Great to talk at Cyprus Gastro congress on often-neglected bowel urgency in UC. Even Mayo score (used by FDA) does not include urgency, despite it's distressing impact that can prevent pts from leaving home! We use SCCAI in practice & research. Time to rethink UC assessment.

2 of 2 Bromelain, a complex mixture of proteolytic enzymes extracted primarily from the stem or fruit of pineapples (Ananas comosus), has been extensively studied for its therapeutic potential in areas like inflammation reduction, cancer treatment, wound healing & digestive health While early research dates back to the late 19th century, modern clinical & preclinical studies have explored its mechanisms, including fibrinolytic, anti-inflammatory & immunomodulatory effects, often with promising but sometimes mixed results requiring further validation Anti-Inflammatory & Immunomodulatory Effects: Multiple studies highlight bromelain’s ability to reduce inflammation by modulating cytokines (e.g., downregulating PGE-2, IL-6, TNF-α) &inhibiting pathways like NF-κB. 2 7 9 A 2023 systematic review of seven randomized controlled trials found that bromelain supplementation, alone or combined, lowered inflammatory markers in adults, supporting its use for conditions like osteoarthritis & post-surgical swelling In a 2025 randomized, triple-blind, placebo-controlled trial on ulcerative colitis patients, daily bromelain significantly reduced disease activity scores (e.g., SCCAI from baseline) over 8 weeks, though quality-of-life improvements were not statistically significant after adjustments For sinusitis, a 2024 review of 54 studies concluded bromelain relieves symptoms by dissolving mucus & reducing nasal swelling, with faster recovery in children compared to standard treatments. In vitro work shows bromelain alters immune cell adhesion & enhances antibiotic absorption Anticancer Properties Preclinical research indicates bromelain’s potential as an anticancer agent through apoptosis induction, angiogenesis inhibition & immune enhancement. A 2021 review cited in vitro studies showing efficacy against melanoma and epidermoid carcinoma cell lines, with reduced tumor growth in animal models Another 2016 review emphasized its role in modulating cancer pathways, though human trials are limited and more data is needed for clinical application Cardiovascular & Antithrombotic Benefits In vivo studies demonstrate bromelain’s fibrinolytic & antithrombotic actions, improving blood flow and reducing platelet aggregation A 2021 analysis noted its potential in treating angina, thrombophlebitis & cardiovascular disorders by enhancing arterial flow and minimizing dissections Other Applications Bromelain aids wound debridement, osteoarthritis relief, and obesity management by improving insulin sensitivity and reducing inflammation. A 2025 review on obesity linked it to cytokine modulation in vitro, with potential for metabolic disorders like NAFLD & diabetes Safety profiles show good bioavailability and minimal side effects, but interactions (e.g., with anticoagulants) warrant caution Overall, while promising, many studies call for larger human trials to confirm efficacy & optimal dosing Bromelain protease activity - Biology Lab Techniques
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This demonstrates bromelain’s proteolytic effects on gelatin, illustrating its enzyme activity in a lab setting WHS Fireside Chat - Bromelain-based enzymatic debridement of chronic wounds
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Discusses a multicenter randomized controlled trial on bromelain for wound debridement, showing rapid efficacy in chronic wounds Can A Pineapple Eat You?
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Explains bromelain’s protein-digesting mechanism, with scientific insights into its two forms (stem and fruit) Exploring the Anti-Inflammatory Properties of Bromelain
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Reviews studies on bromelain’s anti-inflammatory effects from pineapple stem enzymes for pain and swelling reduction What Are the Health Benefits of Pineapple & Pineapple Water? What Are Health Benefits of Bromelain?
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A doctor discusses evidence from studies on bromelain for inflammation, digestion, and potential limitations. 26 Brom

Could plant-derived enzymes bromelain worth considering in #ulcerativecolitis❓ A recent trial in 70 patients with UC found that taking 400 mg of bromelain daily for 8 weeks: ✅ Showed a positive effect on disease activity (SCCAI score) vs placebo ✅ No considerable difference in changes in quality of life ✅ No adverse effects were reported Looking forward to more clinical trials like this one that support alternatives for patients with IBD! nature.com/articles/s41598-0…

🚨 NEW at Frontline Gastroenterology! Upadacitinib as inpatient rescue post-infliximab 📌 UK single-centre experience in hospitalised steroid-refractory moderate–severe UC with prior infliximab exposure Key Findings: 🔹 91.7% colectomy-free at week 12 🔹 Rapid clinical improvement (SCCAI ↓ 9 → 2) 🔹 41% biochemical remission at week 12 🔹 No major safety signals reported ⚠️ Retrospective, small cohort, no comparator 👉 Supports a potential role for oral JAK inhibition as rescue therapy when anti-TNF is not feasible, pending RCT data. Read it here ⬇️ ⬇️ bit.ly/48YDTUr

🚨 NEW at Frontline Gastroenterology! Upadacitinib as inpatient rescue post-infliximab 📌 UK single-centre experience in hospitalised steroid-refractory moderate–severe UC with prior infliximab exposure Key Findings: 🔹 91.7% colectomy-free at week 12 🔹 Rapid clinical improvement (SCCAI ↓ 9 → 2) 🔹 41% biochemical remission at week 12 🔹 No major safety signals reported ⚠️ Retrospective, small cohort, no comparator 👉 Supports a potential role for oral JAK inhibition as rescue therapy when anti-TNF is not feasible, pending RCT data. Read it here ⬇️ ⬇️ bit.ly/48YDTUr @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BMJOpen_Gastro @Gut_BMJ

