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Notarnicola A, Pesce V, Vicenti G, et al. SWAAT study: extracorporeal shock wave therapy and arginine supplementation and other nutraceuticals for insertional Achilles tendinopathy. Adv Ther. 2012 Sep;29:799-814. View abstract.

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Sideris, C. P. and Young, H. Y. GROWTH OF ANANAS COMOSUS (L.) MERR. AT DIFFERENT LEVELS OF MINERAL NUTRITION UNDER GREENHOUSE AND FIELD CONDITIONS. I. PLANT AND FRUIT WEIGHTS AND ABSORPTION OF NITRATE AND POTASSIUM AT DIFFERENT GROWTH INTERVALS. Plant Physiol 1950;25(4):594-616. View abstract.

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Ito, C., Yamaguchi, K., Shibutani, Y., Suzuki, K., Yamazaki, Y., Komachi, H., Ohnishi, H., and Fujimura, H. [Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparation (author's transl)]. Nippon Yakurigaku Zasshi 4-20-1979;75(3):227-237. View abstract.

Levine, N., Seifter, E., Connerton, C., and Levenson, S. M. Debridement of experimental skin burns of pigs with bromelain, a pineapple-stem enzyme. Plast.Reconstr.Surg. 1973;52(4):413-424. View abstract.

Izaka, K. I., Yamada, M., Kawano, T., and Suyama, T. Gastrointestinal absorption and antiinflammatory effect of bromelain. Jpn J Pharmacol 1972;22(4):519-534. View abstract.

Weiss, S. and Scherrer, M. [Crossed double-blind trial of potassium iodide and bromelain (Traumanase) in chronic bronchitis]. Schweiz.Rundsch.Med Prax. 10-24-1972;61(43):1331-1333. View abstract.

Howat, R. C. and Lewis, G. D. The effect of bromelain therapy on episiotomy wounds--a double blind controlled clinical trial. J Obstet.Gynaecol.Br.Commonw. 1972;79(10):951-953. View abstract.

Mader, H. [Comparative studies on the effect of bromelin and oxyphenbutazone in episiotomy pains]. Schweiz Rundsch.Med Prax. 8-28-1973;62(35):1064-1068. View abstract.

Spaeth, G. L. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47(12):634-639. View abstract.

Seligman, B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology 1969;20(1):22-26. View abstract.

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Cowie, D. H., Fairweather, D. V., and Newell, D. J. A double-blind trial of bromelains as an adjunct to vaginal plastic repair operations. J Obstet Gynaecol Br Commonw. 1970;77(4):365-368. View abstract.

Koshiishi, T., Furusawa, Y., Iseki, H., and Iwasaki, Y. A double blind study of the effects of Kimotab on engorgement of the breast. Acta Obstet.Gynaecol.Jpn. 1971;18(4):222-228. View abstract.

Zatuchni, G. I. and Colombi, D. J. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29(2):275-278. View abstract.

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Hine, S. and Tamura, N. [Clinical use of bromelain (Ananase) in chronic rhino-sinusitis]. Jibiinkoka 1966;38(4):439-442. View abstract.

Mattei, O., Fabri, G., and Farina, G. [Occupational health experience regarding four cases of asthma due to bromelain (author's transl)]. Medicina del Lavoro 1979;70(5):404-409. View abstract.

Galleguillos, F. and Rodriguez, J. C. Asthma caused by bromelin inhalation. Clin Allergy 1978;8(1):21-24. View abstract.

Balakrishnan, V., Hareendran, A., and Nair, C. S. Double-blind cross-over trial of an enzyme preparation in pancreatic steatorrhoea. J Assoc Physicians India 1981;29(3):207-209. View abstract.

Ako, H., Cheung, A. H., and Matsuura, P. K. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodyn.Ther 1981;254(1):157-167. View abstract.

Desser, L., Rehberger, A., Kokron, E., and Paukovits, W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology 1993;50(6):403-407. View abstract.

