Antimicrobial effect of different types of honey on Staphylococcus aureus

GC-MS screening of the phytochemical composition of Ziziphus honey: ADME properties and in vitro/in silico study of its antimicrobial activity

A revival interest has been given to natural products as sources of phytocompounds to be used as alternative treatment against infectious diseases. In this context, we aimed to investigate the antimicrobial potential of Ziziphus honey (ZH) against twelve clinical bacterial strains and several yeasts and molds using in vitro and computational approaches. The well-diffusion assay revealed that ZH was able to induce growth inhibition of most Gram-positive and Gram-negative bacteria. The high mean growth inhibition zone (mGIZ) was recorded in E. coli (Clinical strain, 217), S. aureus followed by E. coli ATCC 10536 (mGIZ values: 41.00 ± 1 mm, 40.67 ± 0.57 mm, and 34.67 ± 0.57 mm, respectively). The minimal bactericidal concentrations (MBCs) and minimal fungicidal concentration values (MFCs) from approximately 266.33 mg/mL to over 532.65 mg/mL. Molecular docking results revealed that the identified compounds maltose, 2-furoic acid, isopropyl ester, 2,4-imidazolidinedione, 5-(2-methylpropyl)-(S)- and 3,4,5-trihydroxytoluene, S-Methyl-L-Cysteine, 2-Furancarboxylic acid, L-Valine-N-ethoxycarbonyl, Hexanoic acid, 3,5,5-trimethyl-, Methyl-beta-D-thiogalactoside, gamma-Sitosterol, d-Mannose, 4-O-Methylmannose, 2,4-Imidazolidinedione, 5-(2-methylpropyl)- (S) were found to have good affinity for targeted receptor, respectively. Through a 100-ns dynamic simulation research, binding interactions and stability between promising phytochemicals and the active residues of the studied enzymes were confirmed. The ADMET profiling of all identified compounds revealed that most of them could be qualified as biologically active with good absorption and permeation. Overall, the results highlighted the efficiency of ZH against the tested clinical pathogenic strains. The antimicrobial potential and the potency displayed by the identified compounds could imply their further pharmacological applications.Communicated by Ramaswamy H. Sarma.

Antimicrobial Wound Dressings: A Concise Review for Clinicians

Wound management represents a substantial clinical challenge due to the growing incidence of chronic skin wounds resulting from venous insufficiency, diabetes, and obesity, along with acute injuries and surgical wounds. The risk of infection, a key impediment to healing and a driver of increased morbidity and mortality, is a primary concern in wound care. Recently, antimicrobial dressings have emerged as a promising approach for bioburden control and wound healing. The selection of a suitable antimicrobial dressing depends on various parameters, including cost, wound type, local microbial burden and the location and condition of the wound. This review covers the different types of antimicrobial dressings, their modes of action, advantages, and drawbacks, thereby providing clinicians with the knowledge to optimize wound management.

Chronic Progressive Lymphedema in Belgian Draft Horses: Understanding and Managing a Challenging Disease

Chronic progressive lymphedema (CPL) in draft horses is characterized by increased dermal thickness and fibrosis, with the development of skinfolds and nodules, hyperkeratosis, and ulcerations on the distal limbs of affected horses. Secondary bacterial, fungal, or parasitic infections frequently complicate and aggravate the lesions, as well as the progression of this disease. CPL has a particularly high prevalence of up to 85.86% in the Belgian draft horse breed. Due to the disease's progressive and incurable nature, affected horses are often euthanized prematurely. The treatment options are solely symptomatic, aimed at improving the horse's quality of life. Despite the severity of this condition, many uncertainties about its etiology and pathogenesis still remain to date. The established scientific research on CPL is rather limited, although there is an urgent need for strategies to tackle this disease. This review summarizes the available knowledge, serving as a guideline for practitioners, and provides perspectives for future research programs.

Antimicrobial and Antibiofilm Properties of Latvian Honey against Causative Agents of Wound Infections

Honey is widely used in traditional medicine and modern wound healing biomaterial research as a broad-spectrum antimicrobial, anti-inflammatory and antioxidant agent. The study's objectives were to evaluate the antibacterial activity and polyphenolic profiles of 40 monofloral honey samples collected from beekeepers in the territory of Latvia. The antimicrobial and antifungal activity of Latvian honey samples were compared with commercial Manuka honey and the honey analogue sugar solutions-carbohydrate mixture and tested against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, clinical isolates Extended-Spectrum Beta-Lactamases produced Escherichia coli, Methicillin-resistant Staphylococcus aureus and Candida albicans. Antimicrobial activity was evaluated with the well-diffusion method (80% honey solution w/v) and microdilution method. The honey samples with the highest antimicrobial potential were tested to prevent biofilm development and activity against a preformed biofilm. The principal component analysis of the antimicrobial properties of honey samples vs. polyphenolic profile was performed. Eleven honey samples exhibited antibacterial activity to all investigated bacteria. The antibacterial effect of the samples was most significant on the Gram-positive bacteria compared to the studied Gram-negative bacteria. Latvian honey presents promising potential for use in wound healing biomaterials, opening the possibility of achieving long-term antibacterial effects.

Physicochemical Characteristics and Bioactive Compounds of Different Types of Honey and Their Biological and Therapeutic Properties: A Comprehensive Review

Honey is considered to be a functional food with health-promoting properties. However, its potential health benefits can be affected by individual composition that varies between honey types. Although studies describing the health benefits of Tualang honey (TH), Kelulut honey (KH), and Sidr honey (SH) are scarce, these honey types showed a comparable therapeutic efficacy to Manuka honey (MH). The purpose of this review is to characterise the physicochemical, biological, and therapeutic properties of TH, KH, and SH. Findings showed that these honeys have antibacterial, antifungal, antiviral, antioxidant, antidiabetic, antiobesity, anticancer, anti-inflammatory and wound-healing properties and effects on the cardiovascular system, nervous system, and respiratory system. The physicochemical characteristics of TH, KH, and SH were compared with MH and discussed, and results showed that they have high-quality contents and excellent biological activity sources. Flavonoids and polyphenols, which act as antioxidants, are two main bioactive molecules present in honey. The activity of honey depends on the type of bee, sources of nectar, and the geographic region where the bees are established. In conclusion, TH, KH, and SH could be considered as natural therapeutic agents for various medicinal purposes compared with MH. Therefore, TH, KH, and SH have a great potential to be developed for modern medicinal use.

