Bromelain: Biochemie, Pharmakologie und medizinische Anwendung (zur Enzym-Therapie)

Zusammenfassung

Mit Bromelain bezeichnet man einen gefriergetrockneten Rohextrakt aus der Ananas, der neben anderen Komponenten zahlreiche, eng verwandte Proteasen enthält, die in vitro und in vivo antiödematöse, entzündungshemmende, antithrombotische und fibrinolytische Wirkungen zeigen. Die dafür verantwortlichen Inhaltsstoffe sind bisher nur teilweise biochemisch charakterisiert. Wegen seiner oralen Wirksamkeit und nur sehr seltener unerwünschter Nebenwirkungen genießt Bromelain als Phytotherapeutikum bei Patienten zunehmende Wertschätzung. Für Bromelain wurden verschiedene Indikationen beansprucht: Hemmung der Thrombozyten-Aggregation, Angina pectoris, Bronchitis, Sinusitis, chirurgische Traumen, Thrombophlebitis, Pyelonephritis, verstärkte Resorption von Antibiotika. Biochemische Untersuchungen zeigten, dass die pharmakologischen Effekte nur zum Teil auf der proteolytischen Aktivität beruhen, was die Mitwirkung anderer Stoffe nahelegt. Präklinische und klinische Studien empfehlen Bromelain als oral wirksames Arzneimittel für die komplementäre Tumortherapie. Dabei wirkt es als Immun-Modulator, indem es die geschwächte Immunzytotoxizität der Monozyten gegen die Tumorzellen des Patienten wieder normalisiert und die Bildung bestimmter Zytokine wie Tumornekrosefaktor-alpha, Interleukin-2, -6 und -8 induziert. In einer kürzlich durchgeführten Studie mit Mammatumor-Patientinnen konnten diese Befunde teilweise bestätigt werden[1]. Besonders vielversprechend sind u. a. Berichte von Tierversuchen, wo antimetastatische Effekte und Hemmungen sowohl der Metastase-assoziierten Plättchen-Aggregation als auch des Wachstums und der Invasivität von Tumorzellen beobachtet wurden. Offensichtlich hängt die Antiinvasivität nur zum Teil von der proteolytischen Aktivität ab. Dies gilt auch für Wirkungen auf die Immunmodulation, die Wundreinigung nach Verbrennungen und die Wundheilung. Ob Bromelain eine breite Akzeptanz als Arzneimittel zur Verhinderung der Plättchen-Aggregation, als Antimetastatikum und/oder zur Wundreinigung u. a. erlangen wird, müssen künftige klinische Studien zeigen. Der lange Zeit erhobene Einwand, dass Bromelain nach oraler Gabe gar nicht wirken könne, kann heute als eindeutig widerlegt gelten.

Abstract

Bromelain is a lyophilized crude extract of the pineapple containing, in addition to other components various closely related proteases, which show in vitro and in vivo anti-edematous, anti-inflammatory, antithrombotic, and fibrinolytic effects. So far, the components, which are responsible for these effects, have only been partly characterized biochemically. Due to its oral effectiveness and due to rarely occurring unwanted side-effects, bromelain is more and more esteemed as a phytotherapeutic agent by the patients. Different indications have been claimed for bromelain: inhibition of thrombocyte aggregation, angina pectoris, bronchitis, sinusitis, surgical traumas, thrombophlebitis, pyelonephritis, increased absorption of antibiotics. Biochemical studies showed, that the pharmacological effect is only partly based on the proteolytic activity, which suggests the involvement of other substances. Preclinical and clinical studies recommend bromelain as an orally effective drug for the complementary tumor therapy. In such a therapy bromelain acts as an immunomodulator, by normalizing the weakened immunocytotoxicity of the monocytes against the tumor cells of the patient and by inducing the development of certain cytokines, like tumor necrosis factor-alpha, interleukin-2, -6, and -8. In a recent study with patients suffering from a mammary tumor it has been possible to partly confirm these findings. Especially promising are reports about animal experiments, where anti-metastatic effects and inhibitions of the metastasis-associated platelet aggregation as well as the growth and invasiveness of tumor cells have been observed. Obviously, the anti-invasiveness only partly depends on the proteolytic activity. This is also true for effects on immunomodulation, wound debridement after burn injuries, and wound healing. Whether bromelain will gain broad acceptance as a drug for preventing the platelet aggregation, as an antimetastatic agent, and/or for wound debridement, has to be determined by further clinical studies. The objection which has been raised for a long time, that bromelain can not be effective after oral administration, can be regarded today as being clearly disproven.

Schlüsselwörter

Bromelain - Proteasen - Thrombozytenaggregations-Hemmung - Entzündungshemmung - Thrombose-Prophylaxe - Fibrinolyse - Immunmodulation - komplementäre Tumortherapie - Metastasen-Prophylaxe

Keywords

Bromelain - proteases - inhibition of thrombocyte aggregation - inhibition of inflammations - thrombosis prophylaxis - fibrinolysis - immunomodulation - complementary tumor therapy - metastasis prophylaxis

01 Studie gefördert von der Gesellschaft für Biologische Krebsabwehr e.V.

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