Title:The Therapeutic Effects of Bromelain against Colorectal Cancer: A
Systematic Review
Volume: 20
Issue: 4
Author(s): Mojgan Forootan, Mehdi Mohammadian Amiri, Mohammad Darvishi, Catherine M.T. Sherwin and Koruosh Ghanadi*
Affiliation:
- Internal Department, School of Medicine, Lorestan University of Medical
Science, Khorramabad, Iran
Keywords:
Bromelain, neoplastic cell, colorectal cancer, colon cancer, extracellular signal-related kinase, cochrane library.
Abstract:
Background: Colorectal cancer (CRC) is one of the most prevalent cancers worldwide.
Objective: Considering the side effects of chemotherapy treatments, we reviewed the anti-cancer effects
and mechanisms of bromelain on colon cancer cells in this study.
Methods: The PRISMA guidelines were followed in the design of this systematic review. Various
databases, including PubMed, Web of Science, Cochrane Library, and Scopus, were thoroughly
searched. Finally, 14 articles were retrieved after considering the study's inclusion and exclusion criteria.
The desired data were extracted, entered into an Excel file, and the study results were reviewed.
Results: According to the included studies, bromelain can significantly reduce the survival and death
of cloned cancer cells through different mechanisms. These mechanisms include impeding tumor
growth and metastasis by reducing mucins production/secretion and increasing/reducing reactive oxygen
species (ROS) production. Moreover, bromelain induces apoptosis via reduced expression of
Bcl-2, extracellular signal-related kinase (ERK), Akt, activation caspase system (caspase-3, 7, 8, and
9), and extranuclear p53. Ferroptosis was another mechanism of causing cell death. In addition, bromelain
activates the autophagy pathway, lysosome formation, and deregulation of other autophagyrelated
proteins.
Conclusion: Bromelain effectively inhibits colon cancer cells' growth, proliferation, and metastasis
and reduces their survival by different mechanisms. Therefore, after examining clinical studies, it can
be used as an effective drug for treating CRC.