Topical application of the bee hive protectant propolis is well tolerated and improves human diabetic foot ulcer healing in a pilot study
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Authors: Henshaw,F. R.;Bolton,T.;Nube,V. L.;Veldhoen,D.;Hood,A.;Pfrunder,L.;Mckew,G. L.;Macleod,C.;Mclennan,S. V.;Twigg,S. M.
Start Page: A167
Foot ulcers in diabetes typically have a wound microenvironment of persisting inflammation. Propolis is a naturally occurring anti-inflammatory substance derived from bees applied to hives as a protectant resin. We have published that topical propolis improves preclinical cutaneous ulcer healing in a diabetic rat model. The aim of this study was to determine if propolis shows efficacy in a pilot study of human diabetic foot ulcer (DFU) healing and if it is well tolerated. Patients with chronic DFU â‰¥4 week’s duration were enrolled. Propolis was applied at each clinic review for 6 weeks topically to n=23 serial, consenting subjects; 84% male; HbA1c 8.3Â±1.6%, 73% with Tex1B foot ulcers on oral antibiotic. Post-debridement wound fluid was analyzed for viable bacterial count and pro-inflammatory active MMP-9 level. Ulcer healing data was compared with a matched control cohort of n=88 with DFU of same duration, recently treated at the same Centre; 76% male; HbA1c 8.6Â±2.0%, with 74% Tex.1B DFU on oral antibiotic. Results showed ulcer area starting at a similar mean âˆ¼200mm2 in each group, was reduced by 41% on average in the propolis group compared with 16% in the control group at week 1 (P=0.001), and by 63% compared with 44% at week 3 respectively (P<0.05). In addition, 10% vs. 2% (P<0.001), then 19% vs. 12% (P<0.05) of propolis treated vs. control ulcers had fully healed by weeks 3 and 7, respectively. Post-debridement wound fluid active MMP-9 was reduced 18.1% vs. 2.8% by week 3 each from baseline in propolis treated ulcers vs. controls (P<0.001). Bacterial counts also reduced more rapidly during healing in propolis treated ulcers vs. controls (26% vs. 1%, per 10d; P<0.001). No adverse effects due to propolis were reported. This novel study shows that topical propolis therapy is well-tolerated and appears safe in human DFUs and it may enhance wound closure when applied weekly. A multisite randomized controlled of topical propolis in diabetic foot ulcers appears to now be warranted