Antineoplastic potential of pineapple: Delineating the path from prevention to therapy

Pineapple, over the years, has emerged as an exemplary functional food owing to its efficacy against a wide range of pathological conditions, largely attributable to bromelain, its proteolytic enzyme complex.

This review aims to explore the therapeutic scope and mechanistic basis of pineapple-derived bioactives, particularly bromelain, in suppressing neoplastic growth.

To evaluate the antineoplastic activity of pineapple, a comprehensive literature search was performed using PubMed, ScienceDirect, Scopus, and Web of Science with appropriate keywords.

The anticancer effects of pineapple were exhibited by antiproliferative, pro-apoptotic, anti-invasive, and chemosensitizing effects against a range of malignancies, such as breast, colon, gastric, liver, brain, lung, and hematological cancers. These effects are exerted mainly via caspase activation along with modulation of mitogen-activated protein kinase, nuclear factor-κB, phosphoinositide 3-kinase/protein kinase B, and Wingless-related integration site/β-catenin pathways, apart from oxidative stress and autophagy. Numerous studies have shown the synergistic effects of pineapple and its components with other treatments, such as radiation, natural compounds, non-chemotherapeutic agents, and anticancer drugs.

A critical appraisal of pineapple's antineoplastic effects is presented in a comprehensive manner, which underscores its translational impact in cancer prevention and intervention. However, the lack of robust human data, pharmacokinetic characterization, and dose optimization still limits its clinical application at this time.