I’ve always been intrigued by the digestive & potential anti-inflammatory properties of plant-derived enzymes such as papain & bromelain (from papaya&🍍) Evidence was limited to animal & in-vitro studies with no trials in IBD 🌟Until now, a small trial just published in UC (N=70) bromelain vs placebo showing positive effect on SCCAI score at 8 weeks nature.com/articles/s41598-0…

What are the predictors of colectomy in pts hospitalized with ASUC? 🧐✂️ ⭐️Prospective multi-center study at 5 🇺🇸 centers found a 22% colectomy rate within 1 year, predictors: ⚠️ BMI <21.5 🔥 SCCAI >8 🧪 Albumin <2.4 @LaraChaaban4 @MaiaKayalMD @MLongMD doi.org/10.1093/ibd/izae193

こちらはグッテも携わった研究になります。 活動性潰瘍性大腸炎における心拍変動のバイオマーカーを探すためのスマートウォッチを使用したパイロットスタディ 日本語概要： はじめに: 自律神経の不均衡は、潰瘍性大腸炎 (UC) 患者の臨床的寛解と相関することが報告されています。本研究では、扱いやすいスマートウォッチを用いて、活動期UC患者の心拍変動 (HRV) を評価しました。 方法: 本前向き研究では、活動期のUC患者を対象にしました。患者のHRVは、スマートフォンとBluetoothで連携したFitbit Inspire2™を使用して測定しました。夜間睡眠中のHRVデータを連続的に取得しました。患者は、スマートフォンのアプリケーションを用いて、簡易臨床大腸炎活動指数 (SCCAI) スコアを1日1回入力するよう指示され、これを3か月間継続しました。 結果: UC患者9名が対象となりました。臨床的活動期において、SCCAIスコアは副交感神経活動、すなわち連続するR-R間隔の差 (RMSSD) (r=-0.44, p<0.0001)、高周波 (HF) (r=-0.42, p<0.0001)、および総自律神経活動、低周波 (LF) (r=-0.43, p<0.0001) と弱い逆相関を示しました。受信者動作特性 (ROC) 分析により、RMSSD、HF、LFは活動期UC患者で有意に高い値を示しました。一方、LFは排便切迫感スコアの重症度と最も相関していました。 結論: スマートウォッチを用いて記録された夜間HRVの経時的なデータは、活動期UC患者の疾患活動性と関連していることが示されました。特に、副交感神経系の指標であるRMSSDおよびHFは、UCの潜在的なデジタルバイオマーカーとして有望であることが示唆されました。 karger.com/iid/article/doi/1… #潰瘍性大腸炎 #Fitbit #HRV #デジタルヘルス

CurQD nutraceutical improves #urgency in active UC: A Post-hoc analysis of PCB-RCT now published in @JCC_IBD With caveat of not specifically validated for this outcome, the assessment of urgency is another benefit of SCCAI score. @Y_ECCO_IBD pubmed.ncbi.nlm.nih.gov/3927… Note my COI

Colitis Ulcerosa 🩸Diarrea con sangre 💩Urgencia defecatoria 😣Dolor abdominal 💡Si la afección solo es rectal, puede existir solo tenesmo y estreñimiento 📋Escala de Gravedad Simple Clinical Colitis Activity Index SCCAI pubmed.ncbi.nlm.nih.gov/2326…

Results: we found *no statistically significant differences* in SCCAI or any biochemical markers between the carrageenan and placebo periods. Nor were there any significant differences when comparing either period to the baseline. 13/

The SCCAI score ranges from 0 to 19. At the study's baseline, our patients exhibited a mean value of 1.7 (range 0-3) and all were in clinical remission. Ulcerative colitis is considered active during relapse when scoring 5 or higher. 4/

Our primary aim was to investigate the potential impact of daily carrageenan intake on clinical inflammation. We assessed clinically significant inflammation using SCCAI (Simple Clinical Colitis Activity Index) in combination with fecal and blood markers of inflammation. 3/

【セレンは中～重度の潰瘍性大腸炎患者で寛解を誘導】 UC患者100名に対し200μg/日を10週間にわたって介入 Simple Clinical Colitis Activity Index（SCCAI）による評価 Se群のSCCAIスコアの平均値が低下しQOLは増加 臨床的改善はSe群の19例（38%）で観察された link.springer.com/article/10…

In a double blind RCT of 100 UC pts with mild/mod disease, 200 mcg/day of selenium was associated with a significantly reduced SCCAI score after 10 weeks when compared to placebo. Se was also associated with ⬆️QOL and ⬇️ IL-17 concentrations. link.springer.com/article/10…

10週間後、SCCAIスコアの平均はセレン群で減少した。介入終了時には、臨床的改善がセレン 群の患者19人（38％）とプラセボ群の患者3人（6％）で観察されました。 セレングループの生活の質と血清セレン レベルは研究終了時に向上しました。

Jald hi sabk samne Fakenazz ki sccai ayegi.....Dek Lena.....Fans following decrease ho rahe hain....Ab to Salman k fans v is k kilaf ho gaye Hain.....

@RahulGandhi Bhai ab #MEWAT Haryana se @INCIndia Party ke liye Vote ki ummid mat rkhna ab aap logo ki aur aapki party ki sccai dekh li hai . #JusticeForJunaidAndNasir

Inclusion: ☑️Age 18-65 ☑️Mild to Mod UC ☑️Simple Clinical Colitis Activity Index (SCCAI) 3-9 ☑️UC Endoscopic Index of Severity (UCEIS) >1 ☑️Stable baselines meds 4/

Agree. That's one reason why SCCAI (which includes urgency) may still be better than PRO2 (which does not).