Arabinogalactan proteins contribute to the immunostimulatory properties of New Zealand honeys

The In Vitro Antioxidant and Immunomodulatory Effects of the Irish Monofloral Ivy and Heather Honey Varieties

Honey has long been valued for its medicinal properties, yet the therapeutic potential of Irish monofloral honey remains largely unexplored. This study investigates the antioxidant and immunomodulatory effects of Irish ivy (Hedera helix) and heather (Calluna vulgaris) honey samples on PMA-differentiated THP-1 macrophages, a well-characterised immune model. Antioxidant capacity was assessed through free radical scavenging assays, DPPH and ORAC, while qPCR analysis examined the key inflammatory markers. Both the heather and ivy honey varieties demonstrated antioxidant activity, with heather honey exhibiting the highest total phenolic content (TPC), and ivy honey stimulating Nrf2 activation. Manuka honey showed the strongest radical scavenging capacity, as reflected in its higher ORAC and DPPH values. These findings suggest that the different honey varieties may exert antioxidant effects through distinct mechanisms. Exposure to honey reduced oxidative stress and upregulated the expression of a key antioxidant transcription regulator (Nrf2) and an associated downstream antioxidant defence enzyme, superoxide dismutase (SOD). Additionally, both the honey types exhibited immunomodulatory effects, upregulating pro-inflammatory cytokines, such as TNF-α and IL-1β, while increasing the expression of the anti-inflammatory cytokine IL-10. These findings suggest potential bioactive properties that warrant further investigation. Given the growing interest in alternative treatments for inflammation-related conditions, further research is warranted to determine whether the observed in vitro effects translate into clinically relevant outcomes. This study expands the current understanding of Irish monofloral honey, reinforcing its potential as a functional bioactive compound with relevance in antioxidant therapies, immune modulation, and wound healing.

Antibacterial Properties, Arabinogalactan Proteins, and Bioactivities of New Zealand Honey

Honey has been used for centuries for its antibacterial and healing properties. The aim of this study was to investigate the antibacterial properties, arabinogalactan proteins (AGPs), antioxidant activities, and polyphenolic content of eight different types of New Zealand honey (clover, mānuka, beech honeydew, pōhutukawa, kānuka, rewarewa, kāmahi and thyme honey). The results showed varying antibacterial activities across the honey types, with mānuka, pōhutukawa, and kāmahi honey exhibiting significant inhibitory effects. Interestingly, all honey samples demonstrated inhibitory effects on bacterial growth at 25% concentration. Furthermore, AGPs were found in all eight honey samples, with higher amounts in kānuka, kāmahi, pōhutukawa, mānuka, and rewarewa honey. Thyme had the highest antioxidant values in terms of CUPRAC, FRAP and DPPH, while kāmahi honey had the lowest antioxidant value. Beech honeydew honey had the highest Total Flavonoid Content (TFC) values, while thyme and clover honey had the lowest TFC values. Similarly, thyme honey exhibited the highest Total Phenolic Content (TPC) value, with kāmahi and clover honey having the lowest TPC values. Furthermore, only thyme and beech honeydew New Zealand honeys contained vitamin C. The different honeys contained varying concentrations of polyphenols, with mānuka, kānuka, and pōhutukawa honeys having high amounts of quercetin, luteolin, and gallic acid, respectively. In contrast, clover honey had notable levels of chrysin, pinocembrin, caffeic acid, and pinobanksin. Overall, this study provides valuable insights into the antibacterial properties and bioactivities of native New Zealand honeys, contributing to our understanding of the potential health benefits associated with these honeys and their potential use as natural alternatives to improve human health.

The Effects of Encapsulating Bioactive Irish Honey into Pluronic-Based Thermoresponsive Hydrogels and Potential Application in Soft Tissue Regeneration

Honey has been recognised for centuries for its potential therapeutic properties, and its application in wound healing has gained attention due to its antimicrobial, anti-inflammatory, and regenerative properties. With the rapid increase in multidrug resistance, there is a need for new or alternative approaches to traditional antibiotics. This paper focuses on the physicochemical changes that occur when formulating honey into Pluronic F127 hydrogels. The manual incorporation of honey, irrespective of quality type, presented the amelioration of Pluronic's capacity to undergo sol-gel transitions, as investigated by parallel plate rheology. This novel finding was attributed to the formation of fractal aggregates via the hydrogen-bonding-induced irreversible aggregation of honey-PF127 micelles, which subsequently dominate the entire hydrogel system to form a gel. The hydrogen bonding of micelles was identified through Attenuated Total Reflectance Fourier-Transform Infrared Spectroscopy (ATR-FTIR), Differential Scanning Calorimetry (DSC), and Dynamic Light Scattering (DLS). This is the first known study to provide physicochemical insight into the effects that honey incorporation has on the thermogelation capacity of Pluronic F127 hydrogels for downstream dermal wound applications.

The molecular basis of the immunomodulatory effects of natural products: A comprehensive review

BACKGROUND

Natural products (NPs) have long been recognized for their potential to modulate the immune system, offering a natural and holistic approach to enhancing immune function. In recent years, the immunomodulation effects of various natural products have attained significant attention.

PURPOSE

This article provides an overview of the role of natural products in immunomodulation, exploring their mechanisms of action, common types of NPs with immunomodulation properties, clinical applications, as well as considerations for their safety and efficacy.

METHODS

Extensive research has been conducted to compile important discoveries on the immunomodulatory properties of NPs through thorough searches of multiple databases such as PubMed, Science Direct, and Scopus up until January 2024.

RESULTS

By decreasing the levels of Th2 cytokines and pro-inflammatory cytokines, the results suggested that NPs have the ability to modulate the immune system. Therefore, NPs alleviate inflammation in various disorders such as asthma and cancer. Furthermore, the observed increase in CD4 cells and IFN-ɣ/IL4 levels, along with an increased IFN-c/IL4 ratio, indicates a stimulatory effect of NPs on Th1 activity in various inflammatory conditions. Therefore, NPs regulate the immune system by inhibiting T-cells and decreasing the growth of young B-cell lymphoma cells.