Chemical Composition and Antimicrobial Activity of New Honey Varietals

Due to a widespread occurrence of multidrug-resistant pathogenic strains of bacteria, there is an urgent need to look for antimicrobial substances, and honey with its antimicrobial properties is a very promising substance. In this study, we examined for the first time antimicrobial properties of novel varietal honeys, i.e., plum, rapeseed, Lime, Phacelia, honeydew, sunflower, willow, and multifloral-P (Prunus spinosa L.), multifloral-AP (Acer negundo L., Prunus spinosa L.), multifloral-Sa (Salix sp.), multifloral-Br (Brassica napus L.). Their antimicrobial activity was tested against bacteria (such as Escherichia coli, Bacillus circulans, Staphylococcus aureus, Pseudomonas aeruginosa), yeasts (such as Saccharomyces cerevisiae and Candida albicans) and mold fungi (such as Aspergillus niger). In tested honeys, phenolic acids constituted one of the most important groups of compounds with antimicrobial properties. Our study found phenolic acids to occur in greatest amount in honeydew honey (808.05 µg GAE/g), with the highest antifungal activity aiming at A. niger. It was caffeic acid that was discovered in the greatest amount (in comparison with all phenolic acids tested). It was found in the highest amount in such honeys as phacelia-356.72 µg/g, multifloral (MSa) and multifloral (MBr)-318.9 µg/g. The highest bactericidal activity against S. aureus was found in multifloral honeys MSa and MBr. Additionally, the highest amount of syringic acid and cinnamic acid was identified in rapeseed honey. Multifloral honey (MAP) showed the highest bactericidal activity against E. coli, and multifloral honey (MSa) against S. aureus. Additionally, multifloral honey (MBr) was effective against E. coli and S. aureus. Compounds in honeys, such as lysozyme-like and phenolic acids, i.e., coumaric, caffeic, cinnamic and syringic acids, played key roles in the health-benefit properties of honeys tested in our study.

Synergic Effect of Honey with Other Natural Agents in Developing Efficient Wound Dressings

Honey has been used for therapeutic and nutritional purposes since ancient times. It was considered one of the essential medical assets in wound healing. According to research, honeybees have significant antibacterial, antioxidant, anti-inflammatory, antitumor, and wound-healing properties. Lately, scientific researchers have focused on apitherapy, using bee products to protect and strengthen the immune system. Since honey is the most important natural product rich in minerals, proteins, and vitamins, it has been intensively used in such therapies. Honey has gained significant consideration because of the beneficial role of its antioxidant compounds, such as enzymes, proteins, amino and organic acids, polyphenols, and carotenoids, but mainly due to flavonoids and phenolic acids. It has been proven that phenolic compounds are responsible for honey's biological activity and that its physicochemical properties, antioxidants, and antimicrobial potential are significant for human health. The review also presents some mechanisms of action and the medical applications of honey, such as wound healing dressings, skin grafts, honey-based nanofibers, and cochlear implants, as the most promising wound healing tools. This extensive review has been written to highlight honey's applications in medicine; its composition with the most important bioactive compounds also illustrates its synergistic effect with other natural products having remarkable therapeutic properties in wound healing.

Antimicrobial Activity of Honey against Oral Microorganisms: Current Reality, Methodological Challenges and Solutions

Honey has been shown to have antimicrobial activity against different microorganisms, but its effects on oral biofilms are largely unknown. In this review, we analyzed the currently available literature on the antimicrobial activity of honey against oral biofilms in order to determine its potential as a functional food in the treatment and/or prevention of oral diseases. Here, we compare studies reporting on the antimicrobial activity of honey against systemic and oral bacteria, discuss methodological strategies, and point out current gaps in the literature. To date, there are no consistent studies supporting the use of honey as a therapy for oral diseases of bacterial origin, but current evidence in the field is promising. The lack of studies examining the antibiofilm activity of honey against oral microorganisms reveals a need for additional research to better define aspects such as chemical composition, the mechanism(s) of action, and antimicrobial action.

Clinical Presentation, Electrocardiographic Findings, and Factors Related to the Hospitalization In Mad-Honey Intoxication

OBJECTIVES

Mad-honey intoxication (MHI) often presents with all kinds of bradyarrhythmias. Despite numerous publications focused on clinical findings, we aim to evaluate poor prognostic implications, ischemia likely electrocardiography (ECG) changes, and detailed ECG findings of MHI in the largest series.

METHODS

This is a retrospective single-center study of 117 MHI patients admitted to emergency service.

RESULTS

The study had 26 (22.2%) females (median 52.5 years) and 91 (77.8%) males (median 51.0 years). Fifty-six (47.9%) patients had ischemia likely changes on ECG. Multivariate model demonstrated that beta-blocker usage (odds ratio (OR): 52.871; 95% confidence interval (CI): 3.618-772.554 (p=0.004)), atrioventricular junctional rhythm (AVJR) (OR: 5.319; 95%CI: 1.090-25.949 (p=0.039)), and quantity of mad-honey consumption (OR: 1.035; 95% CI: 1.008-1.063 (p=0.011)) are predictors of hospitalization. ROC curve analysis showed cutoff value of mad-honey consumption quantity 24.79 g had 57% sensitivity and 68% specificity for predicting hospitalization (AUC: 0.7, 95% CI: 0.55-0.816, p=0.027). In addition, all hospitalized cases were male.

CONCLUSION

Our study has shown that male gender, AVJR, the quantity of mad-honey consumption, and beta-blocker usage are high-risk criteria for hospitalization in MHI patients. Furthermore, ischemia likely ECG changes is often observed with MHI even independently from hypotension or bradycardia.

Antimicrobial and Antioxidant Activity of Different Honey Samples from Beekeepers and Commercial Producers

Honey contains compounds with antioxidant and antibacterial capacities, such as phenolic compounds and carotenoids. The current analysis evaluates the antioxidant and antibacterial activity of 100 honey samples from beekeepers from Slovakia and commercially purchased ones. Honey samples were diluted to 50%, 25%, 12.5%, and 6.25% concentrations. The antimicrobial activity of honey samples was evaluated against three Gram-positive, three Gram-negative bacteria, and four Candida spp. by well diffusion method. The highest antimicrobial effect of all honey concentrations was expressed as the size of the inhibition zone and was found against Pseudomonas aeruginosa among Gram-negative bacteria, Bacillus subtilis among Gram-positive bacteria, and Candida tropicalis among yeasts. Antibiotics used in the study showed the highest antimicrobial effect compared to all concentrations of honey samples. Slovakian honey from beekeepers and commercial honey samples from the Slovak market showed variable inhibitory effectiveness against microorganisms. The honey concentration of 50% was found the most effective. Lower concentrations of honey exhibited no effect against yeasts. The best antioxidant activity was found in a sample of buckwheat honey yielding 70.83% of DPPH inhibition and 2373.85 μg/g TEAC. Overall, better antioxidant activity was evaluated in honeydew honey.

SDS-PAGE Protein and HPTLC Polyphenols Profiling as a Promising Tool for Authentication of Goldenrod Honey

The aim of the study was to use protein and polyphenolic profiles as fingerprints of goldenrod honey and to apply them for verification of the labeled variety. The markers for 10 honey samples were correlated with the standard physicochemical parameters and biological activity measured in vitro as antioxidant, antifungal and antibacterial activities. Honey proteins were examined regarding soluble protein, diastase and SDS-PAGE protein profile. The polyphenolic profile was obtained with the use of the HPTLC and the antioxidant activity was detected with standard colorimetric methods. The antimicrobial effect of representative honey samples of different chemical profiles was verified against E. coli and budding yeast. It was found that the SDS-PAGE technique allows for creating the protein fingerprint of the goldenrod honey variety which was consistent for 70% of tested samples. At the same time, the similarity of their polyphenolic profile was observed. Moreover, specific chemical composition resulted in higher bioactivity of honey against tested bacteria and yeast. The study confirmed the usefulness of both SDS-PAGE and HPTLC techniques in honey authentication, as an initial step for selection of samples which required pollen analysis.

