Lupus erythematosus and nutrition: A review of the literature

Brown, Amy C.

doi:10.1053/jren.2000.16323

Cited by 61 publications

(58 citation statements)

References 101 publications

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“…The level of proof, method of bromelain administration and dose, and quality of the studies vary, but beneficial effects were suggested or proven in a variety of inflammatory diseases and models of inflammation. These include the experimental allergic encephalomyelitis (EAE) model of the human autoimmune disease multiple sclerosis (3), carrageenan-induced pleurisy in the rat (4)(5)(6), immunologically mediated arteriosclerosis in rat aortic allografts (7), rheumatologic diseases in mice and humans (8)(9)(10)(11)(12)(13), and allergic asthma (14) and rhinitis (15). Some studies demonstrated that bromelain had efficacy similar to standard anti-inflammatory drugs such as dexamethasone (5,6) or non-steroidal anti-inflammatory agents (NSAIDs) (8,10,11,16).…”

Section: Introductionmentioning

confidence: 99%

Bromelain treatment decreases neutrophil migration to sites of inflammation

Fitzhugh

Shan

Dewhirst

et al. 2008

Clinical Immunology

116

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Bromelain, a mixture of proteases derived from pineapple stem, has been reported to have therapeutic benefits in a variety of inflammatory diseases, including murine inflammatory bowel disease. The purpose of this work was to understand potential mechanisms for this anti-inflammatory activity. Exposure to bromelain in vitro has been shown to remove a number of cell surface molecules that are vital to leukocyte trafficking, including CD128a/CXCR1 and CD128b/CXCR2 that serve as receptors for the neutrophil chemoattractant IL-8 and its murine homologues. We hypothesized that specific proteolytic removal of CD128 molecules by bromelain would inhibit neutrophil migration to IL-8 and thus decrease acute responses to inflammatory stimuli. Using an in vitro chemotaxis assay, we demonstrated a 40% reduction in migration of bromelain-vs. sham-treated human neutrophils in response to rhIL-8. Migration to the bacterial peptide analog fMLP was unaffected, indicating that bromelain does not induce a global defect in leukocyte migration. In vivo bromelain treatment generated a 50 -85% reduction in neutrophil migration in 3 different murine models of leukocyte migration into the inflamed peritoneal cavity. Intravital microscopy demonstrated that although in vivo bromelain treatment transiently decreased leukocyte rolling, its primary long-term effect was abrogation of firm adhesion of leukocytes to blood vessels at the site of inflammation. These changes in adhesion were correlated with rapid re-expression of the bromelain-sensitive CD62L/L-selectin molecules that mediate rolling following in vivo bromelain treatment and minimal re-expression of CD128 over the time period studied. Taken together, these studies demonstrate that bromelain can effectively decrease neutrophil migration to sites of acute inflammation and support the specific removal of the CD128 chemokine receptor as a potential mechanism of action.

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Section: Introductionmentioning

confidence: 99%

Bromelain treatment decreases neutrophil migration to sites of inflammation

Fitzhugh

Shan

Dewhirst

et al. 2008

Clinical Immunology

116

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“…O lúpus eritematoso sistêmico (LES) juvenil é uma doença rara com manifestações clínicas variáveis, dependendo do órgão ou sistema acometido e cujo início pode ser abrupto ou insidioso 4 . Crianças e adolescentes com LES habitualmente apresentam início da doença e curso evolutivo mais graves em relação a pacientes adultos 5 .…”

Section: Introductionunclassified

“…Crianças e adolescentes com LES habitualmente apresentam início da doença e curso evolutivo mais graves em relação a pacientes adultos 5 . As complicações cardiovasculares do LES devem receber atenção especial por representarem a terceira causa de morte em pacientes acometidos pela doença, precedidas apenas pelas complicações renais e infecciosas 4 . Sabe-se que as lesões ateroscleróticas se iniciam na primeira infância, sendo a alimentação e o estilo de vida saudáveis fatores primordiais para a prevenção de doenças cardiovasculares, especialmente em pacientes com LES juvenil 5 .…”

Section: Introductionunclassified

Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus

Caetano¹,

Ortiz²,

Terreri³

et al. 2009

J Pediatr (Rio J)

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Objectives: To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients' clinical and anthropometric characteristics and to the drugs used in their treatment.Methods: By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis.Results: Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. Conclusion:Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients. J Pediatr (Rio J)

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“…Bromelain is a mixture of proteolytic enzymes derived from pineapple stem that has demonstrated beneficial effects in various models of inflammation. These include carrageenan-induced pleurisy in the rat (6)(7)(8), immunologically mediated arteriosclerosis in rat aortic allografts (9), the experimental allergic encephalomyelitis (EAE) model for the human autoimmune disease multiple sclerosis (10), and several human rheumatologic diseases (11)(12)(13). Although the exact composition of bromelain preparations can vary according to source and method of purification, the major protein components are stem bromelain (~80%), fruit bromelain (~10%), and ananain (<5%).…”

Section: Introductionmentioning

confidence: 99%

Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro

Onken

Greer

Calingaert

et al. 2008

Clinical Immunology

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Oral bromelain has been anecdotally reported to decrease inflammation in ulcerative colitis (UC). Proteolytically active bromelain is known to decrease expression of mRNAs encoding proinflammatory cytokines by human leukocytes in vitro. To assess the effect of bromelain on mucosal secretion of cytokines in inflammatory bowel disease (IBD), endoscopic colon biopsies from patients with UC, Crohn's disease (CD), and non-IBD controls were treated in vitro with bromelain or media, then cultured. Secretion of pro-inflammatory cytokines and chemokines was measured. Significant increases in granulocyte colony stimulating factor (G-CSF), interferon (IFN)-γ, interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF) were detected in the media from actively inflamed areas in UC and CD as compared with non-inflamed IBD tissue and non-IBD controls. In vitro bromelain treatment decreased secretion of G-CSF, granulocyte-macrophage colony stimulating factor (GM-CSF), IFN-γ, CCL4/macrophage inhibitory protein (MIP)-1β, and TNF by inflamed tissue in IBD. Bromelain may be a novel therapy for IBD.

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Lupus erythematosus and nutrition: A review of the literature

Cited by 61 publications

References 101 publications

Bromelain treatment decreases neutrophil migration to sites of inflammation

Bromelain treatment decreases neutrophil migration to sites of inflammation

Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus

Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro

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