Bromelain supplementation and inflammatory markers: A systematic review of clinical trials.

BACKGROUND AND AIMS: The inflammatory process is a response mechanism to any stressor agent. Emerging novel therapeutic options derived mainly from natural products such as bromelain have been used to reduce the significant side effects of available anti-inflammatory drugs. Bromelain is an enzyme complex derived from Ananas comosus, known for its anti-inflammatory potential and good tolerance. Therefore, the aim was to assess whether bromelain supplementation exerts anti-inflammatory effects in adults. METHODS: The systematic review was registered in PROSPERO (n° CRD42020221395), and the search was performed in MEDLINE, Scopus, Web of Science, and Cochrane Library. The terms used in the search were: "bromelains", "bromelain", "randomized clinical trial", and "clinical trial". Eligibility criteria were: randomized clinical trials with participants aged 18 years or over, of both sexes, who received supplementation with bromelain alone or in combination with other oral compounds, with an evaluation of inflammatory parameters as primary and secondary outcomes, published in English, Portuguese or Spanish. RESULTS: 1375 studies were retrieved, of which 269 were duplicates. Seven (7) randomized controlled trials were eligible for the systematic review. In most studies, supplementation with bromelain, isolated or in combined therapy, reduced inflammatory parameters. Regarding the reduction of inflammatory parameters among studies with associated bromelain, two presented reduction of inflammatory parameters, while in the evaluation of bromelain treated alone, two studies also showed reduction. In relation to doses supplemented, the studies with associated bromelain ranged from 99.9 to 1200 mg/day and the supplementation time ranged from 3 to 16 weeks. Moreover, the inflammatory parameters evaluated were: IL-12, PGE-2, COX-2, IL-6, IL-8, TNF-α, IL-1ß, IL-10, CRP, NFγ B1, PPAR-α, TNF, TRAF, MCP-1 and adiponectin. In studies with isolated bromelain supplementation, it ranged from 200 to 1050 mg/day for 1 week to 16 weeks. Markers associated with inflammation varied between studies, including IL-2, IL-5, IL-6, IL-8, IL-10, IL-13, IFNγ and MCP-1, PGE-2, CRP and fibrinogen. Eleven (11) participants experienced side effects, and two discontinued treatment in the studies. The reported adverse effects were mainly gastrointestinal but well tolerated. CONCLUSION: The general effect of bromelain supplementation on inflammation is inconsistent because of population heterogeneity, doses used, treatment duration, and parameters evaluated. The observed effects are punctual and isolated, and further standardization is needed to establish doses, supplementation time, and which type of inflammatory condition is indicated.

Food consumption of branched chain amino acids and insulin resistance: A systematic review of observational studies in humans.

This review systematically investigated observational studies in humans that evaluated the dietary intake of branched-chain amino acids (BCAA) and its association with insulin resistance. A search implemented through the electronic databases of PubMed, Scopus, and Web of Science. The evaluation of insulin resistance or the risk of developing insulin resistance in humans were the variables of interest in the search for articles. After using the selection criteria, three studies included in this review. The Food Frequency Questionnaire (FFQ) was the instrument used to evaluate the diet in all of the selected studies. Overall, 1940 studies identified and three thoroughly reviewed. We found only one study with positive effects of BCAA on insulin resistance; the other two reviewed studies did not demonstrate positive effects of the dietary intake of BCAA, individually or the sum of three amino acids on variables of interest. In this sense, the associations between BCAA and insulin resistance are inconsistent, potentially due to other longitudinal outcomes.

Optimization of the antioxidant polyphenolic compounds extraction of yellow passion fruit seeds (Passiflora edulis Sims) by response surface methodology.

The conditions for the solid-liquid extraction of the antioxidant polyphenol compounds from yellow passion fruit seeds were optimized by response surface methodology with the following variables as the extraction parameters: extraction time (12.8-147.2 min), ethanol concentration (13-97%), and temperature (16.4-83.6 °C). The polyphenol content and antioxidant capacity, which were assessed by the 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity, oxygen radical absorbance capacity, ß-carotene bleaching assay, and ferric reducing antioxidant power assay, were considered dependent variables. The association of the dependent variables was effective for explaining the effect of the independent variables within a determination coefficient (R2) range of 0.88-0.96. A moderate-to-strong correlation for the polyphenol content and antioxidant capacity by the investigated methods was established, and optimized conditions were employed to maximize this response. Extraction was carried out at 80 °C using 70% ethanol concentration for 30 min, which was the most efficient condition to obtain an extract with high concentrations of polyphenolic compounds (3.12 g gallic acid equivalent/100 g seed dry basis) and a strong antioxidant capacity. The stilbene piceatannol was the major compound identified by liquid chromatography-electrospray ionization-tandem mass spectrometry (3.68 g/100 g seed dry basis). These results reinforce that agro-industrial waste demonstrates potential as a source of bioactive compounds, with implications in human health as well as in food and chemical industries.