Report from the 2nd International Conference on the Medicinal Use of Honey, 13-15 January, 2010, Kota Bharu, Kelantan, Malaysia
Contact: Professor Dr Nor Hayati Othman, e-mail: hayati@kb.usm.my
The Health Campus of Universiti Sains Malaysia (USM) hosted the 2nd International Conference on the Medicinal Use of Honey from 13th to 15th January, 2010, in Kota Bharu, Malaysia, in joint collaboration with agencies from the Ministry of Agriculture; FAMA [Fedearal Authority Marketting Agency] and MARDI [Malaysian Agriculture Research & Development Institute].
About 300 researchers, medical specialists, bee keepers and related individuals from 17 countries attended the meeting. Fifty-seven research papers were presented related to basic and clinical research, including cancer biology, diabetic, wound management, surgical wound care, radiation mucositis, and the role of
honey in SLE and AIDS.
Dr Stefan Stangaciu of Romania, an expert apitherapist cum family medicine physician and founder of the German Apitherapy Society, presented the current practice and recent development of Honey and other bee products in various disease conditions. He emphasized the role of honey bee resulting in 16 products compared with other ‘food’ animals in the world. The products range from honey, propolis, royal jelly, bee larvae, bee wax, pollen, bee bread, bee sting, bee hive air, bee powder, bee venom, apilarnil, bee stinger etc.
Honey is ubiquitous in the nature, acidic, having numerous compounds and its constituents change as per the floral origin, way of processing and age of honey.
Propolis, the wax present in the bee hives helps in healing, regeneration of diseased liver and infection control.
Honey bee stings, considered as potentially harmful, are now used as therapy in numerous immunological disorders and in improvement of circulation.
Honey is safe and can be administered topical, ophthalmic, intranasal, intra-aural, intratumoral and even he demonstrated administration of diluted honey intravenously. The above products could be useful in infertility, periodontal disease, vasculopathy, and burn wound dressing.
Jennifer Eddy, a renowned family medicine physician from University of Wisconsin, USA, worked on the role of honey in refractory non-healing diabetes; those failed conventional antibiotics due to drug resistance.
She stressed the need for evidence through research and publication to promote the healing effects of honey. In the current teaching of undergraduate and postgraduate medical student there is limited scope of complimentary therapy like honey. Perhaps with accumulation of further evidence, the beneficial effects of this simple treatment could be introduced to the students. She systematically analyzed published randomized controlled clinical trials on various clinical conditions.
Professor Rose Cooper, a honey researcher and microbiologist from Cambridge, UK, pointed out the role of medical grade honey in the treatment of MRSA wound infection. She and her honey research teams demonstrated the induction of cytokines (IL6, TNF-alfa) following administration of honey in the healing of wounds. She works closely with nurses those responsible for management of cancer and non-cancerous wounds in UK. She has published more than 17 research papers related to honey and is editing a specialty international journal of Apitherapy and ApiMedical scienses to popularize of Apitherapy in the world.
Minoru Takeuchi, A professor and research scientist of biotechnology from Kyoto Sangyo University, Japan demonstrated clearly the migration and scavenging properties of polymorphs in response to Jungle honey in experimental condition. He researched extensively on jungle honey derived from deep forests of Nigeria. His team of scientists also demonstrated the regression of an experimental tumors following intraperitoneal administration of jungle honey; a very new finding in honey research.
Perhaps the tumor regressed in response to jungle honey is mediated through production of reactive oxygen species and apoptosis. He is leading further research in the above fields in Japan.
Professor Kamaruddin Mohd Yusoff, a lead researcher from the honey research unit of University Malaya Medical Center, Kuala Lumpur, showed how they developed various tests to detect quality honey from plethora of honey available in the market and bee farms. His research teams have demonstrated anti-inflammatory effects of honey using animal models. His study is an extension on his previous works on wound healing properties of honey, also in experimental animals. He and his team are currently collaborating with clinician for human trials
Prof Siti Amrah Sulaiman a pharmacologist in medical school, Universiti Sains Malaysia, led a team of researchers working on Tualang honey, a Malaysian jungle honey. They studied several types of honey samples compared to Manuka honey donated by FAMA.