CONCLUSION

Reviewing studies indicated that NPs have the potential to serve as immunomodulatory candidates for treating disorders characterized by immune dysregulation. However, additional experimental and clinical studies are necessary before these agents can be implemented in clinical settings.

Anti-Inflammatory and Wound Healing Properties of Different Honey Varieties from Romania and Correlations to Their Composition

The complex composition of honey plays a crucial role in wound healing, exhibiting varying effects at different stages of the healing process. This study investigated seven honey varieties sourced from different regions of Romania using in vitro experimental models developed in macrophage-like, fibroblast, and keratinocyte cell lines to explore the mechanisms by which honey promoted the healing process. This study assessed the impact of honey on inflammatory cytokine production in macrophage-like cells, cell proliferation and collagen synthesis in fibroblasts, and cell proliferation and migration in keratinocytes. Additionally, correlation analysis was conducted to examine the relationship between honey composition and its biological properties. Honey varieties presented both anti- and pro-inflammatory effects. Moreover, they displayed dose-dependent pro-proliferative effects, stimulating collagen synthesis and cell migration, thereby enhancing the re-epithelialization process. The Pearson coefficient analysis indicated a strong positive correlation between biological activities and phenolic content. Additionally, there was a medium positive correlation with the ascorbic acid content and a medium negative correlation with the glucose content in the different honey varieties. Romanian honey varieties rich in phenolics showed potential in modulating inflammation, proliferation, collagen synthesis, and cell migration, suggesting their suitability for further evaluation and development of innovative dressings for skin tissue regeneration.

Investigating the Protein-Based Therapeutic Relationship between Honey Protein SHP-60 and Bevacizumab on Angiogenesis: Exploring the Synergistic Effect through In Vitro and In Silico Analysis

Honey is a natural product produced by honeybees, which has been used not only as food but also as a medicine by humans for thousands of years. In this study, 60 kDa protein was purified from Pakistani Sidr honey named as SHP-60 (Sidr Honey Protein-60), and its antioxidant potential and the effect of Bevacizumab with purified protein on in vitro angiogenesis using human umbilical vein endothelial cells (HUVEC) were investigated. We further validated the molecular protein-protein (SHP-60 with Bevacizumab) interactions through in silico analysis. It showed very promising antioxidant activity by reducing 2,2-diphenyl-1-picrylhydrazyl free radicals with a maximum of 83% inhibition at 50 μM and an IC50 of 26.45 μM statistically significant (**p < 0.01). Angiogenesis is considered a hallmark of cancer, and without it, the tumor cannot grow or metastasize. Bevacizumab, SHP-60, and both in combination were used to treat HUVEC, and the MTT assay was used to assess cell viability. To demonstrate in vitro angiogenesis, HUVEC was grown on Geltrex, and the formation of endotubes was examined using a tube formation assay. HUVEC viability was dose-dependently decreased by Bevacizumab, SHP-60, and both together. Bevacizumab and SHP-60 both inhibited angiogenesis in vitro, and their combination displayed levels of inhibition even higher than those of Bevacizumab alone. We investigated the protein-protein molecular docking interactions and molecular dynamics simulation analysis of MRJP3 (major royal jelly protein 3) similar to SHP-60 in molecular weight with both the heavy chain (HC) and light chain (LC) of Bevacizumab. We found significant interactions between the LC and MRJP3, indicating that ASN468, GLN470, and ASN473 of MRJP3 interact with SER156, SER159, and GLU161 of LC of Bevacizumab. The integration of experimental data and computational techniques is believed to improve the reliability of the findings and aid in future drug design.

Gastrointestinal Effects on the Antioxidant and Immunomodulatory Properties of South African Fynbos Honey

The Fynbos biome, Western Cape Province, South Africa, produces a unique honey from Apis mellifera capensis. The bioactivity of Fynbos (FB1-FB6) honeys and Manuka, unique manuka factor 15+ (MAN UMF15+) honey subjected to simulated in vitro digestion, was compared. The effect of each phase of digestion on the antioxidant properties and nitric oxide- (NO-) associated immunomodulatory effects was determined. The total phenolic content of MAN (UMF15+) was higher than that of FB honeys, and following digestion, the percentage bioaccessibility (BA) was 68.6% and 87.1 ± 27.0%, respectively. With the Trolox equivalent antioxidant capacity assay, the activity of FB1 and FB6 was similar to MAN (UMF15+) but reduced for FB2, FB3, FB4, and FB5 with a %BA of 77.9% for MAN (UMF15+) and 78.2 ± 13.4% for FB. The oxygen radical absorbance capacity of MAN (UMF15+) and FB honeys was similar and unaltered with digestion. In a cellular environment, using colon adenocarcinoma (Caco-2) cells, both undigested and the gastric digested honey reduced 2,2'-azobis-(2-amidinopropane) dihydrochloride- (AAPH-) mediated peroxyl radical formation. In contrast, following gastroduodenal digestion, the formation of reactive oxygen species (ROS) was increased. In murine macrophage (RAW 264.7) cells, all honeys induced different levels of NO which was significantly increased with digestion for MAN (UMF15+) and FB1. In LPS/IFN-γ stimulated RAW 264.7 macrophages, only undigested MAN (UMF15+) effectively reduced NO levels, and with digestion, NO scavenging activity of MAN (UMF15+) was reduced but increased for FB5 and FB6. In a noncellular environment, MAN (UMF15+), FB1, FB2, and FB6 scavenged NO, and with digestion, this activity was maintained. This study has identified that undigested and gastric-digested FB honey has antioxidant properties with strong potential anticancer effects following gastroduodenal digestion, related to ROS formation. MAN (UMF15+) had anti-inflammatory effects which were lost postdigestion, and in contrast, FB5 and FB6 had anti-inflammatory effects postdigestion.