Chemical Composition and the Anticancer, Antimicrobial, and Antioxidant Properties of Acacia Honey from the Hail Region: The in vitro and in silico Investigation

In consideration of the emergence of novel drug-resistant microbial strains and the increase in the incidences of various cancers throughout the world, honey could be utilized as a great alternative source of potent bioactive compounds. In this context, this study pioneers in reporting the phytochemical profiling and the antimicrobial, antioxidant, and anticancer properties of Acacia honey (AH) from the Hail region of Saudi Arabia, assessed using in vitro and molecular docking approaches. The phytochemical profiling based on high-resolution liquid chromatography-mass spectrometry (HR-LCMS) revealed eight compounds and three small peptide-like proteins as the constituents. The honey samples exhibited promising antioxidant activities (DPPH-IC₅₀ = 0.670 mg/mL; ABTS-IC₅₀ = 1.056 mg/mL; β-carotene-IC₅₀ > 5 mg/mL). In the well-diffusion assay, a high mean growth inhibition zone (mGIZ) was observed against Staphylococcus aureus (48.33 ± 1.53 mm), Escherichia coli ATCC 10536 (38.33 ± 1.53 mm), and Staphylococcus epidermidis ATCC 12228 (39.33 ± 1.15 mm). The microdilution assay revealed that low concentrations of AH could inhibit the growth of almost all the evaluated bacterial and fungal strains, with the minimal bactericidal concentration values (MBCs) ranging from 75 mg/mL to 300 mg/mL. On the contrary, high AH concentrations were required to kill the tested microorganisms, with the minimal bactericidal concentration values (MBCs) ranging from approximately 300 mg/mL to over 600 mg/mL and the minimal fungicidal concentration values (MFCs) of approximately 600 mg/mL. The AH exhibited effective anticancer activity in a dose-dependent manner against breast (MCF-7), colon (HCT-116), and lung (A549) cancer cell lines, with the corresponding IC₅₀ values of 5.053 μg/mL, 5.382 μg/mL, and 6.728 μg/mL, respectively. The in silico investigation revealed that the observed antimicrobial, antioxidant, and anticancer activities of the constituent compounds of AH are thermodynamically feasible, particularly those of the tripeptides (Asp-Trp-His and Trp-Arg-Ala) and aminocyclitol glycoside. The overall results highlighted the potential of AH as a source of bioactive compounds with significant antimicrobial, antioxidant, and anticancer activities, which could imply further pharmacological applications of AH.

Antioxidative, Antibacterial and Antiproliferative Properties of Honey Types from the Western Balkans

This paper presents the physicochemical characteristics and antioxidative, antibacterial and antiproliferative effects of nineteen samples of different honey types (acacia, linden, heather, sunflower, phacelia, basil, anise, sage, chestnut, hawthorn, lavender and meadow) collected from different locations in the Western Balkans (Republic of Serbia, Kosovo, Bosnia and Herzegovina, and Northern Macedonia). Physicochemical parameters (moisture, pH, electrical conductivity, free acidity, and hydroxymethylfurfural [HMF]) were analysed. Based on the obtained results, all tested honey samples were in agreement with EU regulation. The antioxidant potential of honey samples was assessed by determination of total phenolic content (TPC) and evaluation of scavenging activity towards diphenilpicrylhydrazyl radicals (DPPH·). The highest phenolic content was found in basil honey (101 ± 2.72 mg GAE/100 g), while the lowest was registered in rapeseed honey (11.5 ± 0.70 mg GAE/100 g). Heather, anise, phacelia, sage, chestnut and lavender honey samples were also rich in TP, containing 80−100 mg GAE/100 g. DPPH scavenging activity varied among the samples being the highest for lavender honey (IC50 = 88.2 ± 2.11 mg/mL) and the lowest for rapeseed honey (IC50 = 646 ± 8.72 mg/mL). Antibacterial activity was estimated in vitro using agar diffusion tests and measuring minimal inhibitory concentration (MIC). Among investigated bacterial strains following resistant potencies were determined: Escherichia coli > Escherichia coli ATCC 8739 > Enterococcus faecalis > Proteus mirabilis > Staphylococcus aureus > Staphylococcus epidermidis. The linden honey from Fruška Gora (MIC values of 3.12% and 6.25% against Staphylococcus aureus and Staphylococcus epidermidis, respectively) and phacelia honey (MIC values of 6.25% and 3.12% against S.Staphylococcus aureus and Staphylococcus epidermidis, respectively) showed the strongest antibacterial activity. Antiproliferative activity was evaluated using the colorimetric sulforhodamine B (SRB) assay. The highest antiproliferative activity was obtained from linden honey sample 1 (IC50MCF7 = 7.46 ± 1.18 mg/mL and IC50HeLa =12.4 ± 2.00 mg/mL) and meadow sample 2 (IC50MCF7 = 12.0 ± 0.57 mg/mL, IC50HeLa = 16.9 ± 1.54 mg/mL and IC50HT−29 = 23.7 ± 1.33 mg/mL) towards breast (MCF7), cervix (HeLa) and colon (HT-29) cancer cells. Active components other than sugars contributed to cell growth activity.

Potential Therapeutic Benefits of Honey in Neurological Disorders: The Role of Polyphenols

Honey is the principal premier product of beekeeping familiar to Homo for centuries. In every geological era and culture, evidence can be traced to the potential usefulness of honey in several ailments. With the advent of recent scientific approaches, honey has been proclaimed as a potent complementary and alternative medicine for the management and treatment of several maladies including various neurological disorders such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and multiple sclerosis, etc. In the literature archive, oxidative stress and the deprivation of antioxidants are believed to be the paramount cause of many of these neuropathies. Since different types of honey are abundant with certain antioxidants, primarily in the form of diverse polyphenols, honey is undoubtedly a strong pharmaceutic candidate against multiple neurological diseases. In this review, we have indexed and comprehended the involved mechanisms of various constituent polyphenols including different phenolic acids, flavonoids, and other phytochemicals that manifest multiple antioxidant effects in various neurological disorders. All these mechanistic interpretations of the nutritious components of honey explain and justify the potential recommendation of sweet nectar in ameliorating the burden of neurological disorders that have significantly increased across the world in the last few decades.

Complete Healing of a Heel Bedsore Using Argania Honey Dressing: Case Report

Background:

Chronic wounds and injuries represent a significant burden for health care professionals due to the difficulties related to their management. The selection and use of appropriate dressings have become essential for successful treatment. Honey has been used for thousands of years as a biological treatment because its bioactive components contribute to the healing process.

Objective:

This case report aims to demonstrate the efficiency of Argania honey dressing on pressure ulcers.

Case Presentation:

The wound care was achieved using pure raw Argania honey with no additives, pasteurization, or manipulation. A previous mechanical debridement process was necessary before the application of honey dressings to a right heel bedsore in a 69-year-old man who suffered an ischemic stroke.

Results:

This case report describes for the first time the complete healing of a right heel bedsore using Argania honey dressing. Bedsore demonstrated rapid recovery and complete healing over approximately 18 weeks (124 days, between June and October 2021).

