Article

The effects of Herstat (3% propolis ointment ACF) application in cold sores: A double-blind placebo-controlled clinical trial

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Abstract

A randomised, double-blind placebo-controlled clinical trial was conducted in Sweden to assess the efficacy of Herstat (3% propolis ointment ACF) in patients with a history of herpes labialis recurrences (cold sores). Patients were block-randomised and instructed to self-initiate the treatment as soon as they had a cold sore, by applying the study medication five times/day. They were instructed to report in a diary (for every application) time of application, cold sore stage and degree of pain. The main outcome measures were time to healing and time to disappearance of pain. Size of the lesion and time to improvement were also compared. The rate of lesion healing was significantly faster among the patients treated with propolis ointment (mean 6.24 days) compared to those treated with placebo (mean 9.77 days) (p<0.00001, Student's t-test for unpaired data, and logrank test). The patients who applied propolis ointment were without pain considerably earlier than those who applied the placebo ointment (logrank test, p=0.00671). There was no overall significant difference between the two groups for time to improvement of the lesion, even if the propolis group appeared to improve faster than the placebo group in the early days of treatment. No differences were found for the size of the lesion. At the end of the treatment, 100% of the patients in the propolis ointment group judged their treatment 'very effective' (81.8%) and 'somewhat effective' (18.2%), and almost the reverse was true for the placebo group, where most found it 'hardly effective' (60%) and 'ineffective' (22.9%).

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... Propolis ointments have been successfully used against cold sores, Herpes simplex skin lesions and Herpes zoster lesions 102,120 and also against genital herpes 102,120,308 . Egyptian propolis was successfully used against different types of warts 318 . ...
... Propolis ointments have been successfully used against cold sores, Herpes simplex skin lesions and Herpes zoster lesions 102,120 and also against genital herpes 102,120,308 . Egyptian propolis was successfully used against different types of warts 318 . ...
... The first positive effects of the topical application of this ointment were reported in clinical investigations conducted in the 1980s, showing a significant shortening of the healing time and a relief of the symptoms of cold sores. These effects have been confirmed in more recent and structured clinical studies, in both types of herpes simplex infection: cold sores by HSV-1 (Hoheisel, 2001), and herpes genitalis by HSV-2 (Vynograd et al., 2000). The aim of this study was to research the reasons for the effects obtained in the clinical studies, by testing samples of PPE extract and ointment for composition and in vitro antiviral activity. ...
... The results obtained in vitro with PPE are in accordance with those of two randomized, placebo-controlled clinical studies, where the topical ointment containing 3% Propolis Extract ACF was used to treat cold sores (Hoheisel, 2001) and herpes genitalis (Vynograd et al., 2000), and support the usefulness of a topical preparation with Propolis Extract ACF against herpes simplex virus lesions. ...
Article
Propolis Extract ACF® (PPE) is a purified extract manufactured from propolis collected in a Canadian region rich in poplar trees, and it is the active substance of a topical ointment used against herpes labialis (cold sores or fever blisters). Aim of this study was to analyze the chemical composition of PPE in order to understand the plant origin and possible relations between compounds and antiviral activity, and to characterize the antiviral activity of the extract against herpes simplex virus in vitro. Material and methods The analysis of the propolis extract samples was conducted by Gas Chromatography–Mass Spectrometry (GC–MS). The antiviral activity was tested against herpes simplex viruses type 1 and type 2 in MDBK cell cultures by treating the cells with PPE at the time of virus adsorption, and by incubating the virus with the extract before infection (virucidal assay). Results Results from the GC–MS analyses revealed a dual plant origin of PPE, with components derived from resins of two different species of poplar. The chemical composition appeared standardized between extract samples and was also reproduced in the sample of topical ointment. The antiviral studies showed that PPE had a pronounced virucidal effect against herpes simplex viruses type 1 and type 2, and also interfered with virus adsorption.
... Patients treated with propolis ointment showed a significantly faster healing rate and were without pain considerably earlier. In particular, treated patients appeared to improve faster in the early days of ointment application, even though no differences were found in the size of lesions.68 An extensive analysis of similarities and differences between the proprietary extracts used in clinical evaluations would be of great help to achieve a full understanding of the peculiarities needed to obtain the therapeutic efficacy.The results of in vitro studies have shown a prominent direct activity on viral particles and synergistic effects with acyclovir, possibly through different mechanisms of action (e.g., direct virucidal activity, inhibition of viral internalization/replication/shedding), suggesting the usefulness of propolis as an add on therapy in combination with antiviral drugs. ...
