Bromelain reduces the non-alcoholic fatty liver disease and periodontal damages caused by ligature-induced periodontitis
Even Herlany Pereira Alves
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Contribution: Data curation, Formal analysis, Investigation, Methodology, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorAndré dos Santos Carvalho
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorFelipe Rodolfo Pereira Silva
Department of Morphology, Federal University of Amazonas, Manaus, Brazil
Search for more papers by this authorLuiz Felipe Carvalho França
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorDavid Di Lenardo
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorAny Carolina Cardoso Guimarães Vasconcelos
Medicine School, Education Institute of Parnaiba Valley (FAHESP/ IESVAP - Afya), Parnaíba, PI, Brazil
Search for more papers by this authorHélio Mateus Silva Nascimento
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorVíctor Lucas Ribeiro Lopes
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorJefferson Soares Oliveira
Laboratory of Biochemistry and Biology of Microorganism and Plants (BIOMIC), Federal University of Parnaiba Delta (UFDPar), Parnaíba, PI, Brazil
Search for more papers by this authorCorresponding Author
Daniel Fernando Pereira Vasconcelos
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Correspondence
Daniel Fernando Pereira Vasconcelos, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Veloso, Colegiado de Biomedicina, Av. São Sebastião, 2819, Reis Veloso, Parnaiba - PI 64204-035, Brazil.
Email: [email protected]
Search for more papers by this authorEven Herlany Pereira Alves
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Contribution: Data curation, Formal analysis, Investigation, Methodology, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorAndré dos Santos Carvalho
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorFelipe Rodolfo Pereira Silva
Department of Morphology, Federal University of Amazonas, Manaus, Brazil
Search for more papers by this authorLuiz Felipe Carvalho França
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorDavid Di Lenardo
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorAny Carolina Cardoso Guimarães Vasconcelos
Medicine School, Education Institute of Parnaiba Valley (FAHESP/ IESVAP - Afya), Parnaíba, PI, Brazil
Search for more papers by this authorHélio Mateus Silva Nascimento
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorVíctor Lucas Ribeiro Lopes
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Search for more papers by this authorJefferson Soares Oliveira
Laboratory of Biochemistry and Biology of Microorganism and Plants (BIOMIC), Federal University of Parnaiba Delta (UFDPar), Parnaíba, PI, Brazil
Search for more papers by this authorCorresponding Author
Daniel Fernando Pereira Vasconcelos
Laboratory of Histological Analysis and Preparation (LAPHis), Federal University of Parnaiba Delta (UFDPar), Parnaiba, PI, Brazil
Correspondence
Daniel Fernando Pereira Vasconcelos, Universidade Federal do Delta do Parnaíba, Campus Ministro Reis Veloso, Colegiado de Biomedicina, Av. São Sebastião, 2819, Reis Veloso, Parnaiba - PI 64204-035, Brazil.
Email: [email protected]
Search for more papers by this authorAbstract
Objective
The objective of this research was to evaluate the effects of bromelain (derived from Ananas comosus) upon periodontitis in rats.
Materials and Methods
Twenty-four rats were separated into groups: control, periodontitis, and bromelain treatment. Bromelain was administered daily by intraperitoneal injection for 20 days. Periodontitis was induced by ligature around the first molars. Oral parameters and blood biomarkers were measured. The histopathological evaluation of the hepatic tissue was performed. Bromelain treatment significantly reduced several oral inflammatory parameters, alveolar bone loss, and blood biomarkers compared to the rats on periodontitis.
Results
Treatment with bromelain improved the steatosis score. Bromelain used in ligature-induced periodontitis in rats was able to reduce the oral inflammatory parameters Gingival Bleeding Index (GBI), tooth mobility (TM), probing pocket depth (PPD), malondialdehyde (MDA), alveolar bone height (ABH) and gingival myeloperoxidase (MPO) and blood parameters (cholesterol, triglycerides, alanine aminotransferase, and aspartate aminotransferase). Bromelain treatment reduced the impact of periodontitis, such as the reduction of hepatic steatosis and improvement in the dosages of MDA and GSH.
Conclusion
Bromelain acts as a potential adjunct in the non-surgical treatment of periodontitis and, consequently, reduces the impact of periodontitis, acting as anti-inflammatory and antioxidant.
