Article

A double-blind, placebo-controlled, randomised trial of active manuka honey and standard oral care for radiation-induced oral mucositis

School of Nursing, Social Work and Midwifery, University of Manchester, Room 5.304 5th Floor, Jean McFarlane Building, University Place, Oxford Road, Manchester M13 9PL, United Kingdom.
British Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.08). 05/2011; 50(3):221-6. DOI: 10.1016/j.bjoms.2011.03.005
Source: PubMed

ABSTRACT

Our aim was to investigate the effect of active manuka honey on radiation-induced mucositis. A total of 131 patients diagnosed with head and neck cancer who were having radiotherapy to the oral cavity or oropharyngeal area were recruited into the study, and were randomly allocated to take either manuka honey or placebo (golden syrup) 20 ml 4 times daily for 6 weeks. Mucositis was assessed according to the Radiation Therapy Oncology Group (RTOG) scale at baseline, weekly during radiotherapy, and twice weekly thereafter until the mucositis resolved. The patient's weight was recorded at the same time as the mucositis was assessed. Throat swabs to identify bacterial or fungal infections were taken at baseline, and during and after radiotherapy. There was no significant difference between honey and golden syrup in their effects on mucositis. Active manuka honey did not improve mucositis, but both the honey and the syrup seemed to be associated with a reduction in bacterial infections. Compliance was a problem after the onset of mucositis, which may have affected the findings.

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    • "However, honey proteins may act as markers for authentication. Interestingly, honey proteins may be bioactive markers which contribute to the pharmacological activities of honey including anti-inflammatory (Tonks et al. 2003; Yusof et al. 2007), anti-microbial (Gomes et al. 2010; Taormina, Niemira, and Beuchat 2001), and anti-cancer (Bardy et al. 2012; Tsiapara et al. 2009) activity. These biological activities were primarily due to the antioxidative properties of honey. "
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    ABSTRACT: This study focused on the extraction and identification of honey proteins from selected samples (Acacia, Tualang, and Gelam) from Malaysia. The extraction methods, dialysis, ammonium sulfate, and sodium tungstate precipitation methods, were used to obtain the proteins from the honey. The method of membrane dialysis provided the highest yield of proteins based on the Bradford assay. This method also provided the highest number of protein bands and the clearest protein bands on a 12% polyacrylamide gel compared with the other two precipitation methods. The results revealed that the precipitation methods may degrade the proteins because of the use of strong chemicals and losses after repeated transfers. Mass spectrometric data showed that the honey contained major royal jelly proteins (MRJP) such as MRJP-1, MRJP-2, MRJP-5, and MRJP-7, as well as a few uncharacterized proteins from Apis mellifera. MRJP-1 was the most abundant protein, particularly in Acacia samples. Honey proteins were also shown to possess significant antioxidant activity as free radical scavengers and reducing agents.
    No preview · Article · Mar 2015 · Analytical Letters
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    • "In the study of Khanal et al., there was no mention about gender. Further, the exact type of cancer of the participants was only reported by Bardy et al. [41] and whilst there is missing information about the stage of cancer for most studies, staging is one of the determinants that can affect the severity of the radiation-induced oral mucositis. Further to these aspects, most studies investigated the effectiveness of honey in patients receiving radiotherapy alone. "
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    ABSTRACT: Aim: To evaluate the effectiveness of honey in the management of oral mucositis in head and neck cancer patients undergoing radiotherapy. Methods: The review of the literature was based on a keyword strategy and pre-determined inclusion and exclusion criteria. The keywords "head and neck cancer", "radiotherapy", "oral mucositis", "controlled trial" and "honey" were used as search terms in the EMBASE, CINAHL, COCHRANE and PUBMED databases. The citation and reference list of the eligible articles were also screened for potentially relevant articles. The methodological quality of the selected trials was assessed by the JADAD scale. Results: In total, 5 studies met the criteria and were included in the systematic review. Three studies assessed the effectiveness of honey against other products including golden syrup, lignocaine and saline and two studies assessed the effectiveness of honey against standard treatment regimes. Four out of the five studies demonstrated significant reduction in the mucositis levels and one study reported that honey had no statistical association with less severe mucositis. Methodologically the quality of most studies was moderate due to the small sample size, which might impact upon the significance of the findings. Conclusions: Although honey appears to be a simple, affordable, available and cost-effective treatment for the management of radiation-induced oral mucositis, there is a need for further multi-centre randomized trials to validate these findings.
    Full-text · Article · Jun 2013 · European Journal of Integrative Medicine
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    • "In the study of Khanal et al., there was no mention about gender. Further, the exact type of cancer of the participants was only reported by Bardy et al. [41] and whilst there is missing information about the stage of cancer for most studies, staging is one of the determinants that can affect the severity of the radiation-induced oral mucositis. Further to these aspects, most studies investigated the effectiveness of honey in patients receiving radiotherapy alone. "
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    ABSTRACT: Aim To evaluate the effectiveness of honey in the management of oral mucositis in head and neck cancer patients undergoing radiotherapy. Methods The review of the literature was based on a keyword strategy and pre-determined inclusion and exclusion criteria. The keywords “head and neck cancer”, “radiotherapy”, “oral mucositis”, “controlled trial” and “honey” were used as search terms in the EMBASE, CINAHL, COCHRANE and PUBMED databases. The citation and reference list of the eligible articles were also screened for potentially relevant articles. The methodological quality of the selected trials was assessed by the JADAD scale. Results In total, 5 studies met the criteria and were included in the systematic review. Three studies assessed the effectiveness of honey against other products including golden syrup, lignocaine and saline and two studies assessed the effectiveness of honey against standard treatment regimes. Four out of the five studies demonstrated significant reduction in the mucositis levels and one study reported that honey had no statistical association with less severe mucositis. Methodologically the quality of most studies was moderate due to the small sample size, which might impact upon the significance of the findings. Conclusions Although honey appears to be a simple, affordable, available and cost-effective treatment for the management of radiation-induced oral mucositis, there is a need for further multi-centre randomized trials to validate these findings.
    Full-text · Article · Jan 2013 · European Journal of Integrative Medicine
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