BROMELAIN

What is bromelain?

Bromelain is a combination of different enzymes naturally found in pineapple, both in the fruit and in the stem. Its job is to break down proteins [^[1]].

What does bromelain do in the body?

Bromelain has many useful clinical properties. It is anti-edema, anti-cancer, anti-inflammatory, and anti-thrombotic. It is also pro-fibrinolytic, which can dissolve blood clots [^[2]]. As an anti-inflammatory agent, bromelain exerts activity widely throughout the body in the respiratory, digestive, immune, and circulatory systems [^[3]]. Bromelain controls inflammation through its effects on biological pathways that regulate the synthesis of the immune system’s inflammatory molecules, cytokines.

Clinical applications of bromelain include treating cardiovascular disorders, bronchitis, sinusitis, surgical trauma, thrombophlebitis, wound healing, osteoarthritis, and diarrhea [^[4]]. Researchers hypothesize that bromelain may also help with chronic fatigue, joint pain, and myalgia [^[5]]. Bromelain shortened symptom duration in one study of children with sinusitis [^[6]].

How can bromelain help alleviate certain Long COVID symptoms and pathophysiology? 

Because bromelain can help treat several disorders, it could be promising for Long COVID patients, who often face multi-organ system challenges. Bromelain’s effects are documented on the cardiovascular, circulatory, musculoskeletal, immune, vascular, and digestive systems. It also has the capacity to impact cancer cells directly and change molecular pathways of cancer malignancy. While it has several benefits, the exact mechanisms by which these benefits are conferred remain unclear. However, its multifaceted effects could benefit Long COVID patients [^[7]].

Inflammation is a problem for Long COVID patients, and bromelain directly modulates inflammatory cytokine pathways. Another issue faced by Long COVID patients is difficulties with clotting and circulation, and bromelain’s effects in preventing thrombosis and breaking down clots can be helpful. Bromelain also may have analgesic effects by regulating the synthesis of pain mediators such as bradykinin. Lastly, bromelain may have inhibitory effects on SARS-CoV-2, which causes COVID-19, by its enzymatic activity breaking down its various proteins and receptors [^[8]].