Mynott, T. L., Luke, R. K., and Chandler, D. S. Oral administration of protease inhibits enterotoxigenic Escherichia coli receptor activity in piglet small intestine. Gut 1996;38(1):28-32. View abstract.

Kleef, R., Delohery, T. M., and Bovbjerg, D. H. Selective modulation of cell adhesion molecules on lymphocytes by bromelain protease 5. Pathobiology 1996;64(6):339-346. View abstract.

Mudrak, J., Bobak, L., and Sebova, I. Adjuvant therapy with hydrolytic enzymes in recurrent laryngeal papillomatosis. Acta Otolaryngol.Suppl 1997;527:128-130. View abstract.

Mynott, T. L., Guandalini, S., Raimondi, F., and Fasano, A. Bromelain prevents secretion caused by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro. Gastroenterology 1997;113(1):175-184. View abstract.

Castell, J. V., Friedrich, G., Kuhn, C. S., and Poppe, G. E. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am.J Physiol 1997;273(1 Pt 1):G139-G146. View abstract.

Hunter RG, Henry GW, and Heinicke RM. The action of papain and bromelain on the uterus. Part I. Mucolytic properties of papain and bromelain, effect on cervical mucus. Am J Obst & Gynec 1957;73(4):867-874.

Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508-510.

Morrison AW and Morrison MC. Bromelain - a clinical assessment in the post-operative treatment of arthrotomies of the knee and facial injuries. Brit J Clin Pract 1965;19(4):207-210.

Cohen A and Goldman J. Bromelains therapy in rheumatoid arthritis. Pennsylvania Med J 1964;67:27-30.

Nasciuti M and Benini P. Sperimentazione clinica in doppio cieco della bromelina in pazienti con fratture recenti degli arti inferiori. Gaz Med It 1977;136:535-546.

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Martin GJ, Ehrenreich J, and Asbell N. Bromelain: pineapple proteases with anti-edema activity. Exp Med Surg 1962;20:227-247.

Tassman GC, Zafran JN, and Zayon GM. Evaluation of a plant proteolytic enzyme for the control of inflammation and pain. Journal of Dental Medicine 1964;19(2):73-77.

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Kleine MW. Introduction to oral enzyme therapy. Int J Immunotherapy 1997;13(3-4):59-65.

Kolac C, Streichhan P, and Lehr CM. Oral bioavailability of proteolytic enzymes. Eur J Pharm Biopharm 1996;42(222):232.

Klein GK. Enzymatic debridement of third degree burns in animals with bromelains - a preliminary report. J Maine Med Assoc 1964;55:169-171.

Klaue P, Dilbert G, Hinke G, and et al. [Experiments on the local treatment of subdermal burns with bromelain]. Therapiewoche 1979;29:796-797.

Kugener H, Bergmann D, and Beck K. [Efficacy of bromelain in pancreatogenic digestive insufficiency]. Zeitschrift fur Gastroenterologie 1968;6:430-433.

Ferrari A, Pifarotti G, Dindelli M, and et al. Clinical trial of the efficacy and safety of seaprose S in patients with benign breast disease. Controlled trial vs bromeline. Gironale Italiano Di Ricerche Cliniche e Terapeutiche 1995;16(1):1-6.

Tassman GC, Zafran JN, and Zayon GM. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20(2):51-54.

Cirelli MG. Five years of clinical experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clinical Medicine 1967;74(6):55-59.

Miller JM, Ginsberg M, McElfatrick GC, and et al. The administration of bromelain orally in the treatment of inflammation and edema. Exper Med & Surg 1964;22:293-299.

Miller, P. C., Bailey, S. P., Barnes, M. E., Derr, S. J., and Hall, E. E. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. J Sports Sci 2004;22(4):365-372. View abstract.

Bolten WW, Glade MJ, Raum S, et al. The safety and efficacy of an enzyme combination in managing knee osteoarthritis pain in adults: a randomized, double-blind, placebo-controlled trial. Arthritis. 2015;2015:251521. View abstract.

