Improving Cancer Treatment with Pineapple Enzyme: A Lab Study

Jenn Hoskins
6th May, 2024

Improving Cancer Treatment with Pineapple Enzyme: A Lab Study

Image Source: Natural Science News, 2024

Key Findings

  • Researchers found that bromelain, an enzyme from pineapples, helps break down mucin in appendiceal cancer
  • Bromelain treatment before chemotherapy improved drug effectiveness by clearing the mucin barrier
  • The study suggests bromelain could aid in more complete tumor removal and potentially improve survival rates
Appendiceal cancer (AC), a rare malignancy originating from the appendix, often involves the production of copious amounts of mucin, a gel-like substance that can complicate treatment. Excessive mucin production can hinder the effectiveness of heated intraperitoneal chemotherapy (HIPEC), a targeted treatment method for cancers within the abdominal cavity. Researchers at Wake Forest University School of Medicine have recently conducted a study[1] to address this challenge, focusing on the use of bromelain, an enzyme extracted from pineapple stems known for its mucolytic properties—its ability to break down mucin. HIPEC involves the surgical removal of visible tumors followed by the direct application of heated chemotherapy drugs into the abdomen. This technique aims to target microscopic cancer cells that may remain post-surgery. However, the mucin produced in AC can act as a physical barrier, preventing the chemotherapy from reaching and effectively killing cancer cells. Previous studies have shown the benefits of combining cytoreductive surgery (CRS) with HIPEC, reporting improved survival rates and reduced complications over time[2][3]. However, the challenge of mucin in AC remains. The Wake Forest study innovatively utilized patient-derived tumor organoids (PTOs), which are three-dimensional models of the patient's tumor grown in the lab, to test the effectiveness of bromelain as a pretreatment to HIPEC. These PTOs offer a more accurate representation of how a patient's cancer might respond to treatment compared to traditional cell culture methods. The research team collected 16 tumor specimens from 13 patients and subjected the PTOs to various treatment conditions, including HIPEC with bromelain, cisplatin, and mitomycin C (MMC) at different temperatures. Their findings were promising. The addition of bromelain, especially when used with N-acetylcysteine (NAC), another mucolytic agent, significantly depleted mucin levels. This pretreatment allowed for increased penetration and effectiveness of the chemotherapy drugs. The results showed a notable reduction in organoid viability, indicating that the cancer cells were being killed more effectively when bromelain was used. Moreover, the study highlighted that bromelain pretreatment not only reduced the expression of proteins associated with tumor proliferation but also increased markers indicative of apoptosis—a form of programmed cell death that is often a goal of cancer therapy. Additionally, bromelain treatment appeared to induce autophagy, a process where cells degrade and recycle components, which can lead to cell death in the context of cancer. These findings are particularly significant when considering past research on factors influencing survival rates in AC. Studies have identified that complete cytoreduction, where all visible tumors are removed, is a key predictor of improved survival[4]. The Wake Forest study suggests that bromelain pretreatment could potentially make complete cytoreduction more achievable by reducing mucin and allowing better access for surgeons and chemotherapy drugs. Furthermore, the research also touches on the negative impact of mucinous histology in other cancers, such as colorectal mucinous adenocarcinoma, where a high mucinous content has been associated with worse outcomes[5]. This raises the potential for bromelain's mucolytic properties to be beneficial in other mucin-producing cancers beyond AC. In conclusion, the Wake Forest University School of Medicine study presents a compelling case for incorporating bromelain as a pretreatment in HIPEC procedures for appendiceal cancer. By improving drug delivery through the reduction of mucin, bromelain may enhance the effectiveness of HIPEC, potentially leading to better patient outcomes. These findings are a step forward in the ongoing effort to optimize treatment for AC and possibly other mucin-producing cancers, reinforcing the importance of innovative approaches in cancer therapy.

MedicineHealthBiotech

References

Main Study

1) Enhancing the Efficacy of HIPEC Through Bromelain: A Preclinical Investigation in Appendiceal Cancer.

Published 4th May, 2024

https://doi.org/10.1245/s10434-024-15355-0

Related Studies

2) Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

https://doi.org/10.1200/JCO.2011.39.7166

3) Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients.

https://doi.org/10.1016/j.jamcollsurg.2013.12.013

4) Peritoneal surface disease (PSD) from appendiceal cancer treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): overview of 481 cases.

https://doi.org/10.1245/s10434-014-4147-y

5) Prognostic implication of mucinous histology in resected colorectal cancer liver metastases.

https://doi.org/10.1016/j.surg.2014.01.011


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