Bromelain in Osteoarthritis Management: A Review of the Evidence

Osteoarthritis (OA) is a common degenerative joint disorder characterized by cartilage breakdown, inflammation, and pain. As conventional treatments may have limitations, there is growing interest in exploring alternative therapies. Bromelain, a mixture of proteolytic enzymes derived from pineapple stems, has gained attention for its potential anti-inflammatory and analgesic properties. This article reviews the existing evidence on the use of bromelain in the management of osteoarthritis, incorporating findings from preclinical and clinical studies.

1. Introduction: Osteoarthritis (OA) is a prevalent musculoskeletal disorder affecting millions worldwide. Current therapeutic options, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics, provide symptomatic relief but may be associated with adverse effects. Bromelain, a natural compound with anti-inflammatory and proteolytic properties, has emerged as a potential adjunctive treatment for OA.
2. Mechanism of Action: Bromelain contains a combination of proteolytic enzymes, including bromelain, ananain, and comosain. These enzymes are thought to exert anti-inflammatory effects by modulating cytokine levels, reducing the production of inflammatory mediators, and inhibiting the activity of cyclooxygenase (COX) enzymes. Additionally, bromelain may promote tissue repair by modulating growth factors and enhancing the clearance of damaged proteins.
3. Preclinical Studies: Several preclinical studies have…