Conclusion:

With the rise of natural medicines and some pathologies that are resistant to conventional treatments, Argania honey can be an asset for its therapeutic effects on the skin, but more studies are needed to explain and identify the complexity of mechanisms involved to ensure this complete healing process.

Antibacterial properties of Apis dorsata honey against some bacterial pathogens

Now-a-days, different bioproducts are being used extensively for the welfare of mankind. However, for proper utility of any bioproduct, the exact biotechnological potential of that product should be explored. Honey is produced in almost every country on the planet. It has long been used as a medicinal agent in addition to its broader use as a popular food throughout the human history. It can be used to treat various diseases without causing any negative side effects. In the present study, the antibacterial potential of honey produced by A. dorsata was investigated at its variable concentrations (25, 50, 75 and 100 %) against four pathogenic bacterial species. The highest antimicrobial action was seen against E. coli at 100 % concentration of the honey while showing zone of inhibition of 37.5 ± 3.5 mm. However, the lowest antibacterial action was observed against E. faecalis. The overall order of growth inhibition by the honey at its 100 % concentration for the implicated bacterial species appeared as: E. coli ˃ P. aeruginosa ˃ S. aureus ˃ E. faecalis. The honey couldn’t show antibacterial action at its 25 % concentration. Our findings of the present study will be helpful for utility of the honey as an alternative medicine for curing different complications caused by microbial pathogens.

Potential effects of Saudi Shaoka (Fagonia bruguieri) honey against multi-drug-resistant bacteria and cancer cells in comparison to Manuka honey

The global spread of antimicrobial-resistant infectious diseases and cancer are the most widespread public health issue and has led to high mortality rates. This study aims to evaluate and verify the antibacterial and antitumor activities of Shaoka and Manuka honey against pathogenic bacteria, human hepatocarcinoma (HepG2) and breast cancer (MCF-7) cell lines. Shaoka hone was analyzed using HPLC, UV–vis, and GC/MC, while antibacterial activity was measured by agar diffusion, broth microdilution methods, and Transmission Electron Microscopy (TEM). Antitumor activity was investigated morphologically and by MTT assay. According to the presented data of HPLC analysis, Shaoka honey was generally richer in polyphenolic components, the antibacterial activity showed that Shaoka honey is equivalent or relatively more active than Manuka honey against a broad spectrum of multi-drug-resistant bacteria. It inhibited the growth of ESBL Escherichia coli in the absence or presence of catalase enzyme with a concentration approximately 8.5%–7.3% equivalent to phenol, which supported the highest level of non-peroxide-dependent activity. The minimum bactericidal concentrations (MBCs) ranged between 5.0% and 15.0% honey (w/v). TEM observation revealed distorted cell morphology, cytoplasmic shrinkage, and cell wall destruction of treated bacteria. The selected honey exerted cytotoxicity on both cancer cell lines, inhibiting cell proliferation rate and viability percent in HepG2 and MCF-7 cancer cells, by different degrees depending on the honey quality, Shaoka honey competed Manuka inhibitory effects against both cancer cells. The obtained data confirmed the potential for use of Saudi Shaoka honey as a remedy, this well introduces a new honey template as medical-grade honey for treating infectious disease and cancer.

Exploring the frostbite healing potential of hyaluronic acid based hydrogel of Manuka honey through in-silico antithrombotic and anti-platelet studies of major phytoconstituents and in-vivo evaluation in Wistar rat model

OBJECTIVE

Development of Frostbite healing hydrogel of Manuka honey and hyaluronic acid.

SIGNIFICANCE

Frostbite is a cold-induced ischemic vascular injury non-responsive to most of the wound healing products. Thrombus-induced ischemia is the main cause of frostbite-related necrosis. Hyaluronic acid is known to possess significant antithrombotic and wound healing activity. Moreover, Manuka Honey is also rich in flavonoids and polyphenols with potential antithrombotic activity. These two agents were together utilized to develop a frostbite healing formulation.

METHODS

In-silico antithrombotic efficacy of major phytoconstituents of Manuka honey was evaluated using in-silico-docking studies against Tissue plasminogen activator and Cyclooxygenase-1 protein. Further in-vivo frostbite healing evaluation was carried out in Wistar rats, by inducing frostbite with a supercooled rod.

RESULTS

The results indicate that major leptosin and other major phytoconstituent of Manuka honey has significant antithrombotic property. The hydrogel formulation of HA and MH possess significant antimicrobial efficacy. The wound contraction studies and histopathological evaluation reveals that the hydrogel also has a good frostbite healing activity showing complete wound healing within an 18-day period. The findings of the western blotting studies suggest that the hydrogel acts by VEGF- NRF-2 pathway.

CONCLUSION

This result implies that the prepared hydrogel can serve as an effective frostbite healing formulation.

Natural Compounds for Preventing Ear, Nose, and Throat-Related Oral Infections

Oral health is an essential element in maintaining general well-being. By preserving the complex equilibrium within the oral microbial community, commensal microorganisms can protect against extrinsic pathogenic threats. However, when an imbalance occurs, the organism is susceptible to a broad range of infections. Synthetic drugs can be administered to help the body fight against the fungal, bacterial, or viral burden. Nonetheless, they may produce undesirable consequences such as toxicity, adverse effects, and drug resistance. In this respect, research has focused on finding safer and more efficient alternatives. Particularly, increasing attention has been drawn towards developing novel formulations based on natural compounds. This paper reviews the plant-based, algae-based, and beehive products investigated for their antimicrobial properties, aiming to thoroughly present the state of the art on oral infection prevention in the ear, nose, and throat (ENT) field.

Polyphenols Content and In Vitro α-Glycosidase Activity of Different Italian Monofloral Honeys, and Their Effect on Selected Pathogenic and Probiotic Bacteria

We evaluated the polyphenol content and the α-glucosidase activity exhibited by different monofloral honeys of Italian origin. Their capacity to act on different pathogenic (Acinetobacter baumannii, Escherichia coli, Listeria monocytogenes, Pseudomonas aeruginosa, and Staphylococcus aureus) as well as probiotic bacteria (Lacticaseibacillus casei, Lactobacillus acidophilus, Lactiplantibacillus plantarum, Lactobacillus gasseri, and Lacticaseibacillus rhamnosus) was also assessed. Total polyphenols varied between 110.46 μg/g of fresh product (rhododendron honey) and 552.29 μg/g of fresh product (strawberry tree honey). Such result did not correspond to a parallel inhibitory α-glycosidase activity that, in each case was never higher than 33 μg/mL. Honeys were differently capable to fight the biofilm formation of the pathogens (inhibition up to 93.27%); they inhibited the in vitro adhesive process (inhibition up to 84.27%), and acted on mature biofilm (with values up to 76.64%). Their effect on bacterial metabolism was different too. Honeys were ineffective to inhibit E. coli mature biofilm nor to act on its metabolism. The action of the honey on probiotic strains seemed almost always stimulate their growth. Thus, these monofloral honeys might exhibit effects on human health and act positively as prebiotics.

