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Honey and its anti-infective miracles
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Have you ever considered why honey, a natural product that is so rich in sugar, is resistant to bacterial or fungal growth, even when kept at room temperature for months?
Honey is a strong antibacterial agent, and its antibacterial properties were discovered by the ancient civilizations. Despite its ancient roots, modern medicine has not exploited this natural product fully. There are anecdotal reports of how honey was effective in healing chronic wounds, including some cases I have treated personally.
The antimicrobial properties of honey stem from an array of phytochemicals, enzymes and high sugar content. The phytochemicals that play an antimicrobial role within honey function via the stimulation of surrounding leukocytes, primarily that of resident-macrophages and their associated monocytes. This stimulation leads to increased secretion of different cytokines that target circulating lymphocytes and granulocytes to further upregulate the immune response.
Javad Parvizi
The enzymes within honey that play an antimicrobial role are invertase and glucose oxidase. These enzymes generate gluconic acid and hydrogen peroxide. The gluconic acid lowers the pH of honey, which is useful for not only inhibiting microbial growth and biofilm formation, but also for stimulating fibroblasts that are critical in wound healing. The hydrogen peroxide, existing at a lower concentration, serves primarily as a stimulatory signal for surrounding immune cells rather than as a cytotoxin. Although the enzymes and phytochemicals are significant, the principal antimicrobial property associated with honey is due to its high sugar content. The high sugar content and the low water availability (< 17%) in honey are critical in few aspects. The high sugar content provides fuel for the function of the above-mentioned enzymes, and also for the burst activity displayed by leukocytes in response to microbial invasion. The second, and probably the most important, role that sugar plays is the generation of a high osmotic gradient. This functions to draw exudate and associated necrotic debris from a wound to enhance healing. In addition, the high osmotic pressure generated by the high sugar content also results in desiccation of any infecting organisms that find their way into honey.
The challenges we face with infection compel us to seek novel strategies to address this dreaded problem. Why not use nature’s remedies to counter a problem generated by unicellular organisms that have inhabited earth for millions of years and well before the human race? Let us use nature to fight nature.
- References:
- Bell SG. Neonatal Netw. 2007;doi:10.1891/0730-0832.26.4.247.
- Cutting KF. Ostomy Wound Manage. 2007; 53:49-54.
- Lusby PE, Coombes A, Wilkinson JM. J Wound Ostomy Continence Nurs. 2002; 29:295-300.
- Molan PC. Ostomy Wound Manage. 2002; 48:28-40.
- Pieper B. J Wound, Ostomy and Continence Nurs. 2009; doi: 10.1097/01.WON.0000345177.58740.7d.
- Waltari M. Sinuhe the Egyptian. 1945 (ISBN 1-55652-441-2).
- For more information:
- Taylor Paziuk, BS; and Javad Parvizi, MD, FRCS, can be reached at Rothman Institute at Thomas Jefferson University Hospital, Sheridan Building, Suite 1000, 125 S. 9th St., Philadelphia, PA 19107; Paziuk’s email: paziuk14@gmail.com; Parvizi’s email: parvj@aol.com.
Disclosures: Paziuk reports no relevant financial disclosures. Parvizi reports he is a consultant to ZimmerBiomet, Ceramtec, Convatec and TissueGene and has ownership in CD Diagnostics, Hip Innovation Technology, ForMD, Alphaeon and Joint Purification Systems.