Article
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Propolis is a complex natural product that possesses antioxidant, anti-inflammatory, immunomodulatory, anti-bacterial, and antiviral properties mainly attributed to the high content in flavonoids, phenolic acids, and their derivatives. The chemical composition of propolis is multifarious, as it depends on the botanical sources from which honey-bees collect resins and exudates. Nevertheless, despite this variability propolis may have a general pharmacological value , and this review systematically compiles, for the first time, the existing preclinical and clinical evidence of propolis activities as an antiviral and immunomodulatory agent, fo-cusing on the possible application in respiratory diseases. In vitro and in vivo assays have demonstrated propolis broad-spectrum effects on viral infectivity and replication, as well as the modulatory actions on cytokine production and immune cell activation as part of both innate and adaptive immune responses. Clinical trials confirmed propolis undeniable potential as an effective therapeutic agent; however , the lack of rigorous randomized clinical trials in the context of respiratory diseases is tangible. Since propolis is available as a dietary supplement, possible use for the prevention of respiratory diseases and their deleterious inflammatory drawbacks on the respiratory tract in humansis considered and discussed. This review opens up newperspectives on the clinical investigation of neglected pro-polis biological properties which, now more than ever, areparticularly relevant with respect to the recent outbreaks of pandemic respiratory infections.
... After treatment, patients from the propolis ointment group considered their treatment very effective (81.8%) and somewhat effective (18.2%). [199] Soroy et al. [200] carried out a clinical trial in Indonesia using patented poplar propolis capsules (Propoelix) on patients with dengue hemorrhagic fever. They performed a double-blind, randomized, placebo-controlled trial. ...
Article
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... Propolis extracts have been tested for many different types of biological and pharmacological activities (Burdock, 1998;Farooqui & Farooqui, 2010;Sforcin & Bankova, 2011), including in clinical trials (Henshaw et al., 2014;Hoheisel, 2001;Paulino, Coutinho, Coutinho, & Scremin, 2014;Soroy, Bagus, Yongkie, & Djoko, 2014;Vaz Coelho et al., 2007). Most significant is the number of clinical trials in dentistry (Anauate-Netto et al., 2014;Pereira et al., 2011;Prabhakar, Karuna, Yavagal, & Deepak, 2015;Purra, Mushtaq, Acharya, & Saraswati, 2014;Torwane et al., 2013). ...
Article
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Propolis is one of the most fascinating honey bee (Apis mellifera L.) products. It is a plant derived product that bees produce from resins that they collect from different plant organs and with which they mix beeswax. Propolis is a building material and a protective agent in the bee hive. It also plays an important role in honey bee social immunity, and is widely used by humans as an ingredient of nutraceuticals, over-the-counter preparations and cosmetics. Its chemical composition varies by geographic location, climatic zone and local flora. The understanding of the chemical diversity of propolis is very important in propolis research. In this manuscript, we give an overview of the available methods for studying propolis in different aspects: propolis in the bee colony; chemical composition and plant sources of propolis; biological activity of propolis with respect to bees and humans; and approaches for standardization and quality control for the purposes of industrial application.
... Interestingly, the presence of all these compounds suggested a mixed botanical origin, the exudates of both P. balsamifera and P. tremuloides [75]. The antiviral activity of Herstat® propolis extract, specifically against both types of Herpes simplex infection: HSV-1 and HSV-2, was determined by clinical studies conducted with the application of this ointment, which resulted to be more effective than acyclovir treatment by presenting a significant shortening of healing time and a reduction of the local symptoms of cold sores [76,77]. Additionally, with the aim to understand the basis of the antiviral activity of Herstat® Canadian propolis extract, Bankova et al. [75] determined by in vitro studies the virucidal effect of this ointment on HSV-1 and HSV-2 and the adsorption suppression of virus HSV-1 on MDBK bovine kidney cells. ...
Chapter
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Propolis is a resinous material produced by bees from the selective collection of plant exudates that are subsequently mixed with beeswax and salivary bee secretions. Propolis has been used in folk medicine, and certainly, several studies have validated its biological properties. The chemical composition and pharmacological activities of propolis collected through North (including Central America and Caribbean) and South America have been studied in the last years, and several papers have reported differences and similarities among the analysed geographical samples. Propolis has been classified according to its aspect and plant source; however, the ecological diversity present along the Americas provides a plethora of botanical resins. Herein, we summarize and discuss most of the studies performed at present on this profitable product for apiculture, attempting to compare the bioactivity, phytochemical diversity and botanical sources of honeybee propolis produced in Americas. http://www.intechopen.com/articles/show/title/advances-in-pharmacological-activities-and-chemical-composition-of-propolis-produced-in-americas.
