Abstract: Metabolism Open 8 (2020) 100066
Contents lists available at ScienceDirect
Metabolism Open
journal homepage: www.journals.elsevier.com/metabolism-open
The combination of bromelain and curcumin as an immune-boosting
nutraceutical in the prevention of severe COVID-19
Panagiotis Kritis a, 1, Irene Karampela b, *, 1, Styliani Kokoris c, Maria Dalamaga d
a
Pulmonary and Tuberculous Diseases Private Practice, 27 K. Aitolou, 14121, Neo Iraklio, Athens, Greece
Second Department of Critical Care, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini
Street, 12462, Haidari, Greece
c
Laboratory of Hematology and Blood Bank Unit, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 1
Rimini Street, 12462, Haidari, Greece
d
Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 27 Mikras Asias, 11527, Goudi, Athens, Greece
b
a r t i c l e i n f o
a b s t r a c t
Article history:
Received 10 November 2020
Accepted 11 November 2020
Available online 13 November 2020
The coronavirus disease 2019 (COVID-19) pandemic is still ongoing, while no treatment has been proven
effective. COVID-19 pathophysiology involves the activation of three main pathways: the inflammatory,
the coagulation and the bradykinin cascades. Here, we highlight for the first time the joint potential
therapeutic role of bromelain and curcumin, two well-known nutraceuticals, in the prevention of severe
COVID-19. Bromelain (a cysteine protease isolated from the pineapple stem) and curcumin (a natural
phenol found in turmeric) exert important immunomodulatory actions interfering in the crucial steps of
COVID-19 pathophysiology. Their anti-inflammatory properties include inhibition of transcription factors
and subsequent downregulation of proinflammatory mediators. They also present fibrinolytic and
anticoagulant properties. Additionally, bromelain inhibits cyclooxygenase and modulates prostaglandins
and thromboxane, affecting both inflammation and coagulation, and also hydrolyzes bradykinin. Interestingly, curcumin has been shown in silico studies to prevent entry of the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) into cells as well as viral replication, while a recent experimental
study has demonstrated that bromelain may also inhibit viral entry into cells. Notably, bromelain substantially increases the absorption of curcumin after oral administration. To the best of our knowledge,
this is the first report highlighting the significance of bromelain and, most importantly, the potential
preventive value of the synergistic effects of bromelain and curcumin against severe COVID-19.
© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords:
Bromelain
COVID-19
Curcumin
Nutraceuticals
SARS-CoV-2
The worldwide spread of the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) has been devastating so far, affecting
more than 45 million people and causing more than 1 million
deaths globally, as of November 2, 2020 [1]. Research efforts in the
quest for an effective treatment for the coronavirus disease 2019
(COVID-19) have been fruitless, while our hopes to contain the
Abbreviations: ACE2, angiotensin-converting enzyme 2; COVID-19, coronavirus
disease 2019; COX-2, cyclooxygenase-2; NF-kB, nuclear..
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