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An enzyme obtained from the stem of pineapple, bromelain belongs to a group of plant-derived proteolytic enzymes that also includes papain, and has a wide range of applications. In vitro and some in vivo studies demonstrate its anti-inflammtory properties. Bromelain reduces serum fibrinogen levels, supports fibrinolysis and has been investigated for its debriding effects on burn wounds. In addition, it may be useful for treating some skin conditions. Bromelain reduces mild, acute knee pain in a dose-dependent fashion. Studies of bromelain’s pain relieving effect on patients with arthritis yielded mix results.

Studies done in vitro and in mice have shown that bromelain has chemopreventive and antitumorigenic effects. Bromelain and other proteolytic enzymes were used as adjuvants in cancer treatments. It also increased the survival indices of animals bearing leukemia, sarcoma, lung, breast, and ascetic tumors; however, the anticancer effects of bromelain have not been evaluated in clinical trials.

Theoretically, bromelain may interfere with anticoagulation therapy and increase bleeding risk due to its antithrombotic effects. Bromelain also inhibits cytochrome P450 (CYP) 2C9 activity.