... Numerous studies reported that propolis and/or isolated compound was active against many virues included: myxovirus, poliovirus, coronavirus, rotavirus, adenovirus [124], antipotato viruses [125], anti-BBMV [126], anti-HSV [123,127]. It has been reported that propolis interfered with the replication of virus [47], but the details of its activity were different. ...
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Propolis is identified as natural resource with effective biological and pharmacological activities. Here, we will discuss the plant sources, chemical composition, biological activities and toxicity of different types of propolis. Propolis is considered as a natural remedy against resistant microorganisms with a promising usage in the near future, but further studies should be conducted to investigate its therapeutic role.
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Headings ethnopharmacological relevance Apitherapy is a branch of traditional medicine that uses bee products to manage numerous diseases. In this context, the antiherpetic effect of these bee products has been demonstrated in some studies with some controversial results. Aim of the study Thus, we conducted a systematic review and meta-analysis to compare the effectiveness of honey and propolis with acyclovir, the reference drug, in the treatment of cold sores and genital herpes. Materials and methods The selection of eligible studies was conducted through the search in Pubmed/MEDLINE, Scopus, Cochrane Library, LILACS, and Electronic Scientific Library. Results This search yielded 147 articles, of which nine were considered eligible for analysis. The analysis of these studies showed that the healing property of propolis is superior to that obtained for acyclovir (95% CI: 2.70 to 8.25; p = 0.0001). Furthermore, honey also presented a better healing effect than acyclovir against HSV-induced wounds (95% CI: 3.58 to −0.19; p = 0.03), inducing complete re-epithelization of herpetic lesions after 8 days, while for acyclovir, the healing time average was 9 days. It also provoked a similar reduction of pain caused by herpetic compared to acyclovir (95% CI: 2.27 to −0.42; p = 0.18). Conclusions Overall, these results confirm the use of honey and propolis as potent antiherpetic agents.
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Objectives To assess the value of bee products with respect to antiviral efficacy against herpes viruses. Design A systematic review was done using the JUSTfind System of the Justus-Liebig-University Gießen and Scopus. Results Three trials on honey and 6 trials on propolis were conducted. Each trial provided evidence that these two bee products are interesting alternatives to acyclovir, especially propolis, which was found to be superior to acyclovir in 4 trials. Conclusions The evidence from these trials suggests that propolis is the best of all natural possibilities in the treatment of herpetic skin lesions, especially those related to HSV-1. Future studies should analyse if propolis could be an adjunct to treatment with acyclovir. For lesions in the oral cavity, honey could be an interesting alternative.
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An increase of total cell number was shown in the cell culture in vitro under the influence of ethanol extract of propolis (EEP). Addition of EEP to the nutrient medium of the cells caused a strong activation of mitoses. Besides, distinctly intensified metabolism of these cells expressed by a strong activation of NADH2-reductase was also observed.
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Artificially induced bone tissue losses after the application of ethanol extract of propolis (EEP) showed an accelerated rate of ossification. The osteogenetic process was just about half as long as in the control group.
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Dressing of artificially formed losses of the cartilaginous tissue with the preparation containing ethanol extract of propolis (EEP) caused acceleration of regenerating processes in the lesioned cartilage. EEP inserted into the joint is well tolerated.
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Topical antiviral chemotherapy has a number of potential advantages over systemic drug delivery for the treatment of cutaneous herpes simplex virus infections, including convenience; higher target tissue drug levels and greater efficacy; and specific targeting of the drug to the site of infection, with reduced cost and reduced exposure of the remainder of the body to drug side effects. Realization of these possibilities has been slow in part because of the paucity of 'active' topical drug formulations with effective penetration-enhancing agents and a technical barrier-our failure as yet to measure drug levels in the epidermis, which could guide formulation development. Recent success with a topical treatment for herpes simplex labialis should stimulate continued laboratory and clinical research in this field.
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Five per cent acyclovir cream containing propylene glycol was used in a double-blind, placebo controlled, randomized trial of topical acyclovir therapy in 30 patients with recurrent orofacial herpes simplex infections. Several patients re-entered the trial and a total of 60 treated episodes were evaluated. Analysis of the first episodes treated showed a significant reduction in the duration of vesiculation from 2.7 to 1.8 days (P = 0.016) and in the total healing time from 8.3 to 5.7 days (P = 0.022). A decrease in the duration of itching was also observed. Evaluation of all episodes treated showed a significant decrease only in the duration of vesiculation from 2.3 to 1.6 days (P = 0.016); the total healing time was decreased from 6.6 to 5.4 days (P = 0.051). The penetration of acyclovir through the skin and the time of initiation of therapy appear to be the major limiting factors governing efficacy. We hypothesize that repeated treatment with acyclovir may decrease the severity of the herpes simplex infections.