Tualang honey has similar properties as well-studied Manuka honey in many aspects. Unlike Manuka honey, Tualang honey is shown to be rich in HMF and also has other compounds not shown in other honey studied previously.
HMF itself has been shown to have anti-microbial properties. Her team researched the role of honey as anti-diabetic properties and its effect on reproductive system in experimental animals.
Though honey is a sweetening agent, contradictory to common understanding of management of diabetes, experimental diabetic rats fed on titrated dosage of honey were shown to have improvement of the disease compared to controls. The serum glucose level declined in response to enteral administration of honey and delayed the progression of renal damage in diabetic animal model.
Honey also protects vaginal mucosa from atrophy and bone from loss of density in ovriectomised rats; an animal model for menopause state in women. Tualang honey also has been shown to have high anti-oxidant properties.
Experimental rats which was induced to develop mammary cancer was found to have smaller cancers and lower histological grading compared when fed on titrated dosage of honey compared to controls. There were also significant increase in numbers of inflammatory cells particularly eosinophils in these tumours, supporting the positive role of honey in promoting immune response of the host.
Randomized open label clinical trials comparing honey and HRT on postmenopausal women were conducted by Assoc Prof Nik Hazlina, an Ob-Gyn specialist. Her team has found out that administration of 20 g of honey daily to postmenopausal women for 4 months were well tolerated and did not give any adverse effect. A longer duration of study is required to show positive effects of honey in this group of women.
Systemic Lupus Erythematosus (SLE) is a chronic immunological disorder affecting various organs such as skin, blood vessels and kidney. There is no cure for this crippling disease; however the symptoms could be palliated using immunosuppressive agents.
In a pilot randomized control trial, administration of Tualang honey in addition to existing immunosuppressive therapy resulted in reduction of disease activity (SLEDAI) score and an increase in both complements C3 and C4. Adjuvant Honey affects the percentages of circulating lymphocyte subsets as there were a significant increase in CD3(T – Lymphocyte) and CD16/56 (NK cells). “This is a remarkable observation” said Associate Professor Kamaliah Mohd Daud, a nephrologist at Universiti Sains Malaysia [USM]. Her team members are excited with the new findings, however she cautioned as the number of subjects were small and further studies should be conducted by other researchers to see whether similar results can be obtained.
AIDS is a group of symptoms secondary to HIV infections. AIDS is common in promiscuous sexual contacts, drug abusers and through feto-placental route. So far, there is no cure for HIV/AIDS. The current standard of care is antiretrovirals and symptom management. Antiretrovirals have impact on reducing mortality and morbidity, prolonging live and quality of life of HIV/AIDS patients however they are associated with severe adverse effects and have limited response.
A group of researchers from Malaysia tried oral honey in asymptomatic HIV patients and monitored their CD4+ count, viral load and quality of life at regular interval. Though recruitment of subjects is slow, the early results are encouraging in terms of CD4+ counts and quality of life said Dr Wan Nazirah Wan Yusuf, a clinical pharmacologist from the same University who led the team on this research. The clinical benefits of honey on SLE and AIDS are probably due to anti-inflammatory effects of honey.
The use of natural products as potential anti-cancer agents is currently an intensive area of research. Although honey has been suggested to possess anti-cancer activities, the mechanism of how this occurs has not been previously reported.
Associate Professor Dr. Nik Soriani Yaacob, a cancer biologist, and her team showed that honey (even at relatively low doses) induced significant cancer cell death via apoptosis, brought about by a specific ‘signal transduction’ pathway.
Furthermore, honey was able to enhance and hasten the cytotoxic activity of low-dose tamoxifen in breast cancer cells in culture which may potentially help reduce the side-effects of this drug. This may be the first time that the anti-cancer property of honey is demonstrated in a well-designed molecular experiment. She emphasized however, that further in vitro as well as animal and human studies need to be carried out before honey could be used in complimentary therapy in breast cancer management.
Wound management is a challenge for the plastic and reconstructing surgeons. Recently many randomized trials and case studies demonstrated the benefit of simple topical therapies of honey above management.