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest.
REFERENCES
- Ali, A. A., Mohammed, A. M., & Isa, A. G. (2015). Antimicrobial effects of crude bromelain extracted from pineapple fruit (Ananas comosus (Linn.) Merr.). Advances in Biochemistry, 3(1), 1–4. https://doi.org/10.11648/j.ab.20150301.11
10.11648/j.ab.20150301.11 Google Scholar
- Al-Otaibi, W. R., Virk, P., & Elobeid, M. (2015). Ameliorative potential of stem bromelain on lead-induced toxicity in Wistar rats. Acta Biologica Hungarica, 66, 149–160. https://doi.org/10.1556/018.66.2015.2.2
- Bernela, M., Ahuja, M., & Thakur, R. (2016). Enhancement of anti-inflammatory activity of bromelain by its encapsulation in katira gum nanoparticles. Carbohydrate Polymers, 143, 18–24. https://doi.org/10.1016/j.carbpol.2016.01.055
- Chang, T. C., Wei, P. L., Makondi, P. T., Chen, W. T., Huang, C. Y., & Chang, Y. J. (2019). Bromelain inhibits the ability of colorectal cancer cells to proliferate via activation of ROS production and autophagy. PLoS One, 14, e0210274. https://doi.org/10.1371/journal.pone.0210274
- Chaudhary, B., Agarwal, S., & Bist, R. (2018). Invulnerability of bromelain against oxidative degeneration and cholinergic deficits imposed by dichlorvos in mice brains. Frontiers in Biology, 13, 56–62. https://doi.org/10.1007/s11515-018-1479-1
- Chaves, L. S., Nicolau, L. A., Silva, R. O., Barros, F. C., Freitas, A. L., Aragao, K. S., … Medeiros, J. V. (2013). Antiinflammatory and antinociceptive effects in mice of a sulfated polysaccharide fraction extracted from the marine red algae Gracilaria caudata. Immunopharmacology and Immunotoxicology, 35, 93–100. https://doi.org/10.3109/08923973.2012.707211
- da Silva, F. R. P., Vasconcelos, A. C. C. G., Alves, E. H. P., Junior, P. V. O., de Oliveira, J. S., & Vasconcelos, D. F. P. (2016). Bromelain: A potential strategy for the adjuvant treatment of periodontitis. Dental Hypotheses, 7, 88. https://doi.org/10.4103/2155-8213.190483
10.4103/2155-8213.190483 Google Scholar
- da Silva, F. R. P., Vasconcelos, A. C. C. G., França, L. F. C., Di Lenardo, D., Nascimento, H. M. S., & Vasconcelos, D. F. P. (2018). Association between the rs1143634 polymorphism in interleukin-1B and chronic periodontitis: Results from a meta-analysis composed by 54 case/control studies. Gene, 668, 97–106. https://doi.org/10.1016/j.gene.2018.05.067
- Dahiya, P., Kamal, R., Gupta, R., Bhardwaj, R., Chaudhary, K., & Kaur, S. (2013). Reactive oxygen species in periodontitis. Journal of Indian Society of Periodontology, 17, 411–416. https://doi.org/10.4103/0972-124X.118306
- de Lencastre Novaes, L. C., Jozala, A. F., Lopes, A. M., de Carvalho Santos-Ebinuma, V., Mazzola, P. G., & Pessoa, J. A. (2016). Stability, purification, and applications of bromelain: A review. Biotechnology Progress, 32, 5–13. https://doi.org/10.1002/btpr.2190
- Dos Santos Carvalho, J., Cardoso Guimarães Vasconcelos, A. C., Herlany Pereira Alves, E., dos Santos Carvalho, A., da Silva, F. R. P., de Carvalho França, L. F., … Medeiros, J. V. (2017). Steatosis caused by experimental periodontitis is reversible after removal of ligature in rats. Journal of Periodontal Research, 52(5), 883–892. https://doi.org/10.1111/jre.12459
- Filho, M. D. S., Medeiros, J. V. R., Vasconcelos, D. F. P., Silva, D. A., Leodido, A. C. M., Fernandes, H. F., … Pinto, G. R. (2018). Orabase formulation with cashew gum polysaccharide decreases inflammatory and bone loss hallmarks in experimental periodontitis. International Journal of Biological Macromolecules, 107, 1093–1101. https://doi.org/10.1016/j.ijbiomac.2017.09.087