Büttner L, Achilles N, Böhm M, et al. Efficacy and tolerability of bromelain in patients with chronic rhinosinusitis--a pilot study. B-ENT. 2013;9(3):217-25. View abstract.

Conrozier T, Mathieu P, Bonjean M, et al. A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain. Altern Ther Health Med. 2014;20 Suppl 1:32-7. View abstract.

de la Barrera-Núñez MC, Yáñez-Vico RM, Batista-Cruzado A, et al. Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period. Med Oral Patol Oral Cir Bucal. 2014;19(2):e157-62. View abstract.

Inchingolo F, Tatullo M, Marrelli M, Inchingolo AM, Picciariello V, Inchingolo AD, Dipalma G, Vermesan D, Cagiano R. Clinical trial with bromelain in third molar exodontia. Eur Rev Med Pharmacol Sci. 2010 Sep;14(9):771-4. View abstract.

Majid OW, Al-Mashhadani BA. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2014;72(6):1043-8. View abstract.

Müller S, März R, Schmolz M, et al. Placebo-controlled randomized clinical trial on the immunomodulating activities of low- and high-dose bromelain after oral administration - new evidence on the antiinflammatory mode of action of bromelain. Phytother Res. 2013;27(2):199-204. View abstract.

Rosenberg L, Krieger Y, Bogdanov-Berezovski A, et al. A novel rapid and selective enzymatic debridement agent for burn wound management: a multi-center RCT. Burns. 2014;40(3):466-74. View abstract.

Bolten WW, Glade MJ, Raum S, Ritz BW. The safety and efficacy of an enzyme combination in managing knee osteoarthritis pain in adults: a randomized, double-blind, placebo-controlled trial. Arthritis 2015;2015:251521. View abstract.

Ghensi P, Cucchi A, Creminelli L, Tomasi C, Zavan B, Maiorana C. Effect of oral administration of bromelain on postoperative discomfort after third molar surgery. J Craniofac Surg. 2017 Mar;28(2):e191-e197. View abstract.

Bormann KH, Weber K, Kloppenburg H, et al. Perioperative bromelain therapy after wisdom teeth extraction - a randomized, placebo-controlled, double-blinded, three-armed, cross-over dose-finding study. Phytother Res. 2016 Dec;30(12):2012-19. View abstract.

Kasemsuk T, Saengpetch N, Sibmooh N, Unchern S. Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis. Clin Rheumatol. 2016 Oct;35(10):2531-40. View abstract.

Desideri I, Francolini G, Becherini C, et al. Use of an alpha lipoic, methylsulfonylmethane and bromelain dietary supplement (Opera) for chemotherapy-induced peripheral neuropathy management, a prospective study. Med Oncol. 2017 Mar;34(3):46. View abstract.

Grabs V, Kersten A, Haller B, et al. Rutoside and hydrolytic enzymes do not attenuate marathon-induced inflammation. Med Sci Sports Exerc. 2017;49(3):387-395. View abstract.

Akhtar NM, Naseer R, Farooqi AZ, Aziz W, Nazir M. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--a double-blind prospective randomized study. Clin Rheumatol. 2004;23(5):410-5. View abstract.

Baumhackl U, Kappos L, Radue EW, et al. A randomized, double-blind, placebo-controlled study of oral hydrolytic enzymes in relapsing multiple sclerosis. Mult Scler. 2005;11(2):166-8. View abstract.

Kerkhoffs GM, Struijs PA, de Wit C, Rahlfs VW, Zwipp H, van Dijk CN. A double blind, randomised, parallel group study on the efficacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med. 2004;38(4):431-5. View abstract.

Shetty V, Mohan A. A prospective, randomized, double-blind, placebo-controlled clinical trial comparing the efficacy of systemic enzyme therapy for edema control in orthognathic surgery using ultrasound scan to measure facial swelling. J Oral Maxillofac Surg. 2013;71(7):1261-7. View abstract.

