Early View (Online Version of Record published before
inclusion in an issue)
Honey is a popular natural product that is used in the
treatment of burns and a broad spectrum of injuries, in particular chronic
wounds. The antibacterial potential of honey has been considered the exclusive
criterion for its wound healing properties. The antibacterial activity of honey
has recently been fully characterized in medical-grade honeys. Recently, the
multifunctional immunomodulatory properties of honey have attracted much
attention.
The aim of this review is to provide closer insight into the
potential immunomodulatory effects of honey in wound healing. Honey and its
components are able to either stimulate or inhibit the release of certain
cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6) from human
monocytes and macrophages, depending on wound condition. Similarly, honey seems
to either reduce or activate the production of reactive oxygen species from
neutrophils, also depending on the wound microenvironment. The honey-induced
activation of both types of immune cells could promote debridement of a wound
and speed up the repair process. Similarly, human keratinocytes, fibroblasts,
and endothelial cell responses (e.g., cell migration and proliferation,
collagen matrix production, chemotaxis) are positively affected in the presence
of honey; thus, honey may accelerate reepithelization and wound closure.
The immunomodulatory activity of honey is highly complex
because of the involvement of multiple quantitatively variable compounds among
honeys of different origins. The identification of these individual compounds
and their contributions to wound healing is crucial for a better understanding
of the mechanisms behind honey-mediated healing of chronic wounds.
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