Secretion of IL-6 by fibroblasts exposed to Australian honeys involves lipopolysaccharide and is independent of floral source

Honey stimulates cellular secretion of cytokines, which has been attributed to activation of lipopolysaccharide (LPS)-dependent and LPS-independent pathways. The objective of this study was to identify whether LPS is present in Australian honey samples at levels that can stimulate interleukin-6 (IL-6) secretion by fibroblasts and whether it can transduce cell signalling by activating toll-like receptor 4 (TLR4). IL-6 was measured in culture media of fibroblasts exposed to honey for 24 h. LPS was detected in a 0.125 mg/mL solution of grey ironbark honey (0.61 ± 0.05 ng/g honey). TLR4 signalling was observed in RAW264.7 macrophages that were exposed to honey and this was prevented by preincubating the honey with the LPS-neutralising agent, polymyxin B. Australian Eucalyptus, Leptospermum and Cyathode honeys stimulated IL-6 secretion in cultured human dermal fibroblasts. To examine whether the response was dependent on floral source, fibroblasts were exposed to four different samples of grey ironbark honey obtained from Queensland and New South Wales, Australia. The magnitude of the cytokine response to these honeys was highly varied. We conclude that Australian honeys contain endotoxin at levels that can stimulate IL-6 secretion by fibroblasts and that signalling in macrophages involves TLR4 activation. The IL-6 secretory response was independent of floral source.

History and the immunostimulatory effects of heat-processed licorice root products with or without honey

ETHNOPHARMACOLOGICAL RELEVANCE

In traditional Chinese medicine, the dried root of Glycyrrhiza uralensis Fisch. (licorice root) is usually used after stir-baked with honey. However, in Japanese traditional Kampo medicine, processed licorice root is prepared by roasting without honey.

AIM OF THE STUDY

We summarized our previous studies on the processed licorice root products to review the effectiveness of the processing for licorice root.

MATERIALS AND METHODS

We summarized our previous studies about processed licorice root. The first report was about investigating the successive literatures of traditional medicine in China and Japan about the processing of licorice root. Next was the report about chemically analyzing for prepared various kinds of processed licorice root samples. The last reports were evaluating in vitro effects of the extracts of these samples and heated honey on granulocyte colony-stimulating factor (G-CSF) secretion in cultured intestinal epithelial cells.

RESULTS

Before the Song dynasty in mainland China, the processing of licorice root for the internal usage had been roasted without any drug adjuvants. Then, clinicians had also used honey-roasted licorice to treat throat pain since the Song dynasty, and honey-roasted licorice has been used as the substitute to roasted licorice since the end of the Qing dynasty. While the descriptions using honey have been disappeared in 18th century in Japan. We found that the conversion between liquiritigenin and isoliquiritigenin or between liquiritin and isoliquiritin in licorice root by heating was accelerated by using honey as drug adjuvant. The inducible effect of G-CSF of licorice root was not augmented by roasting, but significantly augmented by stir-baked with honey. Heated honey also had this activity, and isomaltose contributed the appearance of this activity among the constituents in honey. The best activity was appeared when isomaltose was heated at 180 °C for 60 min or at 200 °C for 15-30 min, and the average molecular weight of the active product was 790 kDa.

CONCLUSIONS

By our previous studies, we believe that the processing method in China is better than that in Japan for licorice root, since the immunostimulatory effects are appeared in honey used as drug adjuvant when honey is heated. Among the ingredients of honey, isomaltose can be used as the marker compound to choose a conforming honey product for the processing of licorice root.

Exploring the Chemical Properties and Biological Activity of Four New Zealand Monofloral Honeys to Support the Māori Vision and Aspirations

Honey production and export are significant contributors to the Aotearoa New Zealand economy, generating over 400 million dollars in revenue. Its main export is mānuka (Leptospermum scoparium) honey, which has a high commercial value due to its medicinal properties that are linked to its unique chemical composition. The compound methylglyoxal (MGO) has been identified as the main floral marker and is used as a quality indicator, often labelled as unique mānuka factor (UMF). However, the high demand for mānuka honey creates pressure on beekeepers and may have negative ecological consequences by favouring extensive mānuka monocultures to the detriment of other native species. There are other honeys native to New Zealand, such as kāmahi (Weinmannia racemosa), kānuka (Kunzea ericoides), rātā (Metrosideros robusta) and rewarewa (Knightia excelsa), that also have medicinal properties; however, they are less well known in the local and global market. Indigenous Māori communities envision the production and commercialization (locally and internationally) of these honeys as an opportunity to generate income and secure a sustainable future in alignment with their worldview (Te Ao Māori) and values (tikanga Māori). Diversifying the market could lead to a more sustainable income for beekeepers and reduce pressure on Māori and the conservation land, while supporting indigenous communities to realize their vision and aspirations. This manuscript provides an extensive review of the scientific literature, technical literature and traditional knowledge databases describing the plants of interest and their traditional medicinal uses (rongoā) and the chemical properties of each honey, potential floral markers and their biological activity. For each honey type, we also identify knowledge gaps and potential research avenues. This information will assist Māori beekeepers, researchers, consumers and other stakeholders in making informed decisions regarding future research and the production, marketing and consumption of these native monofloral honeys.

A Framework for Reviewing Silvopastoralism: A New Zealand Hill Country Case Study

Silvopastoral systems can be innovative solutions to agricultural environmental degradation, especially in hilly and mountainous regions. A framework that expresses the holistic nature of silvopastoral systems is required so research directions can be unbiased and informed. This paper presents a novel framework that relates the full range of known silvopastoral outcomes to bio-physical tree attributes, and uses it to generate research priorities for a New Zealand hill country case study. Current research is reviewed and compared for poplar (Populus spp.), the most commonly planted silvopastoral tree in New Zealand hill country, and kānuka (Kunzea spp.), a novel and potentially promising native alternative. The framework highlights the many potential benefits of kānuka, many of which are underappreciated hill country silvopastoral outcomes, and draws attention to the specific outcome research gaps for poplar, despite their widespread use. The framework provides a formalised tool for reviewing and generating research priorities for silvopastoral trees, and provides a clear example of how it can be used to inform research directions in silvopastoral systems, globally.

The Effect of Adding Honey to Zinc in the Treatment of Diarrhea in Children

Background

Honey has been used in medicine since ancient times. Limited reports are available to indicate its antibacterial, antiviral, and antidiarrheal properties. This study aimed to determine the effect of honey on acute diarrhea in children.

