NexoBrid (bromelain) / MediWound, Kaken Pharma, Teva - LARVOL DELTA

Harnessing therapeutic potential of bromelain and its nanoformulations: sojourn of pineapple from food to nanomedicine. (PubMed, Daru) - "Bromelain exhibits wide-ranging therapeutic benefits, and NDDS-based nanoformulations provide a promising strategy to overcome its pharmacokinetic limitations. Further clinical research is needed to validate its efficacy and establish its role in pharmaceutical and nutraceutical applications. Our evaluation emphasizes that nano-enabled delivery is the most credible route to consistent pharmacokinetics and effect sizes across indications; however, dose-exposure-response data remain sparse and should be prioritized in upcoming trials."

Journal • Review • Oncology

Co-encapsulation of bromelain and doxorubicin in acid-responsive nanogels for enhanced chemotherapy via tumor ECM degradation. (PubMed, J Biomater Sci Polym Ed) - "In a murine osteosarcoma model, the PEG-rich nanogels showed prolonged circulation and increased tumor accumulation via the enhanced permeability and retention (EPR) effect, accompanied by collagen I degradation and effective tumor growth inhibition, with final tumor volumes reduced to approximately one-tenth of those in the control group and without observable systemic toxicity. This microencapsulation approach provides an enzyme-drug co- encapsulation system that combines ECM degradation with chemotherapy in a single nanogel platform and may be adapted to other proteolytic enzymes and cytotoxic agents for the treatment of stroma-rich solid tumors."

Journal • Oncology • Osteosarcoma • Sarcoma • Solid Tumor

Does enzymatic debridement reduce the occurrence of hypertrophic scarring in intermediate depth burns? (PubMed, Burns) - "The overall incidence of HTS after scar maturation was low in both the conservative group (13.6 %) and in the EDNX group (9.3 %). A small, but in significant difference was observed in HTS prevalence between intermediate depth burns treated conservatively and those treated with EDNX. These findings support conservative management through local wound care as the preferred approach for intermediate depth burns."

Journal • Thermal Injury

Associated Water Stabilization Mechanism Reconciles the Enigmatic Differential Response of Proteins to a Single Osmolyte. (PubMed, J Phys Chem B) - "In the same context, this study uses the associated water stabilization mechanism (AWSM) to investigate sorbitol's effect on papain and bromelain...These findings validate the AWSM framework as a more nuanced approach to understanding protein-osmolyte interactions. Our results highlight the importance of the hydration shell in modulating protein stability and provide a deeper, more mechanistic view of these complex relationships."

Journal

Diffusion-Controlled Release of Bromelain from κ-Carrageenan Nanocomposite Hydrogels Reinforced with Bio-Derived Nanofillers. (PubMed, Int J Mol Sci) - "All hydrogels were bio-based, biodegradable, and fully cytocompatible, highlighting their suitability for sustainable biomedical applications. Overall, this work provides a quantitative structure-property-function framework for designing enzyme-active κ-carrageenan systems for tunable bromelain release and related biomedical applications."

Journal

Bromelain-functionalized omega-3 nanocarriers for targeted icariin delivery: a multifunctional shield for cardiac repair in doxorubicin-induced injury. (PubMed, J Mater Sci Mater Med) - "Combination index (CI) analysis using Compusyn further verified the synergistic interaction between nano-formulated icariin and bioactive excipients, enabling improved therapeutic outcomes with lower effective doses. These findings highlight the potential of NLC-based delivery systems in counteracting doxorubicin-induced cardiotoxicity, supporting further preclinical studies for clinical translation."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction

Effects of bromelain supplementation on disease activity and quality of life in patients with ulcerative colitis: a randomized, triple-blind, placebo-controlled study. (PubMed, Sci Rep) - "After correcting for baseline, the findings remained significant for the SCCAI variable but not for the QoL variable (p < 0.001 and p = 0.99). In UC patients, the severity of the disease is reduced by bromelain supplementation, which is an alternative therapy.Trial registration: The study protocol received approval from the Ethics Committee at Iran University of Medical Sciences "IR.IUMS.REC.1402.125" and was registered with the Iranian Clinical Trials Registry "IRCT20191105045340N2" on 09/07/2023."

HEOR • Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

Histaminergic vs. PAR-2 Mediated Non-Histaminergic Pruritus: A Narrative Review of Chemical and Mechanical Triggers in Atopic Dermatitis (ISDS 2025) - "Distinguishing histaminergic from PAR-2 mediated non-histaminergic itch is vital for both clinical management and board-level teaching. While cowhage remains the "gold standard" pruritogen, its limited availability, variable itch profiles, and thermal inactivation warrant the investigation and use of more accessible proteases like papain, ficin, and bromelain in educational and research settings."

