Bromelain: a natural proteolytic for intra-abdominal adhesion prevention.

Abstract

INTRODUCTION:

Peritoneal adhesions are pathological fibrous connections between peritoneal surfaces resulting from incomplete peritoneal repair. Adhesions cause various health problems ranging from pelvic pain and bowel obstruction to infertility. To date, no effective agent exists for intra-abdominal adhesion prevention. Bromelain is the crude extract of the pineapple and it has fibrinolytic, antithrombotic, and anti-inflammatory properties. Bromelain has been shown to be effective for removing necrotic tissues and has been found to be effective for treating various wounds, inflammatory conditions, and thrombotic pathologies. In the present study, we evaluated bromelain as a novel agent for preventing intra-abdominal adhesions.

METHODS:

Group 1 (control group): Adhesions were produced by cecal abrasion method, and no treatment was applied. Group 2 (i.p. bromelain-treated group): After adhesion formation, 10 mg/kg/BW of bromelain dissolved in 1 mL saline solution was applied intraperitoneally for 10 days. Group 3 (i.p. saline-treated group): After adhesion formation, 1 mL saline solution was applied intraperitoneally for 10 days. On postoperative day 10, all animals were sacrificed.

RESULTS:

All 30 rats survived surgery. Throughout the follow-up period, no complications were observed. Statistically significant differences were found between the groups with regards to macroscopic adhesion scores, inflammation, fibrosis and neo-vascularization (p < 0.001, <0.001, p = 0.001, p = 0.002, respectively). Macroscopic and histopathologic (inflammation, fibrosis, neo-vascularization) adhesion scores were lowest in the bromelain-treated group.

CONCLUSION:

Bromelain, acting through its barrier, anti-inflammatory, antioxidant, and proteolytic effects and without increasing bleeding tendency or having any adverse effects on wound healing, may be a suitable agent for intra-abdominal adhesion prevention.

• Authors: Ahmet Sahbaz, Oner Aynioglu, Hatice Isik, Ulku Ozmen, Osman Cengil, Banu Dogan Gun, Kemal Gungorduk
• Journal: International journal of surgery (London, England) (Int J Surg) Vol. 14 Pg. 7-11 (Feb 2015) ISSN: 1743-9159 [Electronic] England
• PMID: 25573606 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Plant Extracts
• Bromelains

Topics

• Animals
• Bromelains (administration & dosage, therapeutic use)
• Female
• Peritoneal Diseases (prevention & control)
• Phytotherapy
• Plant Extracts (therapeutic use)
• Postoperative Complications (prevention & control)
• Rats, Wistar
• Tissue Adhesions (prevention & control)
• Wound Healing (drug effects)