Methods

This randomized clinical trial included 80 children with acute diarrhea. Forty children received honey and zinc gluconate (trial group) and 40 received only zinc gluconate (control group). After treatment, vomiting/diarrhea duration, the recovery time, and the duration of hospitalization were compared between the groups.

Results

Among the 40 children in the trial group, 19 were male and 21 were female. In the control group, 25 children were male and 15 female (P=0.26). After initiating treatment, the duration of diarrhea, recovery time, and the duration of hospitalization was significantly shorter in the trial group than in the control group (P<0.05).

Conclusion

This study showed that honey with zinc gluconate reduces the duration of diarrhea, accelerates the recovery time, and shortens the duration of hospitalization.

The Immunomodulatory Effects of Honey and Associated Flavonoids in Cancer

Honey has exerted a high impact in the field of alternative medicine over many centuries. In addition to its wound healing, anti-microbial and antioxidant properties, several lines of evidence have highlighted the efficiency of honey and associated bioactive constituents as anti-tumor agents against a range of cancer types. Mechanistically, honey was shown to inhibit cancer cell growth through its pro-apoptotic, anti-proliferative and anti-metastatic effects. However, the potential of honey to regulate anti-tumor immune responses is relatively unexplored. A small number of in vitro and in vivo studies have demonstrated the ability of honey to modulate the immune system by inducing immunostimulatory as well as anti-inflammatory effects. In the present review, we summarize the findings from different studies that aimed to investigate the immunomodulatory properties of honey and its flavonoid components in relation to cancer. While these studies provide promising data, additional research is needed to further elucidate the immunomodulatory properties of honey, and to enable its utilization as an adjuvant therapy in cancer.

Honey and its protein components: Effects in the cancer immunology

The immune system plays an important role in cancer development, but some tumor cells can evade or inhibit the processes of innate and adaptive immunity. This review made a description of honey and its proteins effect on diverse mediators from the immune system. Scientific evidence reported that many types of honey (jungle, manuka, pasture, and others) and some isolated proteins enhanced the release of reactive oxygen species (O₂ ^- and H₂ O₂ ) and cytokines (mostly IL-1β, IL-6, and TNF-α) by innate immune system cells. Furthermore, honey elicited proliferation and functions of T lymphocytes, cells related to specific adaptive immune responses. These studies have established a precedent over the honey and its properties on the immune system, demonstrating that it can promote the innate and adaptive immunity. PRACTICAL APPLICATIONS: Cancer is a genetic illness that represents a world health problem. Recognizing the potential of diet therapy in the prevention and treatment of chronic diseases, the present work summarizes the effects of honey on the immune system and mediators involved in cancer elimination processes, establishing the importance of this natural product as a future anticancer agent.

The effects of honey on pro- and anti-inflammatory cytokines: A narrative review

Honey contains flavonoids and phenolic acids, and because of their antioxidant and anti-inflammatory properties, they may play an important role in human health. The purpose of this review was to synthesize the effects of natural honey on pro- and anti-inflammatory cytokines. The effects of honey on wound healing and immunity appear to be inconsistent. The available databases )PubMed and Scopus) were searched and 42 studies were assessed. In patients with cancer, honey has been reported to inhibit the effects of pro-inflammatory factors such as TNF-α and IL-6. In patients with neuro-inflammatory disorders honey has been shown to inhibit the expression of pro-inflammatory markers. It has also been reported that honey can reduce TNF-α expression in conditions associated with liver injury, by suppressing TNF-α converting enzyme activity. Honey inhibits APAP-induced hepatocellular necrosis by modulating the expression of IL-10 and IL-1ß. Animal studies have shown that honey can reduce serum IL-1ß, IL-6 and TNF-α concentration and increase IL-10 concentrations in a model of gastric ulcer. Some studies in diabetics have shown that honey can reduce serum TNF-α, IL-6, IL-1ß and TGF-ß by inhibiting NF-Kß. The source and type of honey and its component have not been indicated in various clinical and practical studies, which are a limitation of these studies, in relation to reproducing them. Sigma, Manuka, Gelam and Tulang honey have been used in most of the in vitro and animal studies. The animal studies have demonstrated similar effects on pro-inflammatory factors, which include reducing serum TNF-α, IL-6 and IL-1β as well as increasing IL-10. There are few human RCTs investigating the effects of honey on inflammatory cytokines. Only one RCT has reported the type of honey that they have used. Tulang honey has been reported to increase serum TNF-α and decrease hs-CRP, which is therefore controversial. Further high-quality studies are needed to firmly establish the clinical efficacy of honey. Because most studies had used different duration, type of honey and dosage, which make them difficult to contextualize, as the phytochemical content of a honey may depend on its source. Furthermore, it is unclear whether honey's anti-inflammatory effects are related to its phenolic or tocopherol compounds, and whether its effects are greater than these individual components.

Proteus mirabilis Biofilm: Development and Therapeutic Strategies

Proteus mirabilis is a Gram negative bacterium that is a frequent cause of catheter-associated urinary tract infections (CAUTIs). Its ability to cause such infections is mostly related to the formation of biofilms on catheter surfaces. In order to form biofilms, P. mirabilis expresses a number of virulence factors. Such factors may include adhesion proteins, quorum sensing molecules, lipopolysaccharides, efflux pumps, and urease enzyme. A unique feature of P. mirabilis biofilms that build up on catheter surfaces is their crystalline nature owing to their ureolytic biomineralization. This leads to catheter encrustation and blockage and, in most cases, is accompanied by urine retention and ascending UTIs. Bacteria embedded in crystalline biofilms become highly resistant to conventional antimicrobials as well as the immune system. Being refractory to antimicrobial treatment, alternative approaches for eradicating P. mirabilis biofilms have been sought by many studies. The current review focuses on the mechanism by which P. mirabilis biofilms are formed, and a state of the art update on preventing biofilm formation and reduction of mature biofilms. These treatment approaches include natural, and synthetic compounds targeting virulence factors and quorum sensing, beside other strategies that include carrier-mediated diffusion of antimicrobials into biofilm matrix. Bacteriophage therapy has also shown successful results in vitro for combating P. mirabilis biofilms either merely through their lytic effect or by acting as facilitators for antimicrobials diffusion.

