Bromelain's activity and potential as an anti-cancer agent: Current evidence and perspectives.

Objective: To estimate the incidence and severity of nocebo responses in trials of symptomatic treatments (STs) and disease-modifying treatments (DMTs) for multiple sclerosis (MS).Methods: We conducted a systematic Medline search for all randomised, placebo-controlled MS trials published between 1989 and 2009. Meta-analysis of the incidence of nocebo responses was performed by pooling the percentage of placebo-treated patients that exhibited adverse events. Nocebo severity was calculated from the percentage of placebo-treated patients that dropped-out due to drug-related adverse events.Results: Data were extracted from 56 DMT and 44 ST eligible trials. The pooled incidence of nocebo responses was 74.4% (95% CI: 69.92—88.30) in DMT trials and 25.3% (95% CI: 15.24—36.90) in ST trials and was significantly higher in the former (p < 0.0001). The pooled nocebo severity was 2.1% (95% CI: 1.6—2.67) in DMT and 2.34% (95% CI: 1.54—3.29) in ST trials. Meta-regression analysis revealed a higher nocebo incidence in p...

Nocebo effects in multiple sclerosis trials: a meta-analysis

Discriminating brain tumor from stroke in patients presenting with acute focal neurologic signs and symptoms is crucial to avoid improper treatment, or delay correct treatment of the brain tumor patient. Data from the era before computed tomography (CT) suggests that 3% of patients with brain tumors are initially thought to have had a stroke. Our goal was to see if this has improved in the CT era. We reviewed hospital charts of all patients admitted to the Johns Hopkins Hospital with a brain tumor during a one year period. Eleven (4.9%) of the 224 patients discharged with a diagnosis of brain tumor were initially thought to have had a stroke. Seven had primary brain tumors and 4 had metastatic tumors. Patients who were originally misdiagnosed were significantly older (p = 0.01) and more likely to have a Glioblastoma Multiforme (p = 0.04) than those correctly diagnosed. Eighty-two percent of those misdiagnosed had no prior history of cancer compared to 59% of patients correctly diagnosed. Distinguishing the acute presentation of brain tumor and stroke remains an important diagnostic consideration. Physicians should recognize that while CT is frequently employed for acute neurologic deficits to exclude intracranial hemorrhage, CT may not be sufficient to exclude brain tumor. A prospective study is needed to confirm these findings.

Brain Tumor Masquerading as Stroke

Cholangiocarcinoma (CC) worldwide is the most common biliary malignancy with poor prognostic value and new systemic treatments are desirable. Plant extracts like bromelain and papain, which are cysteine proteases from the fruit pineapple and papaya, are known to have antitumor activities. Therefore, in this study for the first time we investigated the anticancer effect of bromelain and papain in intra- and extrahepatic human CC cell lines. The effect of bromelain and papain on human CC cell growth, migration, invasion and epithelial plasticity was analyzed using cell proliferation, wound healing, invasion and apoptosis assay, as well as western blotting. Bromelain and papain lead to a decrease in the proliferation, invasion and migration of CC cells. Both plant extracts inhibited NFκB/AMPK signalling as well as their downstream signalling proteins such as p-AKT, p-ERK, p-Stat3. Additionally, MMP9 and other epithelial-mesenchymal-transition markers were partially found to be downregulated. Apoptosis was induced after bromelain and papain treatment. Interestingly, bromelain showed an overall more effective inhibition of CC as compared to papain. siRNA mediated silencing of NFκB on CC cells indicated that bromelain and papain have cytotoxic effects on human CC cell lines and bromelain and partially papain in comparison impair tumor growth by NFκB/AMPK signalling. Especially bromelain can evolve as promising, potential therapeutic option that might open new insights for the treatment of human CC.

/pdf/comparative-study-of-antitumor-effects-of-bromelain-and-4mub2qfd3p.pdf

Comparative study of antitumor effects of bromelain and papain in human cholangiocarcinoma cell lines.

Complementary and alternative medicine (CAM) is used by one-half to three-fourths of multiple sclerosis (MS) patients. Although it is used widely, CAM may not be discussed during a conventional medical visit. In MS, CAM therapies exhibit a broad range of risk-benefit profiles; some of these therapies are low risk and possibly beneficial, whereas others are ineffective, dangerous, or unstudied. Health professionals who provide objective and practical information about the risks and benefits of CAM therapies may improve the quality of care for those with MS.

https://www.neurologic.theclinics.com/article/S0733-8619(10)00159-3/pdf

Complementary and Alternative Medicine and Multiple Sclerosis

Oral administration of hydrolytic enzymes (HE), such as bromelain, trypsin and rutosid, may have beneficial effects on the clinical course of neurological symptoms related to multiple sclerosis (MS). This is supported by a complete protection by HE from experimental allergic encephalomyelitis, an animal model related to MS. Three hundred and one patients with relapsing MS were enrolled in a double-blind, placebo-controlled trial. No treatment effect between the placebo and the HE groups was found either for clinical or MRI parameters.

http://www.slcmsr.net/download/publikationen/26Oral_Hydrolytic_enzymes_MS_2005.pdf

A randomized, double-blind, placebo-controlled study of oral hydrolytic enzymes in relapsing multiple sclerosis.

327 adult patients presenting with a first epileptic seizure were evaluated in respect to underlying causes. The majority suffered from alcohol-related seizures, in the elderly patients vascular patho

Type-Specific Diagnostic Analysis of First Epileptic Seizure in Adults

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A randomized, double-blind, placebo-controlled study of oral hydrolytic enzymes in relapsing multiple sclerosis.

Type-Specific Diagnostic Analysis of First Epileptic Seizure in Adults