Professor Ahmad Sukari Halim, a renowned plastic and reconstructing surgeon from Universiti Sains Malaysia is developing honey based dressings (Honey hydrogel) for the treatment of graft site and burn wounds.
The patients treated with honey dressings showed better granulation tissue development and healed better compared to controls. He is leading a team of researchers on various aspects of wound management.
Radiation mucositis is a world-wide problem among head and neck cancer patients undergoing radiation treatment. Conventional radiation therapy, brachytherapy and precision radiotherapy techniques induce significant symptomatic mucositis.
Mucositis is further enhanced by altered fractionations and concurrent chemo-radiotherapy protocols being used in the current treatment policies. There is no standard of care for this debilitating morbidity.
Honey is found to be a simple and cost effective treatment in above radiation side-effect.
Associate professor and clinical oncologist Biswa Mohan Biswal from Malaysia for the first time reported the mucoprotective and nutritional properties of honey in radiation mucositis compared to controls.
Subsequently, two more similar studies from Iran and Egypt showed similar benefits. At the moment there are 3-multi-center randomized trials involving topical natural honey ongoing for the management of radiation mucositis to prove its effectiveness among large group of patients.
With collaborative efforts, one day honey could be a standard of therapy in the common radiation side-effect, explained Dr Biswal.
Dr. Laid Boukraa from Algeria has highlighted the healing properties of Royal jelly. It has antibacterial, anti-inflammatory, anti-aging, anti-tumor and immuno-modulatories activities. Royal jelly, when combined with starch, has shown to have promising antibacterial activities against organisms that are frequently found to be resistant towards common antibiotics.
There was a special symposium devoted to the use of honey in various cultures. Professor Osman Bakar, the Director of International Islamic Thought and Civilization, cited the specific surahs in the Quran where Allah [God], says ’in honey there is remedy for various ailments.” He also cited hadiths [the sayings of Prophet Muhammad [PBUH] on the use honey in certain clinical conditions.
In the present days context the clinicians and researchers are trying to prove the age old description of therapy used by people of the past.
In Indian culture, Ayurveda; the science of life is very prominent and dates back to 5000 BC. Ayurveda is based on the three major principles of Vaata, Pita, and Kapha, and that all human beings are different according to the combination or overlapping of above major characteristics.
The speaker, Dr M Rajen, a pharmacologist by training articulated the importance of 5-types of honey bees making different types of honey.
Honey is also good as a vehicle for the administration of other drugs and agents said Dr M. Rajen, who is now a holistic medicine practitioner.
The Chinese culture too enjoyed the benefits of honey in the traditional Chinese medicine. Dr Yong Kian Fui, a Chinese Medicine Practitioner, said in Chinese medicine, honey could be given in fresh or in ‘cooked’ form.
Despite many pitfalls in the earlier researches on the role of apitherapy, the 2nd International Conference on the Medicinal Use of Honey demonstrated numerous scientific evidence for the judicious use of honey in specific disease conditions.
The Chairman of the conference, Professor Dr Nor Hayati Othman, dean for clinical science research, Universiti Sains Malaysia, a pathologist by profession expressed her satisfaction on the progress of honey research since last 4 years, after hosting the last honey conference in 2006.
The clinical gadgets that could be developed by researchers of Honey and Honey bee products could range from a simple gadget such as nasal drip applicator to development of nano-tubes to deliver bee products to the diseased sites.
Prof Dzulkifli Abdul Razak, the vice-Chancellor of USM expressed his heart-felt support for the honey related research. Universiti Sains Malaysia is encouraging application of products of biodiversity in line with the Apex status awarded to the University which champion the term ‘sustainability’ referring to all facets of the current and future generations. Honey indeed is almost a complete food for sustainable health. On the basis of research presentations and publications, Dr Stefan Stangaciu of Romania and Dr Jennifer Eddy of Wisconsin, USA, commended Universiti Sains Malaysia for not only pioneering honey conference but also currently the most active and focused research works on honey for medicinal purposes.
The abstracts of the conference were published in Journal of ApiProduct and ApiMedical Science and American Medical Journal offered to publish full papers of the papers presented in this conference.