Honey: An Effective Regenerative Medicine Product in Wound Management

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Honey has successfully been used in the treatment of a broad spectrum of injuries including burns and non-healing wounds. It acts as an antibacterial and anti-biofilm agent with anti/pro-inflammatory properties. However, besides these traditional properties, recent evidence suggests that honey is also an immunomodulator in wound healing and contains several bee and plant-derived components that may speed up wound healing and tissue regeneration process. Identifying their exact mechanism of action allows better understanding of honey healing properties and promotes its wider translation into clinical practice.

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This review will discuss the physiological basis for the use of honey in wound management, its current clinical uses, as well as the potential role of honey bioactive compounds in dermal regenerative medicine and tissue re-modeling.

Kanuka honey versus aciclovir for the topical treatment of herpes simplex labialis: a randomised controlled trial

OBJECTIVE

To compare New Zealand medical grade kanuka honey with topical aciclovir for the treatment of herpes simplex labialis.

DESIGN

Prospective parallel randomised controlled open-label superiority trial.

SETTING

76 community pharmacies across New Zealand between 10 September 2015 and 13 December 2017.

PARTICIPANTS

952 adults randomised within the first 72 hours of a herpes simplex labialis episode.

INTERVENTIONS

Random assignment 1:1 to either 5% aciclovir cream or medical grade kanuka honey (90%)/glycerine (10%) cream, both applied five times daily.

OUTCOME MEASURES

The primary outcome was time from randomisation to return to normal skin (stage 7). Secondary outcomes included time from randomisation to stage 4 (open wound), time from stage 4 to 7, maximal pain, time to pain resolution and treatment acceptability.

RESULTS

Primary outcome variable: Kaplan-Meier-based estimates (95% CI) for the median time in days for return to normal skin were 8 (8 to 9) days for aciclovir and 9 (8 to 9) for honey; HR (95% CI) 1.06 (0.92 to 1.22), p=0.56. There were no statistically significant differences between treatments for all secondary outcome variables. No related serious adverse events were reported.

CONCLUSION

There was no evidence of a difference in efficacy between topical medical grade kanuka honey and 5% aciclovir in the pharmacy-based treatment of herpes simplex labialis.

TRIAL REGISTRATION NUMBER

ACTRN12615000648527;Post-results.

Effect of Acacia Honey on Transforming Growth Factor-Beta-1-Induced Myofibroblast Differentiation and Matrix Metalloproteinase-9 Production in Nasal Polyp Fibroblasts

Background

Acacia honey is known to have antioxidant, immune-modulatory, and antiproliferative properties. Nasal fibroblasts participate in local immune responses that control the recruitment of inflammatory cells and the production of extracellular matrix.

Objectives

The aim of this study was to determine the effect of acacia honey on myofibroblast differentiation and matrix metalloproteinase-9 (MMP-9) production in nasal polyp fibroblasts.

Methods

Primary nasal fibroblasts were isolated from nasal polyps and treated with transforming growth factor-beta 1 (TGF-β1). Reverse transcription-polymerase chain reaction and Western blot analysis were then performed to determine α-smooth muscle actin (α-SMA), tissue inhibitors of matrix metalloproteinase-1, and MMP-9 mRNA expression and protein production in nasal polyp fibroblasts. Phosphorylated Smad ( pSmad) 2/3 and phosphorylated adenosine monophosphate-activated protein kinase ( pAMPK) were then determined by Western blotting.

Results

TGF-β1 stimulation increased α-SMA and MMP-9 mRNA expression and protein production in nasal polyp fibroblasts. Acacia honey effectively suppressed α-SMA and MMP-9 mRNA expression and protein production. It also prevented phosphorylation of Smad 2/3 and AMPK.

Conclusion

Acacia honey can inhibit TGF-β1-induced myofibroblast differentiation and MMP-9 production in nasal fibroblasts. These results suggest that acacia honey might be useful for inhibiting nasal polyp formation.

The immunostimulatory effects and chemical characteristics of heated honey

ETHNOPHARMACOLOGICAL RELEVANCE

In traditional Chinese medicine (TCM), honey has been used as an additive in the heat-processing of herbal medicines to enhance their immunostimulatory activities.

AIM OF THE STUDY

We investigated the immunostimulatory activity of heated honey in vitro and in vivo.

MATERIALS AND METHODS

For the in vitro study, we compared the differences among the inducible effects of honey subjected to various heating conditions on granulocyte colony-stimulating factor (G-CSF) secretion from the cultured enterocytes and investigated the active ingredient. For the in vivo study, we conducted a survival test of mice infected by Streptococcus pyogenes with and without oral administration of heated honey.

RESULTS

We found that heating the honey induced the appearance of G-CSF secretions from the cultured enterocytes, and that this appearance depended on the heating temperature and time. No G-CSF secretions appeared when honey was not heated. Mice infected with Streptococcus pyogenes that were fed heated honey revealed prolonged survival. The active ingredient in heated honey was a high-molecular compound with about 730 kDa. When this compound was hydrolyzed, galactose, glucose, rhamnose, α-ribofuranose β-ribofuranose 1,5':1',5-dianhydride, and 5-hydroxymethylfurfural were generated.

CONCLUSIONS

Heated honey reveals immunostimulatory activity both in vitro and in vivo. These results support the scientific evidences of the TCM theory.

Wound Healing Properties of Selected Natural Products

Wound healing is a complex process of recovering the forms and functions of injured tissues. The process is tightly regulated by multiple growth factors and cytokines released at the wound site. Any alterations that disrupt the healing processes would worsen the tissue damage and prolong repair process. Various conditions may contribute to impaired wound healing, including infections, underlying diseases and medications. Numerous studies on the potential of natural products with anti-inflammatory, antioxidant, antibacterial and pro-collagen synthesis properties as wound healing agents have been performed. Their medicinal properties can be contributed by the content of bioactive phytochemical constituents such as alkaloids, essential oils, flavonoids, tannins, saponins, and phenolic compounds in the natural products. This review highlights the in vitro, in vivo and clinical studies on wound healing promotions by the selected natural products and the mechanisms involved.

