Current Uses of Bromelain in Children: A Narrative Review

TL;DR

Bromelain, a natural enzyme from pineapple, shows potential health benefits in children, but more research is needed to confirm its effectiveness and safety.

Contribution

This paper reviews the current understanding and limited clinical evidence of bromelain use in pediatric populations.

Findings

Bromelain has potential therapeutic effects beyond digestion, including anti-inflammatory and anticoagulant properties.

There is limited evidence supporting bromelain's use in children for conditions like upper respiratory infections and burns.

Most studies on bromelain are in vitro, animal-based, or in adults, highlighting a need for pediatric-focused research.

Abstract

Bromelain is a complex natural mixture of sulfhydryl-containing proteolytic enzymes that can be extracted from the stem or fruit of the pineapple. This compound is considered a safe nutraceutical, has been used to treat various health problems, and is also popular as a health-promoting dietary supplement. There is continued interest in bromelain due to its remarkable therapeutic properties. The mechanism of action of bromelain appears to extend beyond its proteolytic activity as a digestive enzyme, encompassing a range of effects (mucolytic, anti-inflammatory, anticoagulant, and antiedematous effects). Little is known about the clinical use of bromelain in pediatrics, as most of the available data come from in vitro and animal studies, as well as a few RCTs in adults. This narrative review was aimed at highlighting the main aspects of the use of bromelain in children, which still appears to be limited compared to its potential. Relevant articles were identified through searches in MEDLINE, PubMed, and EMBASE. There is no conclusive evidence to support the use of bromelain in children, but the limited literature data suggest that its addition to standard therapy may be beneficial in treating conditions such as upper respiratory tract infections, specific dental conditions, and burns. Further studies, including RCTs in pediatric settings, are needed to better elucidate the mechanism of action and properties of bromelain in various therapeutic areas.