Review • Atopic Dermatitis • Dermatitis • Dermatology • Immunology • Inflammation • Pruritus • TRPA1 • TRPV1

Enzymatic Bromelain-based Debridement with Nexobrid®: A new treatment to effectively prevent Traumatic Tattoos after abrasive incidents and explosive events. (PubMed, J Burn Care Res) - "Enzymatic debridement presents a comprehensive approach to wound care in cases of traumatic tattoos, offering precision, tissue preservation, and user-friendly application, to optimize functional and cosmetic outcomes. These advantages position it as an effective alternative to more traditional methods, particularly in settings that require minimal invasiveness and maximal tissue conservation."

Journal • Anesthesia

Purification and Characterization of Anti-Inflammatory Peptide Fractions from Enzymatic Hydrolysate of Abalone Viscera. (PubMed, Foods) - "In the present study, abalone viscera served as the raw material; four commercial proteases-papain, bromelain, neutral protease and trypsin-were comparatively evaluated...Mechanistic investigations revealed that both peptides dose-dependently attenuated the secretion and mRNA expression of IL-1β, IL-6 and TNF-α and concurrently blocked mitogen-activated protein kinase (MAPK) signaling by down-regulating the phosphorylation of ERK, JNK and p38. These findings demonstrate that abalone viscera represent an abundant reservoir of anti-inflammatory peptides, offering both a theoretical framework and a technological roadmap for the valorisation of marine waste proteins and the development of next-generation natural anti-inflammatory agents."

Journal • IL1B • IL6 • TNFA

Protective role of bromelain's antioxidant and anti-inflammatory effects in experimental lower limb ischemia-reperfusion injury. (PubMed, Sci Rep) - "Bromelain effectively mitigates lower limb ischemia-reperfusion injury by reducing oxidative stress, restoring antioxidant capacity, and suppressing inflammatory responses. These protective effects suggest that bromelain holds potential as a therapeutic agent for managing oxidative and inflammatory damages associated with IR conditions, warranting further clinical investigation."

Journal • Cardiovascular • Inflammation • Muscular Atrophy • Reperfusion Injury

The Effect of Toothpaste Suspensions on the Formation of Oral Biofilms In Situ. (PubMed, Int Dent J) - "Toothpastes with active ingredients significantly reduced biofilm formation and/or viability. Paste III, containing hydroxyapatite, was particularly effective in reducing bacterial viability. Further research is needed to explore alternatives to chlorhexidine as a preservative."

Journal

A randomized controlled trial of Shengji ointment combined with bromelain in promoting healing of tendon-exposed diabetic foot wounds: integrated 16S rDNA sequencing and metabolomics analysis. (PubMed, Front Pharmacol) - "Correlation analysis indicated a strong negative association between Pontimonas, Hydrogenovibrio, Aquabacterium, and the majority of the differential metabolites. The Shengji ointment combined with bromelain has shown notable effectiveness in treating diabetic foot wounds with tendon exposure by modulating microbial composition (reducing pathogenic bacteria and increasing beneficial bacteria) and optimizing the metabolic environment (targeting key metabolic pathways), providing valuable insights for further exploration of its mechanisms."

Journal • Infectious Disease

Nexobrid Use in the Elderly. (PubMed, Eur Burn J) - "In elderly burn patients, NXB facilitates precise eschar removal and reliably prevents compartment syndrome, demonstrating a strong safety profile even in high-risk individuals. Its primary benefit shifts from reducing surgical incidence to optimizing the wound bed for grafting. These findings support the use of NXB in the elderly, with the understanding that subsequent grafting is often still required due to age-related delayed healing."

Journal • Thermal Injury

Evidence-Based Management of Burns: A Narrative Review of Evolving Practices. (PubMed, Eur Burn J) - " Key advances include the integration of propranolol and oxandrolone for metabolic modulation; enzymatic debridement agents such as NexoBrid®; regenerative approaches like epidermal cell sprays (e.g., RECELL®) and dermal substitutes (e.g., Integra®, MatriDerm®, NovoSorb® BTM); and innovations in scar modulation, notably fractional CO2 laser therapy. The integration of systemic, local, and rehabilitative strategies is improving outcomes in survival, function, and quality of life. Ongoing challenges include cost, access, and translation of novel therapies into widespread clinical practice."

Journal • Review • Thermal Injury

Long-term skin quality and scar formation after enzymatic debridement of deep-dermal burn wounds: A follow-up comparative study of Suprathel® and Jelonet®. (PubMed, Burns) - "Nexobrid®, a bromelain-based enzymatic debridement agent, has become an established treatment modality for deep-dermal burns, particularly of the hand, due to its selective action and tissue-sparing properties...These results confirm that both Suprathel® and Jelonet® are effective options for post-enzymatic debridement wound coverage, showing comparable long-term scar outcomes. The choice may reasonably depend on clinical workflow and dressing-management preferences, with Suprathel® remaining the standard in our burn center due to its reduced frequency of dressing changes."