Comparative effect of manuka honey on anaerobic parasitic protozoans with standard drug therapy under in vitro conditions: A preliminary study

BACKGROUND

From the past five decades, metronidazole and tinidazole have been used for treating nonresistant and resistant giardiasis and trichomoniasis. However, due to the occurrence of drug resistance to standard therapy idealizes us to explore some additional therapies which is cost-effective, easy accessibility, and natural which has least side effects. Manuka honey obtained from Leptospermum scoparium is well known for its antibacterial and wound healing properties and is thought to be a better option as an additional therapy.

OBJECTIVE

The present study was conducted to find out the effect of manuka honey on anaerobic protozoans that includes Giardia and Trichomonas under in vitro conditions in comparison to metronidazole and tinidazole.

MATERIALS AND METHODS

Axenic culture of Giardia lamblia strain Portland 1 and Trichomonas vaginalis strain 413 was used for drug sensitivity assay to tinidazole, metronidazole, and manuka honey with the highest concentration of 17.1 μg/ml, 24.7 μg/ml, and 50%v/v by using (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, a tetrazole). For this, head-to-head comparison has been done and IC 50 of the standard drug as well as manuka honey was calculated.

RESULTS

The result showed that percentage inhibition on the growth of both the parasites is dependent on concentration as well as exposure time of the drug. The calculated IC 50 was found to be 5.6%v/v and 1.5%v/v for manuka honey with respect to G. lamblia and T. vaginalis.

CONCLUSION

The present study suggests that manuka honey can be used as an additional therapy for the patient with giardiasis or trichomoniasis. However, in vivo study in the near future will elucidate more about the effectiveness of honey in treating parasitic infections.

Successful Treatment of Actinic Keratosis with Kanuka Honey

Actinic keratoses form as rough, scaly plaques on sun-exposed areas; they can be an important step in premalignant progression to squamous cell cancer of the skin. Currently, pharmacological treatments consist of topical immunomodulatory agents with poor side effect profiles. Use of honey has been common in both ancient and modern medicine, where it is now a key therapy in the management of wound healing. In vitro studies show the New Zealand native Kanuka honey to have immunomodulatory and antimitotic effects, with recent evidence suggesting efficacy of topical application in a variety of dermatological contexts, including rosacea and psoriasis. Here, we present a case report of a 66-year-old gentleman with an actinic keratosis on his hand, which had been present for years. Regular application of Kanuka honey over three months resulted in remission immediately following the treatment period with no signs of recurrence at nine months.

Comparison of the inducible effects of licorice products with or without heat-processing and pre-treatment with honey on granulocyte colony-stimulating factor secretion in cultured enterocytes

ETHNOPHARMACOLOGICAL RELEVANCE

Licorice (the roots and rhizomes of Glycyrrhiza uralensis Fisch.) is occasionally used as crude drug following processing including roasting or honey-roasting (soaking with honey before roasting) in traditional Japanese Kampo medicine and traditional Chinese medicine (TCM).

AIM OF THE STUDY

We investigated the differences in the inducible effect of processed licorice products on granulocyte colony-stimulating factor (G-CSF) secretion in cultured intestinal epithelial cells and elucidated the active ingredients in both unprocessed and processed licorice products.

MATERIALS AND METHODS

We prepared heat-processed licorice with or without pretreatment with honey, and fractionated the extracts by Sephadex G-100. Enterocyte-like differentiated MCE301 cells were incubated in media comprising a hot water extract of licorice products for 24h, and the concentrations of G-CSF in the media were measured using enzyme-linked immunosorbent assay (ELISA).

RESULTS

Licorice extract induced G-CSF secretion in MCE301 cells, and the active ingredients of licorice were high molecular compounds. Although the roasted licorice extract exhibited the activity similar to that of the unprocessed licorice extract, honey-roasted licorice extracts exhibited a significantly higher inducible effect on G-CSF secretion in the cells than that of unprocessed or roasted licorice extracts without pretreatment with honey. This enhanced activity was dependent on the temperature and heating time.

CONCLUSIONS

The enhanced inducible effect of honey-roasted licorice on G-CSF secretion might be attributed to the combined effect of licorice-derived high molecular compounds and heated-honey-derived compounds. The results of this study can scientifically explain the objective of processing via honey-roasting in TCM theory.

Therapeutic Properties of Bioactive Compounds from Different Honeybee Products

Honeybees produce honey, royal jelly, propolis, bee venom, bee pollen, and beeswax, which potentially benefit to humans due to the bioactives in them. Clinical standardization of these products is hindered by chemical variability depending on honeybee and botanical sources, but different molecules have been isolated and pharmacologically characterized. Major honey bioactives include phenolics, methylglyoxal, royal jelly proteins (MRJPs), and oligosaccharides. In royal jelly there are antimicrobial jelleins and royalisin peptides, MRJPs, and hydroxy-decenoic acid derivatives, notably 10-hydroxy-2-decenoic acid (10-HDA), with antimicrobial, anti-inflammatory, immunomodulatory, neuromodulatory, metabolic syndrome preventing, and anti-aging activities. Propolis contains caffeic acid phenethyl ester and artepillin C, specific of Brazilian propolis, with antiviral, immunomodulatory, anti-inflammatory and anticancer effects. Bee venom consists of toxic peptides like pain-inducing melittin, SK channel blocking apamin, and allergenic phospholipase A2. Bee pollen is vitaminic, contains antioxidant and anti-inflammatory plant phenolics, as well as antiatherosclerotic, antidiabetic, and hypoglycemic flavonoids, unsaturated fatty acids, and sterols. Beeswax is widely used in cosmetics and makeup. Given the importance of drug discovery from natural sources, this review is aimed at providing an exhaustive screening of the bioactive compounds detected in honeybee products and of their curative or adverse biological effects.

Honey as a Complementary Medicine

The beneficial effects of honey on human health have long been recognized. Today, many of those positive effects have been studied to elucidate its mode of action. This review briefly summarizes the best studied features of honey, highlighting it as an appealing alternative medicine. In these reports, the health benefits of honey range from antioxidant, immunomodulatory, and anti-inflammatory activity to anticancer action, metabolic and cardiovascular benefits, prebiotic properties, human pathogen control, and antiviral activity. These studies also support that the honey's biological activity is mainly dependent on its floral or geographic origin. In addition, some promising synergies between honey and antibiotics have been found, as well as some antiviral properties that require further investigation. Altogether, these studies show that honey is effectively a nutraceutical foodstuff.