Pharmaceutical Prospects of Bee Products: Special Focus on Anticancer, Antibacterial, Antiviral, and Antiparasitic Properties

Bee products have long been used in traditional healing practices to treat many types of disorders, including cancer and microbial-related diseases. Indeed, several chemical compounds found in bee products have been demonstrated to display anticancer, antibacterial, antiviral, and antiparasitic properties. With the improvement of research tools and in view of recent advances related to bee products, this review aims to provide broad yet detailed insight into the pharmaceutical prospects of bee products such as honey, propolis, bee pollen, royal jelly, bee bread, beeswax, and bee venom, in the domain of cancer and infectious disease management. Available literature confirms the efficacy of these bee products in the alleviation of cancer progression, inhibition of bacterial and viral proliferation, and mitigation of parasitic-related symptoms. With such potentials, bioactive components isolated from the bee products can be used as an alternative approach in the long-run effort to improve humans’ health at a personal and community level.

Biological Properties of Bee Bread Collected from Apiaries Located across Greece

Bee bread is the only fermented product of the beehive. It constitutes the main source of proteins, lipids, vitamins, and macro- and microelements in honeybee nutrition and it exerts antioxidant and antimicrobial properties, though research on these aspects has been limited so far. In this study 18 samples of Greek bee bread, two of which were monofloral, were collected during different seasons from diverse locations such as Crete and Mount Athos and were tested for their bioactivity. Samples were analyzed for their antibacterial properties, antioxidant activity, total phenolic content (TPC), and total flavonoid content (TFC). The antimicrobial activity of each sample was tested against Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Salmonella typhimurium. Our data demonstrate that all samples exert inhibitory and most of them bactericidal activity against at least two pathogens. Furthermore, all samples exert significant antioxidant activity, where the monofloral Castanea Sativa sample demonstrated superior antioxidant activity. Nevertheless, the antioxidant and antimicrobial activity were not strongly correlated. Furthermore, machine learning methods demonstrated that the palynological composition of the samples is a good predictor of their TPC and ABTS activity. This is the first study that focuses on the biological properties of Greek bee bread and demonstrates that bee bread can be considered a functional food and a possible source of novel antimicrobial compounds.

Manuka Honey: Feasibility and Safety in Postoperative Neurosurgical Wound Care

OBJECTIVE

To date, no reports have been published on active Leptospermum manuka honey (ALH) feasibility as a postoperative topical wound supplement in neurosurgical patients. The objective of the study is to present the authors' initial experience with using ALH in postoperative neurosurgical patients.

METHODS

A single-surgeon retrospective case series review of cranial and spinal operations between 2018 and 2020 was performed in patients with nonhealing wounds or wounds deemed "at risk" as defined by grade 1 Sandy surgical wound dehiscence grading classification. An ALH gel or ointment was applied to these incisions once a day for 2 to 4 weeks. Patients were followed up in the clinic every 2 weeks until incisions had healed.

RESULTS

Twenty-five postoperative patients (12 cranial, 13 spinal) were identified to be at high risk of operative debridement. All 25 patients were prescribed a topical application of ALH, which was easily adopted without patient-related adverse events. Seven (four cranial, three spinal) patients required operative debridement and treatment with long-term antibiotic therapy.

CONCLUSIONS

In this small case series of neurosurgical patients who were at risk of poor wound healing, the application of medical-grade ALH was well tolerated without patient-reported adverse events. The ALH may have prevented the need for operative debridement in the majority of patients. Further prospective studies are necessary to establish its efficacy in wound healing in the neurosurgical population.

A Study on the Synbiotic Composition of Bifidobacterium bifidum and Fructans from Arctium lappa Roots and Helianthus tuberosus Tubers against Staphylococcus aureus

A number of mechanisms have been proposed explaining probiotics and prebiotics benefit human health, in particular, probiotics have a suppression effect on pathogen growth that can be enhanced with the introduction of prebiotics. In vitro models enhanced with computational biology can be useful for selecting a composition with prebiotics from new plant sources with the greatest synergism. Water extracts from burdock root and Jerusalem artichoke tubers were purified by ultrafiltration and activated charcoal and concentrated on a rotary evaporator. Fructans were precipitated with various concentrations of ethanol. Bifidobacterium bifidum 8 VKPM AC-2136 and Staphylococcus aureus ATCC 43300 strains were applied to estimate the synbiotic effect. The growth of bifidobacteria and staphylococci in monocultures and cocultures in broths with glucose, commercial prebiotics, as well as isolated fructans were studied. The minimum inhibitory concentrations (MICs) of lactic and acetic acids for the Staphylococcus strain were determined. A quantitative model joining the formation of organic acids by probiotics as antagonism factors and the MICs of pathogens (as the measure of their inhibition) was tested in cocultures and showed a high predictive value (R2 ≥ 0.86). The synbiotic factor obtained from the model was calculated based on the experimental data and obtained constants. Fructans precipitated with 20% ethanol and Bifidobacterium bifidum have the greater synergism against Staphylococcus.

The antibacterial activities of honey

Honey is a powerful antimicrobial agent with a wide range of effects. Various components contribute to the antibacterial efficacy of honey: the sugar content; polyphenol compounds; hydrogen peroxide; 1,2-dicarbonyl compounds; and bee defensin-1. All of these elements are present at different concentrations depending on the source of nectar, bee type, and storage. These components work synergistically, allowing honey to be potent against a variety of microorganisms including multidrug resistant bacteria and modulate their resistance to antimicrobial agents. The effectiveness and potency of honey against microorganisms depends on the type of honey produced, which is contingent on its botanical origin, the health of the bee, its origin, and processing method. The application of antibiotics with honey yielded better antimicrobial potential and synergistic effects were noted against biofilms. In medicine, honey has been used in the treatment of surface wounds, burns, and inflammation, and has a synergistic effect when applied with antibiotics. Tissue repair is enhanced by the low pH of honey (3.5-4): causing a reduction in protease activity on the wound site, elevating oxygen release from hemoglobin and stimulating fibroblast and macrophage activity. Furthermore, H2O2 has antiseptic effects, and it disinfects the wound site and stimulates production of vascular endothelial growth factor. The use of honey will clean wounds or burn areas from free radicals and reduces scarring and contractures. The anti-inflammatory and antibacterial potential of honey will keep the injured area moist and as such prevents it from deterioration and fibrosis. Honey can promote fast healing and reduce scarring and is very convenient for plastic surgery. Skin maceration is protected by honey due to its high osmolarity and because it keeps the injury moist. In non-infected areas, honey still reduced pain and inflammation. In general, the use of honey in medical settings has reduced economic loss and provided proven economic benefits by lowering direct costs in comparison to conventional treatments and by using less antibiotics, faster healing and less hospitalization stay. This review is intended to provide an overview of the antibacterial activities of honey and its applications.