- Fitzhugh, D. J., Shan, S., Dewhirst, M. W., & Hale, L. P. (2008). Bromelain treatment decreases neutrophil migration to sites of inflammation. Clinical Immunology, 128, 66–74. https://doi.org/10.1016/j.clim.2008.02.015
- França, L. F. C., Vasconcelos, A., da Silva, F. R. P., Alves, E. H. P., Carvalho, J. S., Lenardo, D. D., … Vasconcelos, D. F. P. (2017). Periodontitis changes renal structures by oxidative stress and lipid peroxidation. Journal of Clinical Periodontology, 44, 568–576. https://doi.org/10.1111/jcpe.12729
- Hale, L. P., Greer, P. K., & Sempowski, G. D. (2002). Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation. Clinical Immunology, 104, 183–190. https://doi.org/10.1006/clim.2002.5254
- Junior, R. F. A., Souza, T. O., de Moura, L. M., Torres, K. P., de Souza, L. B., Alves, M. S., … de Araujo, A. A. (2013). Atorvastatin decreases bone loss, inflammation and oxidative stress in experimental periodontitis. PLoS One, 8, e75322. https://doi.org/10.1371/journal.pone.0075322
- Komazaki, R., Katagiri, S., Takahashi, H., Maekawa, S., Shiba, T., Takeuchi, Y., … Izumi, Y. (2017). Periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans affect non-alcoholic fatty liver disease by altering gut microbiota and glucose metabolism. Scientific Reports, 7, 13950. https://doi.org/10.1038/s41598-017-14260-9
- Lee, J. H., Lee, J. B., Lee, J. T., Park, H. R., & Kim, J. B. (2018). Medicinal effects of bromelain (Ananas comosus) targeting oral environment as an anti-oxidant and anti-inflammatory agent. Journal of Food and Nutrition Research, 6, 773–784. https://doi.org/10.12691/jfnr-6-12-8
- Liu, R., Li, N., Liu, N., Zhou, X., Dong, Z. M., Wen, X. J., & Liu, L. C. (2012). Effects of systemic ornidazole, systemic and local compound ornidazole and pefloxacin mesylate on experimental periodontitis in rats. Medical science monitor: International Medical Journal of Experimental and Clinical Research, 18, BR95–BR102. https://doi.org/10.12659/msm.882514
- Manji, F., Dahlen, G., & Fejerskov, O. (2018). Caries and periodontitis: Contesting the conventional wisdom on their aetiology. Caries Research, 52, 548–564. https://doi.org/10.1159/000488948
- Maurer, H. R. (2001). Bromelain: Biochemistry, pharmacology and medical use. Cellular and Molecular Life Sciences, 58, 1234–1245. https://doi.org/10.1007/PL00000936
- Nicu, E. A., & Loos, B. G. (2016). Polymorphonuclear neutrophils in periodontitis and their possible modulation as a therapeutic approach. Periodontology, 2000(71), 140–163. https://doi.org/10.1111/prd.12113
- Novaes, L. C. L., Jozala, A. F., Lopes, A. M., Santos-Ebinuma, V. C., Mazzola, P. G., & Junior, A. P. (2016). Stability, purification, and applications of bromelain: A review. Biotechnology Progress, 32, 5–13. https://doi.org/10.1002/btpr.2190
- Nyblom, H., Bjornsson, E., Simren, M., Aldenborg, F., Almer, S., & Olsson, R. (2006). The AST/ALT ratio as an indicator of cirrhosis in patients with PBC. Liver International: Official Journal of the International Association for the Study of the Liver, 26, 840–845. https://doi.org/10.1111/j.1478-3231.2006.01304.x
- Pessoa, L. S., Silva, F. R. P., Alves, E. H., Franca, L. F., di Lenardo, D., Carvalho, J. S., … Vasconcelos, D. F. P. (2018). One or two ligatures inducing periodontitis are sufficient to cause fatty liver. Medicina Oral, Patologia Oral Y Cirugia Bucal, 23, e269–e276. https://doi.org/10.4317/medoral.22204
- Praveen, N. C., Rajesh, A., Madan, M., Chaurasia, V. R., Hiremath, N. V., & Sharma, A. M. (2014). In vitro evaluation of antibacterial efficacy of pineapple extract (Bromelain) on periodontal pathogens. Journal of International Oral Health: JIOH, 6, 96–98.
