979 .

[20]  G. Martin,et al.  BROMELAINS. THE PHARMACOLOGY OF THE ENZYMES. , 1963, Archives internationales de pharmacodynamie et de therapie.