A comprehensive study of parameters correlated with honey health benefits

One hundred honey samples of different floral origin (acacia, sunflower, meadow, and forest) collected from nine European countries (Serbia, Albania, Croatia, Montenegro, Romania, Bulgaria, Bosnia and Herzegovina, North Macedonia and Hungary) were analysed for various physicochemical, sensory, antioxidant and antibacterial parameters. The relative antioxidant capacity index and relative antibacterial index were calculated, integrated and expressed as a new property - Power of Honey, intended to be used to predict the health potential of a honey based on its antioxidant and antibacterial activities. Free acidity and colour coordinates L* and a* were chosen for building an artificial neural network model for the prediction of honey health potential. These were chosen based on the obtained correlations between the investigated parameters and in light of the simplicity of the analysis. This model successfully predicted the Power of Honey with a gained coefficient of determination of 0.856. Forest honey samples exhibited the highest Power of Honey. This novel approach should make it possible for honey producers to predict the honey health potential of a particular honey based on a quick and simple analysis.

Antibacterial Activity of Honey Samples from Ukraine

The employment of natural substances such as beehive products with a preventive and therapeutic purpose has been a widespread custom since ancient times. In this investigation, the antibacterial activity of 41 honey samples from different Ukraine regions has been evaluated. For each honey, melissopalynological and physico-chemical analysis were performed in order to determine botanical origin, pH, glucose and fructose contents and free acidity. So, antibacterial activity against Staphylococcusaureus CCM 4223, Listeria monocytogenes ATCC 7644, Salmonella enterica serovar Typhimurium CCM 3807 and Escherichia coli ATCC 25922 was assessed through the determination of MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) values by the microdilutions method. The results show that the most susceptible bacterial strain was L. monocytogenes. Its growth was inhibited at a honey concentration ranging from 0.094 to 0.188 g/mL. The most resistant bacterial strain was S. aureus. As concerns MBC values, L. monocytogenes was the most susceptible bacteria, while S. aureus was the most resistant. Helianthus spp. honeys was the most effective against all tested bacterial strains, followed by Robinia spp. and multifloral honeys. Promising results for MIC tests have been found for Brassica spp.

Antimicrobial activity of heat-treated Polish honeys

Bactericidal properties of honey depend on botanical and geographical origin, where thermal treatment can have a significant affect. The aim of this study was to investigate the effect of temperature on minimum bactericidal concentration (MBC), vitamin C content, total polyphenols content and antioxidant capacity of ferric reducing antioxidant potential (FRAP) of several nectar honey varieties from northern Poland (lime, rapeseed, multifloral and buckwheat). The honeys were subjected to thermal treatment at 22 °C, 42 °C, 62 °C, 82 °C and 100 °C for two exposure times. The results showed a significant reduction of antimicrobial properties (MBC ⩾50%) at 82 °C and 62 °C after 15 and 120 min exposure time for most samples. Short time exposure reduced vitamin C content (⩽50 %) but increased total polyphenols content (⩾27%) and FRAP value (⩾106%).

Comparison of Antibacterial and Antifungal Effects of Different Varieties of Honey and Propolis Samples

Honey is the most important bee product. There are many secondary metabolites, carbohydrates, enzymes, and vitamins in honey, thus, honey has antimicrobial activity. In this study, in vitro antimicrobial activity of forty-two honey and eight propolis ethanolic extracts (PEE) were investigated against 16 microorganisms. Total phenolic content ranged between 20.00–124.10 mg GAE/100 g and 103–232 mg GAE/g for honey and raw propolis samples, respectively. Pine and oak honeydew honeys had higher antimicrobial activity than four different grades of Manuka Honeys up to 18 mm minimum inhibition zone diameters. The ethanolic propolis extracts showed much higher antimicrobial activity than the honey samples. Fungi species were inhibited by the propolis samples. Helicobacter pylorii (H. pylorii) was the most sensitive, whereas Streptococcus agalactiae was the most resistant bacteria among the studied microorganisms. Brazilian and Zonguldak propolis had the closest antimicrobial activity to ampicillin, streptomycin, and fluconazole. It can be concluded that both honey and propolis could be used in preservative and complementary medicine.

Clinical Significance of Manuka and Medical-Grade Honey for Antibiotic-Resistant Infections: A Systematic Review

Antimicrobial resistance is an ever-increasing global issue that has the potential to overtake cancer as the leading cause of death worldwide by 2050. With the passing of the "golden age" of antibiotic discovery, identifying alternative treatments to commonly used antimicrobials is more important than ever. Honey has been used as a topical wound treatment for millennia and more recently has been formulated into a series of medical-grade honeys for use primarily for wound and burn treatment. In this systematic review, we examined the effectiveness of differing honeys as an antimicrobial treatment against a variety of multidrug-resistant (MDR) bacterial species. We analysed 16 original research articles that included a total of 18 different types of honey against 32 different bacterial species, including numerous MDR strains. We identified that Surgihoney was the most effective honey, displaying minimum inhibitory concentrations as low as 0.1% (w/v); however, all honeys reviewed showed a high efficacy against most bacterial species analysed. Importantly, the MDR status of each bacterial strain had no impact on the susceptibility of the organism to honey. Hence, the use of honey as an antimicrobial therapy should be considered as an alternative approach for the treatment of antibiotic-resistant infections.

Quality Assessment, Functional Potentials, and Safety Evaluation of Stored Egyptian Honey as an Environmental Pollution Bioindicator

Egyptian honeys are distinguished by their variety, properties, and therapeutic applications. The aim of the present study was to evaluate the quality and the functional and safety characteristics of Egyptian honey as a sensitive environmental bioindicator collected from 9 different locations in Egypt that were exposed to various air pollution sources, either stationary, mobile, or area sources, and stored for 6 mo at ambient temperature (22 ± 2 °C) compared with Codex Alimentarius international standards. Physicochemical properties, sugar profile via high performance liquid chromatography, functional potentials (antioxidant and antimicrobial), and safety parameters (microbiological quality, aflatoxins, and heavy metal pollutants) were assessed. The results revealed that honey obtained from Shabshir Hessa, El Gharbia Governorate (GSH-1), showed the best quality with the highest monosaccharide and phenolic and flavonoid content (73.07%, 363.07, and 15.33 mg/g, respectively) and clear of biotic and abiotic contaminants, reflecting good hygienic, environmental conditions and apiarian practices. The other 8 honey samples reflected inferior quality in physicochemical parameters either of low monosaccharide content (40.46-50.25%), high hydroxymethylfurfural (HMF) values as in Borg El-Arab Industrial Zone, Alexandria Governorate (BAI-9), and Nubaria Desert Road, Alexandria Governorate (NDR-4; 50.83 and 48.25 mg/kg), or of high acidity as in Agricultural Road, El Gharbia Governorate (GAR-3), and NDR-4 (74.72 and 68.47 mEq/kg) attributable to contaminated locations (fermentations) or thermal treatment (HMF). Furthermore, safety assessment revealed that coliform counts exceeded 2.5 log₁₀ cfu/g in 6 samples-Chemicals Company, Kafr El Zayyat Governorate (KZC-2); GAR-3; NDR-4; Mansoura Fertilizer Talkha Company, Daqahlia Governorate (MFT-5); Gharbaniyat Cement Company, Beheira Governorate; and BAI-9-and the highest counts of yeast and molds in Abees Ceramic Company, Alexandria Governorate (3.72 log₁₀ cfu/g), which was reflected in its total aflatoxins (679.83 μg/kg). Samples MFT-5; GAR-3; Kafr El-Sheikh Petroleum Company, Kafr El-Sheikh Governorate; and KZC-2 exceeded the lead permissible limit (0.75, 0.61, 0.57, and 0.51 mg/kg, respectively) as a result of inferior hygienic quality and the negative effects of environmental pollutants. The results ring alarm bells about how we should take substantial steps toward stringent standards for quality control practices of honey production operations. Environ Toxicol Chem 2020;39:1894-1907. © 2020 SETAC.

