Anticancer property of bromelain with therapeutic potential in malignant peritoneal mesothelioma

Our plain-English summary of Anticancer property of bromelain with therapeutic potential in malignant peritoneal mesothelioma, by K. Pillai, J. Akhter, T.C. Chua, et al (Cancer Investigation, 2013).

The study

• Authors: K. Pillai, J. Akhter, T.C. Chua, D.L. Morris
• Journal: Cancer Investigation
• Published: 2013;31(4):241-50
• Type of article: Review
• Cited by: 36 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Bromelain is a mixture of proteolytic enzymes that is capable of hydrolyzing glycosidic linkages in glycoprotein. Glycoprotein's are ubiquitously distributed throughout the body and serve a variety of physiologic functions. Faulty glycosylation of proteins may lead to cancer. Antitumor properties of bromelain have been demonstrated in both, in vitro and in vivo studies, along with scanty anecdotal human studies. Various mechanistic pathways have been proposed to explain the anticancer properties of bromelain. However, proteolysis by bromelain has been suggested as a main pathway by some researchers. MUC1 is a glycoprotein that provides tumor cells with invasive, metastatic, and chemo-resistant properties. To date, there is no study that examines the effect of bromelain on MUC1. However, the viability of MUC1 expressing pancreatic and breast cancer cells are adversely affected by bromelain. Further, the efficacy of cisplatin and 5-FU are enhanced by adjuvant treatment with bromelain, indicating that the barrier function of MUC1 may be affected. Other studies have also indicated that there is a greater accumulation of 5-FU in the cell compartment on treatment with 5-FU and bromelain. Malignant peritoneal mesothelioma (MPM) expresses MUC1 and initial studies have shown that the viability of MPM cells is adversely affected by exposure to bromelain. Further, bromelain in combination with either 5-FU or cisplatin, the efficacy of the chemotherapeutic drug is enhanced. Hence, current evidence indicates that bromelain may have the potential of being developed into an effective anticancer agent for MPM.

In plain English

This article is a review, not an original study. The authors, at St. George Hospital, University of New South Wales, Australia, reviewed published laboratory, animal and scanty anecdotal human research on bromelain, a mixture of protein-digesting enzymes from the pineapple plant, as a possible cancer treatment. They focused on MUC1, a glycoprotein they describe as helping tumor cells invade, spread and resist chemotherapy. They noted that no study had examined bromelain's effect on MUC1. The authors also reported their own unpublished results. A chemotherapy-resistant malignant peritoneal mesothelioma cell line called YOU was adversely affected by bromelain at concentrations as low as 100 μg/mL, and the effect of cisplatin and 5-FU was increased when bromelain was added. In 42 peritoneal mesothelioma patients, those with high MUC1 had poor survival; no survival figures were given in the text. The article does not discuss asbestos exposure. The authors noted that blood levels stay low after oral bromelain. They concluded that bromelain may have potential as an anticancer agent for malignant peritoneal mesothelioma, which needs further investigation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review, with the authors' own unpublished laboratory and patient survival data presented in a figure
• Who was studied: Published in vitro, animal and anecdotal human studies of bromelain, plus the authors' unpublished work on a chemo-resistant malignant peritoneal mesothelioma cell line (YOU) and 42 malignant peritoneal mesothelioma patients assessed for MUC1 expression
• Exposure: Bromelain (a mixture of proteolytic enzymes from pineapple), alone and combined with cisplatin or 5-FU; asbestos exposure is not addressed
• Main results:
  • In the authors' unpublished work, the chemo-resistant malignant peritoneal mesothelioma cell line YOU was adversely affected by bromelain at concentrations as low as 100 μg/mL
  • In the authors' unpublished work, the efficacy of cisplatin and 5-FU against these cells was increased in the presence of bromelain
  • In unpublished data on 42 malignant peritoneal mesothelioma patients, those with high MUC1 expression had poor survival (no survival figures given in the text)
  • The authors found no studies that had examined the molecular integrity of MUC1 after exposure to bromelain
• The authors' conclusion: The authors concluded that current evidence indicates bromelain may have potential to be developed into an effective anticancer agent for malignant peritoneal mesothelioma, alone or with chemotherapy drugs
• Limitations the authors state:
  • Human evidence for bromelain's anticancer effect is scanty and anecdotal
  • Research on bromelain's antitumor effect is at an early stage
  • After oral dosing, bromelain blood levels stay low because of blood enzymes and deactivating proteins
  • Treating malignant peritoneal mesothelioma with bromelain, alone or with intraperitoneal chemotherapy, needs further investigation

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Glycoprotein, Cisplatin, Fluorouracil (5-FU).

Related studies

• Anticancer effect of bromelain with and without cisplatin or 5-FU on malignant peritoneal mesothelioma cells — K. Pillai, A. Ehteda, et al. (2014)
• Splicing modulation as novel therapeutic strategy against diffuse malignant peritoneal mesothelioma — R. Sciarrillo, A. Wojtuszkiewicz, et al. (2019)
• 1-[2-(2-Methoxyphenylamino)ethylamino]-3-(naphthalene-1-yloxy)propan-2-ol as a potential anticancer drug — T. Kanno, A. Tanaka, et al. (2013)
• Peritoneal mesothelioma: current status and future directions — T.C. Chua, C.H. Chong, et al. (2012)
• Resveratrol contributes to chemosensitivity of malignant mesothelioma cells with activation of p53 — Y.J. Lee, I.S. Park, et al. (2014)
• The role of BCL-2 family proteins and therapeutic potential of BH3-mimetics in malignant pleural mesothelioma — S. Arulananda, E.F. Lee, et al. (2021)

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