Honey and Wound Healing: An Update

For centuries, honey has been utilized for wound healing purposes. In recent times, this specific topic has become a field of interest, possibly due to the advent of antibiotic resistance in microbial pathogens. With constant technological advancement, the information regarding honey's mechanisms of action on wound healing has accumulated at a rapid pace. Similarly, clinical studies comparing honey with traditional wound care therapies are steadily emerging. As a follow-up to a previous review published in the journal in 2011, the current review article outlines publications regarding honey and wound healing that have been published between June 2010 and August 2016. Here we describe the most recent evidence regarding multiple types of honey and their mechanisms of action as antimicrobial agents, immunologic modulators, and physiologic mediators. In addition, outcomes of clinical studies involving a multitude of cutaneous wounds are also examined.

Honey and Cancer: Current Status and Future Directions

Cancer is a leading cause of death worldwide and poses a challenge to treatment. With overwhelming evidence of the role played by diet and lifestyle in cancer risk and prevention, there is a growing interest into the search for chemopreventative or chemotherapeutic agents derived from natural products. Honey is an important source of bioactive compounds derived from plants and recent years have seen an increased interest in its anticancer properties. This review examines the role of honey in targeting key hallmarks of carcinogenesis, including uncontrolled proliferation, apoptosis evasion, angiogenesis, growth factor signalling, invasion, and inflammation. The evidence for honey as an adjunct to conventional cancer therapy is also presented. The review also highlights gaps in the current understanding and concludes that, before translation of evidence from cell culture and animal studies into the clinical setting, further studies are warranted to examine the effects of honey at a molecular level, as well as on cells in the tumour environment.

Honey: A Therapeutic Agent for Disorders of the Skin

Problems with conventional treatments for a range of dermatological disorders have led scientists to search for new compounds of therapeutic value. Efforts have included the evaluation of natural products such as honey. Manuka honey, for example, has been scientifically recognised for its anti-microbial and wound healing properties and is now used clinically as a topical treatment for wound infections. In this review, scientific evidence for the effectiveness of honey in the treatment of wounds and other skin conditions is evaluated. A plethora of in vitro studies have revealed that honeys from all over the world have potent antimicrobial activity against skin relevant microbes. Moreover, a number of in vitro studies suggest that honey is able to modulate the skin immune system. Clinical research has shown honey to be efficacious in promoting the healing of partial thickness burn wounds while its effectiveness in the treatment of non-burn acute wounds and chronic wounds is conflicted. Published research investigating the efficacy of honey in the treatment of other types of skin disorders is limited. Nevertheless, positive effects have been reported, for example, kanuka honey from New Zealand was shown to have therapeutic value in the treatment of rosacea. Anti-carcinogenic effects of honey have also been observed in vitro and in a murine model of melanoma. It can be concluded that honey is a biologically active and clinically interesting substance but more research is necessary for a comprehensive understanding of its medicinal value in dermatology.

Randomised controlled trial of topical kanuka honey for the treatment of rosacea

OBJECTIVE

To investigate the efficacy of topical 90% medical-grade kanuka honey and 10% glycerine (Honevo) as a treatment for rosacea.

DESIGN

Randomised controlled trial with blinded assessment of primary outcome variable.

SETTING

Outpatient primary healthcare population from 5 New Zealand sites.

PARTICIPANTS

138 adults aged ≥ 16, with a diagnosis of rosacea, and a baseline blinded Investigator Global Assessment of Rosacea Severity Score (IGA-RSS) of ≥ 2. 69 participants were randomised to each treatment arm. 1 participant was excluded from the Honevo group, and 7 and 15 participants withdrew from the Honevo and control groups, respectively.

INTERVENTIONS

Participants were randomly allocated 1:1 to Honevo or control cream (Cetomacrogol), applied twice daily for 8 weeks.

MAIN OUTCOME MEASURES

The primary outcome measure was the proportion of participants who had a ≥ 2 improvement in the 7-point IGA-RSS at week 8 compared to baseline. Secondary outcomes included change in IGA-RSS and subject-rated visual analogue score of change in severity (VAS-CS) on a 100 mm scale (0 mm 'much worse', 100 mm 'much improved') at weeks 2 and 8.

RESULTS

24/68 (34.3%) in the Honevo group and 12/69 (17.4%) in the control group had a ≥ 2 improvement in IGA-RSS at week 8 compared to baseline (relative risk 2.03; 95% CI 1.11 to 3.72, p=0.020). The change in IGA-RSS for Honevo compared to control at week 2 minus baseline was -1 (Hodges-Lehman estimate, 95% CI -1 to 0, p=0.03), and at week 8 minus baseline was -1 (Hodges-Lehman estimate, 95% CI -1 to 0, p=0.005). The VAS-CS at week 2 was 9.1 (95% CI 3.5 to 14.7), p=0.002, and at week 8 was 12.3 (95% CI 5.7 to 18.9)¸ p<0.001 for Honevo compared to control.

CONCLUSIONS

Honevo is an effective treatment for rosacea.

TRIAL REGISTRATION NUMBER

This trial was registered in the Australian and New Zealand Clinical Trials Registry ACTRN12614000004662.

Antimicrobial properties of honey

Honey has been widely accepted as food and medicine by all generations, traditions, and civilizations, both ancient and modern. For at least 2700 years, honey has been used by humans to treat a variety of ailments through topical application, but only recently have the antiseptic and antimicrobial properties of honey been discovered. Honey has been reported to be effective in a number of human pathologies. Clinical studies have demonstrated that application of honey to severely infected cutaneous wounds rapidly clears infection from the wound and improves tissue healing. A large number of in vitro and limited clinical studies have confirmed the broad-spectrum antimicrobial (antibacterial, antifungal, antiviral, and antimycobacterial) properties of honey, which may be attributed to the acidity (low pH), osmotic effect, high sugar concentration, presence of bacteriostatic and bactericidal factors (hydrogen peroxide, antioxidants, lysozyme, polyphenols, phenolic acids, flavonoids, methylglyoxal, and bee peptides), and increase in cytokine release, and to immune modulating and anti-inflammatory properties of honey; the antimicrobial action involves several mechanisms. Despite a large amount of data confirming the antimicrobial activity of honey, there are no studies that support the systemic use of honey as an antibacterial agent.