Characteristic Components and Authenticity Evaluation of Rape, Acacia, and Linden Honey

Honey fraud has an extensive global magnitude and impacts both honey price and beekeeper viability. This study aimed at investigating the characteristic phytochemicals of rape, acacia, and linden honey to verify honey authenticity. We discovered methyl syringate, phaseic acid, and lindenin (4-(2-hydroxypropan-2-yl) cyclohexa-1,3-diene-1-carboxylic acid) as particular or unique phytochemicals of rape, acacia, and linden honey. Methyl syringate and lindenin were the most abundant components in rape and linden honey; moreover, their average contents reached up to 10.44 and 21.25 mg/kg, respectively. The average content of phaseic acid was 0.63 mg/kg in acacia honey. To our knowledge, the presence of phaseic acid in honey is a novel finding. Furthermore, we established the HPLC fingerprints of three monofloral honeys. We offered assessment criteria and combined characteristic components with standard fingerprints to evaluate the authenticity of commercial rape, acacia, and linden honeys. For uncertain commercial honey samples, genuine pure honeys constituted nearly 70%. We differentiate the adulteration of acacia and linden honeys with low-price rape honey. Our results reveal that 10% of commercial honeys were pure syrups. Overall, we seem to propose a novel and reliable solution to assess the authenticity of monofloral honey.

In Vitro Efficacy of Essential Oils from Melaleuca Alternifolia and Rosmarinus Officinalis, Manuka Honey-based Gel, and Propolis as Antibacterial Agents Against Canine Staphylococcus Pseudintermedius Strains

Essential oils (EOs) and honeybee products (e.g., honey and propolis) are natural mixtures of different volatile compounds that are frequently used in traditional medicine and for pathogen eradication. The aim of this study was to evaluate the antibacterial properties of tea tree (Melaleuca alternifolia) EO (TTEO), Rosmarinus officinalis EO (ROEO), manuka-based gel, and propolis against 23 strains of Staphylococcus pseudintermedius (SP) isolated from canine pyoderma. Antimicrobial resistance screening was assessed using a panel of nine antimicrobial agents coupled with a PCR approach. An aromatogram was done for both EOs, using the disk diffusion method. The minimum inhibitory concentration (MIC) was determined for all the compounds. Among the 23 SP strains, 14 (60.9%) were multidrug-resistant (MDR), 11 strains (47.8%) were methicillin-resistant (MRSP), and 9 (39.1%) were non-MDR. The mean diameter of the inhibition zone for Melaleuca and Rosmarinus were 24.5 ± 8.8 mm and 15.2 ± 8.9 mm, respectively, resulting as statistically different (p = 0.0006). MIC values of TTEO and ROEO were similar (7.6 ± 3.2% and 8.9 ± 2.1%, respectively) and no statistical significances were found. Honeybee products showed lower MIC compared to those of EOs, 0.22 ± 0.1% for Manuka and 0.8 ± 0.5% for propolis. These findings reveal a significant antibacterial effect for all the tested products.

Institutional protocols for the oral administration (gavage) of chemicals and microscopic microbial communities to mice: Analytical consensus

IMPACT STATEMENT

Institutional protocols designed for the oral administration of live microbial communities, either complex or microscopic (microcosmic), to mice do not exist. However, this approach is increasingly employed by investigators focusing on the gut microbiome in experimental research. Herein, we propose two analytically Kappa-based consensus protocols to promote reproducibility and standardization in research practices and describe biologically relevant factors in achieving optimal microbial engraftment of communities in germ-free mice.

Antibiotics, Acid and Heat Tolerance of Honey adapted Escherichia coli, Salmonella Typhi and Klebsiella pneumoniae

The medicinal importance of honey has been known for many decades due to its antimicrobial properties against life-threatening bacteria. However, previous studies revealed that microorganisms are able to develop adaptations after continuous exposure to antimicrobial compounds. The present study was conducted to explore the impact of subinhibitory concentrations of branded honey (Marhaba) and unbranded honey (extracted from Ziziphus mauritiana plant) locally available in Pakistan on Escherichia coli ATCC 10536, Salmonella Typhi and Klebsiella pneumoniae by investigating the development of self- or cross-resistance to antibiotics (gentamicin, kanamycin and imipenem). Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of autoclaved honeys were determined. The bacterial cells of E. coli ATCC 10536, S. Typhi and K. pneumoniae were subjected to honey adaptation by exposing to ¼ × MIC (4 passages) and ½ × MIC (4 passages) of both honeys. Moreover, tolerance to low pH and high temperature was also studied in adapted and unadapted cells. The decreasing trend in growth pattern (OD_600nm) of E. coli ATCC 10536, S. Typhi and K. pneumoniae was observed with increases in the concentration of honeys (6.25–50% v/v) respectively. Our results showed that continuous exposure of both honeys did not lead to the development of any self- or cross-resistance in tested bacteria. However, percent survival to low pH was found to be significantly higher in adapted cells as compared to unadapted cells. The results indicate that both branded honey (Marhaba) and unbranded honey (extracted from Ziziphus mauritiana plant) were effective in controlling the growth of tested pathogenic bacteria. However, the emergence of tolerance to adverse conditions (pH 2.5, temperature 60 °C) deserves further investigation before proposing honey as a better antibacterial agent in food fabrication/processing, where low pH and high temperatures are usually implemented.

In vitro antimicrobial activities of Saudi honeys originating from Ziziphus spina-christi L. and Acacia gerrardii Benth. trees

Honeys originating from Sidr (Ziziphus spina-christi L.) and Talh (Acacia gerrardii Benth.) trees in Saudi Arabia exhibited substantial antimicrobial activity against pathogenic gram-positive bacteria (Bacillus cereus, Staphylococcus aureus), gram-negative bacteria (Escherichia coli, Salmonella enteritidis), and a dermatophytic fungus (Trichophyton mentagrophytes). The diameter of zones of inhibition represents the level of antimicrobial potency of the honey samples. Precisely, Talh honey showed significantly higher antibacterial activity against all tested bacteria than Sidr honey. The antifungal activity of Talh and Sidr honey types was significantly at par against a dermatophytic fungus. The water-diluted honey types (33% w/v) significantly induced a rise in the antimicrobial activity from that of the natural nondiluted honeys. Microbial strains displayed differential sensitivity; gram-positive bacteria were more sensitive and presented larger inhibition zones than gram-negative bacteria and the fungus. The sensitivity was highest in B. cereus and S. aureus, followed by T. mentagrophytes, E. coli, and S. enteritidis. The antimicrobial activity of water-diluted honeys (Sidr and Talh) was high than that of broad-spectrum antibacterial antibiotics (tetracycline and chloramphenicol) against bacterial strains, but these honeys were relativity less potent than antifungal antibiotics (flucoral and mycosat) against a fungal strain. Our findings indicate the antimicrobial potential of Saudi honeys to be considered in honey standards, and their therapeutic use as medical-grade honeys needs further investigations.