- Rathnavelu, V., Alitheen, N. B., Sohila, S., Kanagesan, S., & Ramesh, R. (2016). Potential role of bromelain in clinical and therapeutic applications. Biomedical Reports, 5, 283–288. https://doi.org/10.3892/br.2016.720
- Rosenberg, L., Krieger, Y., Silberstein, E., Arnon, O., Sinelnikov, I. A., Bogdanov-Berezovsky, A., & Singer, A. J. (2012). Selectivity of a bromelain based enzymatic debridement agent: A porcine study. Burns: Journal of the International Society for Burn Injuries, 38, 1035–1040. https://doi.org/10.1016/j.burns.2012.02.011
- Sahbaz, A., Aynioglu, O., Isik, H., Ozmen, U., Cengil, O., Gun, B. D., & Gungorduk, K. (2015). Bromelain: A natural proteolytic for intra-abdominal adhesion prevention. International Journal of Surgery, 14, 7–11. https://doi.org/10.1016/j.ijsu.2014.12.024
- Sedlak, J., & Lindsay, R. H. (1968). Estimation of total, protein-bound, and nonprotein sulfhydryl groups in tissue with Ellman's reagent. Analytical Biochemistry, 25, 192–205. https://doi.org/10.1016/0003-2697(68)90092-4
- Toker, H., Ozdemir, H., Eren, K., Ozer, H., & Sahin, G. (2009). N-acetylcysteine, a thiol antioxidant, decreases alveolar bone loss in experimental periodontitis in rats. Journal of Periodontology, 80, 672–678. https://doi.org/10.1902/jop.2009.080509
- Tomofuji, T., Ekuni, D., Yamanaka, R., Kusano, H., Azuma, T., Sanbe, T., … Takata, T. (2007). Chronic administration of lipopolysaccharide and proteases induces periodontal inflammation and hepatic steatosis in rats. Journal of Periodontology, 78, 1999–2006. https://doi.org/10.1902/jop.2007.070056
- Uchiyama, M., & Mihara, M. (1978). Determination of malonaldehyde precursor in tissues by thiobarbituric acid test. Analytical Biochemistry, 86, 271–278. https://doi.org/10.1016/0003-2697(78)90342-1
- Vasconcelos, A., Vasconcelos, D. F. P., Silva, F. R. P., Franca, L. F. C., Alves, E. H. P., Lenardo, D. D., … de Oliveira, A. P. (2019). Periodontitis causes abnormalities in the liver of rats. Journal of Periodontology, 90, 295–305. https://doi.org/10.1002/JPER.18-0226
- Vasconcelos, D. F., Silva, F. R. P., Pinto, M. E., Santana, L. A., Souza, I. G., Souza, L. K. M., … Oliveira, J. S. (2017). Decrease of pericytes is associated with liver disease caused by ligature-induced periodontitis in rats. Journal of Periodontology, 88, e49–e57. https://doi.org/10.1902/jop.2016.160392
- Xu, Y., & Wei, W. (2006). A comparative study of systemic subantimicrobial and topical treatment of minocycline in experimental periodontitis of rats. Archives of Oral Biology, 51, 794–803. https://doi.org/10.1016/j.archoralbio.2006.03.018
- Younossi, Z. M., Baranova, A., Ziegler, K., Del Giacco, L., Schlauch, K., Born, T. L., … Chandhoke, V. (2005). A genomic and proteomic study of the spectrum of nonalcoholic fatty liver disease. Hepatology, 42, 665–674. https://doi.org/10.1002/hep.20838
- Ziebolz, D., Schmalz, G., Kauffels, A., Widmer, F., Widmer, K., Slotta, J. E., … Kollmar, O. (2017). Periodontal pathogenic bacteria and aMMP-8 findings depending on periodontal conditions of patients before and after liver transplantation. Clinical Oral Investigations, 21, 745–752. https://doi.org/10.1007/s00784-016-1821-4