Tilwe GH, Beria S, Turakhia NH, Daftary GV, Schiess W. Efficacy and tolerability of oral enzyme therapy as compared to diclofenac in active osteoarthrosis of knee joint: an open randomized controlled clinical trial. J Assoc Physicians India. 2001;49:617-21. View abstract.

de Souza GM, Fernandes IA, Dos Santos CRR, Falci SGM. Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis. Phytother Res. 2019;33(3):473-481. View abstract.

Mendes ML, do Nascimento-Júnior EM, Reinheimer DM, Martins-Filho PR. Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e61-e69. View abstract.

Palmisano F, Spinelli MG, Luzzago S, et al. Medical Expulsive Therapy for Symptomatic Distal Ureter Stones: Is the Combination of Bromelain and Tamsulosin More Effective than Tamsulosin Alone? Preliminary Results of a Single-Center Study. Urol Int. 2019;102(2):145-152. View abstract.

Harats M, Haik J, Cleary M, Vashurin I, Aviv U, Kornhaber R. A retrospective review of an off-label bromelain-based selective enzymatic debridement (Nexobrid®) in the treatment of deep, partial, and full thickness burns and hard to heal wounds. Isr Med Assoc J 2020;22(2):83-8. View abstract.

Michelini S, Fiorentino A, Cardone M. Melilotus, rutin and bromelain in primary and secondary lymphedema. Lymphology 2019;52(4):177-86. View abstract.

Naeem H, Naqvi SN, Perveen R, et al. Efficiency of proteolytic enzymes in treating lumbar spine osteoarthritis (low back pain) patients and its effects on liver and kidney enzymes. Pak J Pharm Sci 2020;33(1(Supplementary)):371-8. View abstract.

Kutlu Ö, DemirbaS A, Elmas ÖF, Güvenç U, Metin A. Fixed drug eruption: a new side effect of bromelain. Contact Dermatitis 2020. Online ahead of print. View abstract.

Shoham Y, Shapira E, Haik J, et al. Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial. Wound Repair Regen 2021;29(6):899-907. View abstract.

Claes KEY, Amar S, Hoeksema H, et al. Pain management during a bromelain-based selective enzymatic debridement in paediatric and adult burn patients. Burns 2021. View abstract.

Desideri I, Lucidi S, Francolini G, et al. Use of an alfa-lipoic, methylsulfonylmethane, Boswellia serrata and bromelain dietary supplement (OPERA®) for aromatase inhibitors-related arthralgia management (AIA): a prospective phase II trial (NCT04161833). Med Oncol 2022;39(8):113. View abstract.

Gupta AA, Kambala R, Bhola N, Jadhav A. Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial. J Dent Anesth Pain Med 2022;22(1):29-37. View abstract.

Pfister P, Garcia Wendel PD, Kim BS, et al. Coagulation side effects of enzymatic debridement in burned patients. Burns 2022. View abstract.

De Luca P, D'Ascanio L, Cingolani C, et al. A Supplement with Ribes Nigrum, Boswellia Serrata, Bromelain and Vitamin D to Stop Local Inflammation in Chronic Sinusitis: A Case-Control Study. J Clin Med 2023;12(8):2929. View abstract.

Ma JW, Hung JL, Takeuchi M, Shieh PC, Horng CT. A New Pharmacological Vitreolysis through the Supplement of Mixed Fruit Enzymes for Patients with Ocular Floaters or Vitreous Hemorrhage-Induced Floaters. J Clin Med 2022;11(22):6710. View abstract.

Hasham S, Riyat H, Fletcher A, O'Boyle CP, Alexander S. To bleed or not to bleed? Case series and discussion of haemorrhage risk with enzymatic debridement in burn injuries. Scars Burn Heal 2023;9:20595131231168333. View abstract.

Babazade H, Mirzaagha A, Konarizadeh S. The effect of bromelain in periodontal surgery: a double-blind randomized placebo-controlled trial. BMC Oral Health 2023;23(1):286. View abstract.

Leelakanok N, Petchsomrit A, Janurai T, Saechan C, Sunsandee N. Efficacy and safety of bromelain: A systematic review and meta-analysis. Nutr Health 2023. View abstract.