Manuka honey chelates iron and impacts iron regulation in key bacterial pathogens

AIM

The aim of this study was to test the hypothesis that Manuka honey (MH) chelates iron and promotes an iron-limiting environment, which contributes to its antimicrobial activity.

METHODS AND RESULTS

Employing a ferrozine-based assay, we observed that MH is an iron chelator that depletes iron from solution. Siderophores are small molecules that bind ferric iron (III) with high affinity and their levels are upregulated by bacteria under iron-limiting conditions. We demonstrated by quantitating siderophore production that Escherichia coli and Pseudomonas aeruginosa treated with MH sub-minimum inhibitory concentrations (sub-MIC) experience an iron-limiting environment and increase siderophore production. In addition, supplementation with ferrous iron (II) significantly increased growth of E. coli, Staphylococcus aureus and P. aeruginosa cultured at their MH MIC above that observed in nonsupplemented controls. By contrast, supplementation with ferric iron (III) significantly increased growth for only E. coli and P. aeruginosa, above their nonsupplemented controls.

CONCLUSIONS

Manuka honey chelates iron, thereby generating an iron-limiting environment for E. coli and P. aeruginosa, and to a lesser extent S. aureus, which contributes to its antimicrobial properties.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our work demonstrates that MH-induced iron chelation is an antimicrobial mechanism that differentially impacts the bacterial species tested here. Iron chelation affects multiple diverse physiological processes in bacteria and would contribute to the lack of bacterial resistance to MH. Iron metabolism is tightly regulated; bacteria require this essential nutrient for survival, but in excess it is toxic. Additional exploration of MH's iron chelation mechanism will facilitate its future use in mainstream medicine.

Dissecting the Antimicrobial Composition of Honey

Honey is a complex sweet food stuff with well-established antimicrobial and antioxidant properties. It has been used for millennia in a variety of applications, but the most noteworthy include the treatment of surface wounds, burns and inflammation. A variety of substances in honey have been suggested as the key component to its antimicrobial potential; polyphenolic compounds, hydrogen peroxide, methylglyoxal and bee-defensin 1. These components vary greatly across honey samples due to botanical origin, geographical location and secretions from the bee. The use of medical grade honey in the treatment of surface wounds and burns has been seen to improve the healing process, reduce healing time, reduce scarring and prevent microbial contamination. Therefore, if medical grade honeys were to be included in clinical treatment, it would reduce the demand for antibiotic usage. In this review, we outline the constituents of honey and how they affect antibiotic potential in a clinical setting. By identifying the key components, we facilitate the development of an optimally antimicrobial honey by either synthetic or semisynthetic production methods.

Antibacterial activity of varying UMF-graded Manuka honeys

Honey has been used as a traditional remedy for skin and soft tissue infections due to its ability to promote wound healing. Manuka honey is recognized for its unusually abundant content of the antibacterial compound, methylglyoxal (MGO). The Unique Manuka Factor (UMF) grading system reflects the MGO concentration in Manuka honey sold commercially. Our objective was to observe if UMF values correlated with the antibacterial activity of Manuka honey against a variety of pathogens purchased over the counter. The antibacterial effect of Manuka honey with UMF values of 5+, 10+, and 15+ from the same manufacturer was assessed by the broth microdilution method. Minimum inhibitory concentration (MIC) values were determined against 128 isolates from wound cultures representing gram-positive, gram-negative, drug-susceptible, and multi-drug resistant (MDR) organisms. Lower MICs were observed with UMF 5+ honey for staphylococci (n = 73, including 25 methicillin-resistant S. aureus) and Pseudomonas aeruginosa (n = 22, including 10 MDR) compared to UMF 10+ honey (p<0.05) and with UMF 10+ compared to UMF 15+ (p = 0.01). For Enterobacteriaceae (n = 33, including 14 MDR), MIC values were significantly lower for UMF 5+ or UMF 10+ compared to UMF 15+ honey (p<0.01). MIC₅₀ for UMF 5+, UMF 10+, and UMF 15+ honey against staphylococci was 6%, 7%, and 15%, and for Enterobacteriaceae was 21%, 21%, and 27%, respectively. For Pseudomonas aeruginosa MIC₅₀ was 21% and MIC₉₀ was 21–27% for all UMFs. Manuka honey exhibited antimicrobial activity against a spectrum of organisms including those with multi-drug resistance, with more potent activity overall against gram-positive than gram-negative bacteria. Manuka honey with lower UMF values, in our limited sampling, paradoxically demonstrated increased antimicrobial activity among the limited samples tested, presumably due to changes in MGO content of honey over time. The UMF value by itself may not be a reliable indicator of antibacterial effect.

Exosome-like vesicles in Apis mellifera bee pollen, honey and royal jelly contribute to their antibacterial and pro-regenerative activity

Microvesicles are key players in cellular communication. As glandular secretions present a rich source of active exosomes, we hypothesized that exosome-like vesicles are present in Apis mellifera hypopharyngeal gland secretomal products (honey, royal jelly and bee pollen), and participate in their known antibacterial and pro-regenerative effects. We developed an isolation protocol based on serial centrifugation and ultracentrifugation steps and demonstrated the presence of protein-containing exosome-like vesicles in all three bee-derived products. Assessing their antibacterial properties, we found that exosome-like vesicles had bacteriostatic, bactericidal and biofilm-inhibiting effects on Staphylococcus aureus Furthermore, we demonstrated that mesenchymal stem cells (MSCs) internalize bee-derived exosome-like vesicles and that these vesicles influence the migration potential of the MSCs. In an in vitro wound-healing assay, honey and royal jelly exosome-like vesicles increased migration of human MSCs, demonstrating their inter-kingdom activity. In summary, we have discovered exosome-like vesicles as a new, active compound in bee pollen, honey and royal jelly.

Alternative Treatments for Atopic Dermatitis: An Update

Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease in which management with topical anti-inflammatory agents during exacerbations remains the mainstay of treatment. With no cure in sight, a significant proportion of patients elect to incorporate complementary and alternative medicine (CAM) as an adjunct to conventional treatment. Many clinicians find it difficult to provide recommendations as the field covers an extensive number of very disparate therapies, with limited quality evidence to indicate efficacy. Since publication of the last review on this topic in the Journal that compiled and analyzed randomized controlled trials (RCTs) on CAMs in 2015, several new studies have surfaced. This update aims to aggregate and review these new data. A literature search was conducted in the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Global Resource for EczemA Trials (GREAT) databases for RCTs on complementary and alternative therapies in AD from March 2015 through May 2018, resulting in 15 studies being included in this review. The preliminary results for many treatments such as vitamin E, East Indian Sandalwood Oil (EISO), melatonin, L-histidine, and Manuka honey show positive clinical effects, but there is currently not enough evidence to recommend their use in AD therapy. Future investigative efforts should focus on reproducing some of these studies with a larger sample size whose clinical characteristics and demographics are more reflective of the general AD population, and standardizing the process to produce reliable data.