Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Bromelain ve Kanser
Bromelain and Cancer
Tuğba GÜNDOĞDUa, Gamze AKBULUTb
aBeslenme ve Diyet Bölümü, Sağlık Bilimleri Üniversitesi, Antalya Eğitim ve Araştırma Hastanesi, Antalya, TÜRKİYE
bBeslenme ve Diyetetik Bölümü, Gazi Üniversitesi Sağlık Bilimleri Fakültesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2019;4(1):79-84
doi: 10.5336/healthsci.2018-60225
Article Language: TR
Full Text
ÖZET
 Kanser, dünya çapında önemli bir halk sağlığı sorunudur ve günümüzde en yaygın ölüm nedenlerinden biridir. Kanserden korunmada ve kanser tedavisinde beslenme büyük bir öneme sahiptir. Günümüzde kanser tedavisinde besinsel desteklere ilgi giderek artmaktadır. Besinsel destekler arasında ananastan elde edilen ve ham sulu bir özüt olan bromelain ön plana çıkmaktadır. Bromelain, güvenli kullanım geçmişine sahiptir ve uzun süre tüketildiğinde insan vücudunda ciddi düzeyde yan etkilere neden olmamaktadır. Bromelainin yapısında endopeptidazlar, fosfatazlar, glukozidazlar, peroksidazlar, selülazlar, glikoproteinler, proteinaz inhibitörleri, kalsiyum ve karbonhidrat bulunmaktadır. Bromelainin anti-kanser aktivitesi proteolitik aktivitesinden kaynaklanmaktadır. Bromelain antikanser aktivitesini; büyüme/invaziv kapasite, apoptoz/hücre sağkalımı, inflamasyon, immünomodülatör, hemostatik sistem üzerine etkileri ile göstermektedir. Farelerde yürütülen çalışmalarda; bromelainin Bax ekspresyonunu artırdığı, Akt ve Erk gibi hücre sağkalım düzenleyicilerinin aktivitesini azalttığı ve tümörlerde apoptotik hücre ölümünü teşvik ettiği bildirilmiştir. Bromelain; inflamatuar yolaklar aracılığı ile kanserli hücreler üzerinde nükleer faktör kappa-B, siklooksijenaz-2 ve prostaglandin E2 aktivitesinin inhibisyonunu sağlamaktadır. Ayrıca, bromelainin dolaşımdaki CD44 birikimini engellediği, dönüştürücü büyüme faktörü beta ekspresyonunu azalttığı ve tümörlü hücrelerde reaktif oksijen türleri üretimini artırdığı rapor edilmiştir. Kanser hastalarında bromelain süplemantasyonu ile yapılan çalışmaların yetersiz olmasından dolayı, aktif kanser tedavisi sırasında süplemantasyon kullanımının uygunluğu ve dozu hakkında net bir öneri verilememekte, ancak bromelainin birlikte kullanılan kemoterapik ilaçlar ile kanserli hücrelere karşı sinerjik etkiler gösterdiği ve ilaçların sitotoksik aktivitesini artırdığı vurgulanmaktadır. Sonuç olarak, bromelain proteolitik aktivitesinden dolayı anti-kanser aktivite göstermektedir ve gelecekte kanser tedavisi için etkin bir besinsel destek olabileceği düşünülmektedir. Ancak, bu konu hakkında yürütülecek daha fazla çalışmaya gereksinim duyulmaktadır.

Anahtar Kelimeler: Kanser; bromelain; beslenme; süplementasyon
ABSTRACT
 Cancer is a major public health problem worldwide and is one of the most common causes of death today. Nutrition has a great importance in prevention and treatment of cancer. At present, interest in nutritional supplements in cancer treatment is increasing. Among the nutritional supplements, bromelain, which is obtained from ananas (ananas cosmosus) and is a raw juice extract, is the foreground. Bromelain has a history of safe use and does not cause serious side effects in the human body when consumed for a long time. Bromelain structure includes endopeptidases, phosphatases, glucosidases, peroxidases, cellulases, glycoproteins, proteinase inhibitors, calcium and carbohydrates. Anti-cancer activity of bromelain is due to its proteolytic activity. Bromelain shows anticancer activity via its effects on growth/invasive capacity, apoptosis/cell survival, inflammation, immunomodulator, hemostatic system. Studies conducted in mice have reported that bromelain increases Bax expression, decreases the activity of cell survival regulators such as Akt and Erk, and induces apoptotic cell death in tumors. Bromelain provides inhibition of nuclear factor kappa-B, cyclooxygenase-2 and prostaglandin E2 activity on cancer cells via inflammatory pathways. It has also been reported that bromelain inhibits circulating CD44 accumulation, decreases the expression of transforming growth factor beta, and increases the production of reactive oxygen species in tumor cells. Since studies with bromelain supplementation in cancer patients are inadequate, there is no clear recommendation on the suitability and dosage of supplementation during active cancer treatment. Finally, it has been emphasized that bromelain has synergistic effects on cancerous cells, when it is used in combination with chemotherapeutic drugs, and increases the cytotoxic activity of the drugs. As a result, bromelain shows anti-cancer activity due to its proteolytic activity and it is considered that there may be an effective nutritional supplement for cancer treatment in the future. However, there is a need to study more about this issue.

Keywords: Cancer; bromelain; nutrition; supplementation
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30.03.2014

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