Journal • Inflammation • Pain • Thermal Injury

A Randomized Controlled Trial Evaluating Whether Pre-operative Trinase Reduces Post-operative Pain in Patients With Symptomatic Irreversible Pulpitis Compared to Placebo, Using VAS Scores and Analgesic Intake Over 48 Hours. (clinicaltrials.gov) - P=N/A | N=182 | Recruiting | Sponsor: Fayoum University

New trial • Dental Disorders • Pain

Interventions for reducing bleeding and swelling in eyelid and periocular surgeries: a systematic review of randomized controlled trials. (PubMed, Orbit) - "Herbal and adjunctive therapies, including Arnica montana and bromelain, showed no significant benefits. Tranexamic acid, vessel-preserving surgical methods, and magnesium sulfate dressings are among the most effective strategies for minimizing ecchymosis and edema in eyelid and periocular surgery. Further RCTs should explore optimized combinations of these interventions and assess long-term patient-reported outcomes."

Journal • Review • Aesthetic Medicine • Anesthesia • Pain

The Effect of Three Different Medications on Anesthetic Success and Postoperative Pain (clinicaltrials.gov) - P=N/A | N=120 | Recruiting | Sponsor: Cairo University | Trial completion date: Oct 2025 ➔ Jan 2026 | Trial primary completion date: Aug 2025 ➔ Dec 2025 | Trial primary completion date: Aug 2025 ➔ Dec 2025

Trial completion date • Trial primary completion date • Anesthesia • Dental Disorders • Pain

Combined Effects of Diosmin, Hesperidin, Ruscus aculeatus, Ananas comosus, and Bromelain on Endothelial Function and Gut Barrier Integrity In Vitro. (PubMed, Int J Mol Sci) - "These findings indicate a potential role for Vesvein in supporting endothelial health and vascular function in vitro. Preliminary evidence from intestinal models further suggests preserved barrier properties, which may positively influence absorption and bioavailability, thereby enhancing its vascular benefits."

Journal • Preclinical • Cardiovascular

Real-World Experience of Anacaulase-bcdb Debridement in Burns. (PubMed, J Burn Care Res) - "Patients treated with anacaulase-bcdb had a shorter time to first surgery from admission (4 days [3, 5] vs 6 [5, 7], P = .017) and higher average maximum wound care pain scores during the first 5 days (7 [6, 8] vs 5 [3, 7], P = .047). There was no difference in length of stay, area grafted, number of surgeries, total opioids/benzodiazepines received, or sedation scores."

Journal • Real-world evidence • Anesthesia • Pain • Thermal Injury

Two Cases of Enzymatic Debridement for Deep Burn Wounds Associated with Automobile Run-over Injuries. (PubMed, J Plast Reconstr Surg) - "These cases suggest anacaulase as a valuable alternative to surgical debridement, especially in complex trauma cases where conventional methods are less feasible. Further research is warranted to optimize its use in burn treatment protocols."

Journal • Musculoskeletal Diseases • Orthopedics • Thermal Injury

Bromelain Alleviates 3-Nitropropionic Acid-Induced Huntington's Disease-Like Symptoms in Rats Through the Interplay of SIRT1/PGC-1α and FOXO3a Pathways. (PubMed, Biofactors) - "These effects were further substantiated by improvements in muscle strength, locomotor coordination, cognitive performance, and neuronal integrity. In conclusion, bromelain could be a beneficial neuroprotective candidate against HD-like aberrations experimentally induced by 3-NP."

Journal • Preclinical • Huntington's Disease • Movement Disorders • NFE2L2 • NQO1 • TFAM

Dose Determination and Efficacy Evaluation of the Gastrointestinal ReProgramming (GaRP) Dietary supplement in Irritable Bowel Syndrome patients (ANZCTR) - P1/2 | N=200 | Completed | Sponsor: Anatara Lifesciences | Recruiting ➔ Completed

Trial completion • Gastrointestinal Disorder

Identification and exploration of sleep-enhancing peptides from goat milk casein by peptidomics and virtual screening. (PubMed, Food Res Int) - "In silico computational simulation predicted that papain, chymotrypsin, alcalase, and bromelain generate peptides with the highest activity. Notably, FAWPQY was particularly effective in extending sleep duration (37.08 ± 3.88 min) and decreasing sleep latency (5.06 ± 1.03 min) in mice. These results indicated that combining peptidomics, molecular docking, and animal testing is an effective strategy for screening sleep-enhancing peptides."

Journal • Sleep Disorder