Antibiotic-specific differences in the response of Staphylococcus aureus to treatment with antimicrobials combined with manuka honey

Skin infections caused by antibiotic resistant Staphylococcus aureus are a significant health problem worldwide; often associated with high treatment cost and mortality rate. Complex natural products like New Zealand (NZ) manuka honey have been revisited and studied extensively as an alternative to antibiotics due to their potent broad-spectrum antimicrobial activity, and the inability to isolate honey-resistant S. aureus. Previous studies showing synergistic effects between manuka-type honeys and antibiotics have been demonstrated against the growth of one methicillin-resistant S. aureus (MRSA) strain. We have previously demonstrated strong synergistic activity between NZ manuka-type honey and rifampicin against growth and biofilm formation of multiple S. arueus strains. Here, we have expanded our investigation using multiple S. aureus strains and four different antibiotics commonly used to treat S. aureus-related skin infections: rifampicin, oxacillin, gentamicin, and clindamycin. Using checkerboard microdilution and agar diffusion assays with S. aureus strains including clinical isolates and MRSA we demonstrate that manuka-type honey combined with these four antibiotics frequently produces a synergistic effect. In some cases when synergism was not observed, there was a significant enhancement in antibiotic susceptibility. Some strains that were highly resistant to an antibiotic when present alone become sensitive to clinically achievable concentrations when combined with honey. However, not all of the S. aureus strains tested responded in the same way to these combinational treatments. Our findings support the use of NZ manuka-type honeys in clinical treatment against S. aureus-related infections and extend their potential use as an antibiotic adjuvant in combinational therapy. Our data also suggest that manuka-type honeys may not work as antibiotic adjuvants for all strains of S. aureus, and this may help determine the mechanistic processes behind honey synergy.

Separating morphologically similar pollen types using basic shape features from digital images: A preliminary study(1.)

PREMISE OF THE STUDY

One of the many advantages offered by automated palynology systems is the ability to vastly increase the number of observations made on a particular sample or samples. This is of particular benefit when attempting to fully quantify the degree of variation within or between closely related pollen types. •

METHODS

An automated palynology system (Classifynder) has been used to further investigate the variation in pollen morphology between two New Zealand species of Myrtaceae (Leptospermum scoparium and Kunzea ericoides) that are of significance in the New Zealand honey industry. Seven geometric features extracted from automatically gathered digital images were used to characterize the range of shape and size of the two taxa, and to examine the extent of previously reported overlap in these variables. •

RESULTS

Our results indicate a degree of overlap in all cases. The narrowest overlap was in measurements of maximum Feret diameter (MFD) in grains oriented in polar view. Multivariate statistical analysis using all seven factors provided the most robust discrimination between the two types. •

DISCUSSION

Further work is required before this approach could be routinely applied to separating the two pollen types used in this study, most notably the development of comprehensive reference distributions for the types in question.

Honey: an immunomodulator in wound healing

Honey is a popular natural product that is used in the treatment of burns and a broad spectrum of injuries, in particular chronic wounds. The antibacterial potential of honey has been considered the exclusive criterion for its wound healing properties. The antibacterial activity of honey has recently been fully characterized in medical-grade honeys. Recently, the multifunctional immunomodulatory properties of honey have attracted much attention. The aim of this review is to provide closer insight into the potential immunomodulatory effects of honey in wound healing. Honey and its components are able to either stimulate or inhibit the release of certain cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6) from human monocytes and macrophages, depending on wound condition. Similarly, honey seems to either reduce or activate the production of reactive oxygen species from neutrophils, also depending on the wound microenvironment. The honey-induced activation of both types of immune cells could promote debridement of a wound and speed up the repair process. Similarly, human keratinocytes, fibroblasts, and endothelial cell responses (e.g., cell migration and proliferation, collagen matrix production, chemotaxis) are positively affected in the presence of honey; thus, honey may accelerate reepithelization and wound closure. The immunomodulatory activity of honey is highly complex because of the involvement of multiple quantitatively variable compounds among honeys of different origins. The identification of these individual compounds and their contributions to wound healing is crucial for a better understanding of the mechanisms behind honey-mediated healing of chronic wounds.

The effect of New Zealand kanuka, manuka and clover honeys on bacterial growth dynamics and cellular morphology varies according to the species

Treatment of chronic wounds is becoming increasingly difficult due to antibiotic resistance. Complex natural products with antimicrobial activity, such as honey, are now under the spotlight as alternative treatments to antibiotics. Several studies have shown honey to have broad-spectrum antibacterial activity at concentrations present in honey dressings, and resistance to honey has not been attainable in the laboratory. However not all honeys are the same and few studies have used honey that is well defined both in geographic and chemical terms. Here we have used a range of concentrations of clover honey and a suite of manuka and kanuka honeys from known geographical locations, and for which the floral source and concentration of methylglyoxal and hydrogen peroxide potential were defined, to determine their effect on growth and cellular morphology of four bacteria: Bacillus subtilis, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. While the general trend in effectiveness of growth inhibition was manuka>manuka-kanuka blend>kanuka>clover, the honeys had varying and diverse effects on the growth and cellular morphology of each bacterium, and each organism had a unique response profile to these honeys. P. aeruginosa showed a markedly different pattern of growth inhibition to the other three organisms when treated with sub-inhibitory concentrations of honey, being equally sensitive to all honeys, including clover, and the least sensitive to honey overall. While hydrogen peroxide potential contributed to the antibacterial activity of the manuka and kanuka honeys, it was never essential for complete growth inhibition. Cell morphology analysis also showed a varied and diverse set of responses to the honeys that included cell length changes, cell lysis, and alterations to DNA appearance. These changes are likely to reflect the different regulatory circuits of the organisms that are activated by the stress of honey treatment.