Effect of Propolis on moderate persistent asthma: A phase two randomized, double blind, controlled clinical trial

Document Type : Original Research Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran

2 Innovative Medical Research Center, Faculty of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran

3 Shahid Hasehemi Nezhad Research Center, Kavosh High School, Ministry of Education, Mashhad, Iran

4 Independent Pharmacist

5 Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Objective: The aims of this study was to determine the effect of Propolis (resinous mixture that honey bees produce by mixing saliva and beeswax) on clinical and physiological findings of moderate persistent asthma.
Materials and Methods: Fifty-two subjects aged 44.6±18.5 years old with moderate asthma and Forced expiratory volume in 1 second (FEV1) 60-79% of predicted, were enrolled in this clinical trial. We randomly allocated subjects to receive either propolis (75 mg three times a day) or a matched placebo for one month. Primary outcome was Asthma control test (ACT) score and secondary outcomes included dyspnea, spirometry, fractional exhaled nitric oxide (FENO) and sputum cytology including inflammatory cell. Sputum induction was done by hypertonic saline and cytology slides were stained by Papanicolaou stain.
Results: Clinical findings significantly improved after the treatment. ACT scores significantly increased by using propolis (12.8±5.5 before and 18.1±4.99 after the trial), which was significantly higher than the placebo group (14.4±6.6 after the trial). The most significant physiological improvements were significant increases in FEV1, FV1/Forced vital capacity and expiratory flows. FENO showed significant decreases in the propolis group but increases in the placebo group. Cytological examination of sputum showed that the pattern of inflammation was eosinophilic in 44% subjects with an average eosinophil of 7.2±1.01%. Eosinophilia significantly decreased (p <0.05) by using propolis (7.2±1.01 and 4.3±3.1%, before and after treatment, respectively), but it significantly increased (p <0.04) in the placebo group (5.5±2.8, and 11.1±6.6%, before and after treatment, respectively).
Conclusion: Propolis improved the clinical and physiological findings of moderate persistent asthma, and it was able to suppress eosinophilic inflammation.

Keywords


Burdock G. 1998. Review of the biological
properties and toxicity of bee propolis
(propolis). Food Chem toxicol, 36:347-
363.
Djukanović R, Sterk P, Fahy J, Hargreave F.
2002. Standardised methodology of sputum
induction and processing. Eur Res J, 20:1s2s.
de Farias JH, Reis AS, Araújo MA, Araújo MJ,
Assunção AK, de Farias JC, Fialho EMS,
Silva LA, Conceição Costa G, Meireles
Guerra RN, Sousa Ribeiro MN, Fernandes
do Nascimento FR. 2014. Effects of
stingless bee propolis on experimental
Effect of Propolis on asthma
AJP, Vol. 11, No. 1, Jan-Feb 2021 31
asthma. Evid-Base Complement Alternat
Med, 2014. doi: 10.1155/2014/951478.
Iwamura C, Shinoda K, Yoshimura M,
Watanabe Y, Obata A, Nakayama T. 2010.
Naringenin chalcone suppresses allergic
asthma by inhibiting the type-2 function of
CD4 T cells. Allergol Int, 59:67-73.
Juniper E, O′ byrne P, Guyatt G, Ferrie P, King
D. 1999. Development and validation of a
questionnaire to measure asthma control.
Eur res j, 14:902-907.
Kao H-F, Chang-Chien P-W, Chang W-T, Yeh
T-M, Wang J-Y. 2013. Propolis inhibits
TGF-β1-induced epithelial–mesenchymal
transition in human alveolar epithelial cells
via PPARγ activation. Int
immunopharmacol, 15:565-574.
Khayyal M, El-Ghazaly M, El-Khatib A. 1993.
Mechanisms involved in the
antiinflammatory effect of propolis extract.
Drugs exp clin res, 19:197-203.
Liao Y-R, Hsu J-Y, Chu J-J, Fu L-S. 2010.
Caffeic acid phenethyl ester suppresses the
induction of eotaxin in human lung
fibroblast cells. J Asthma, 47:233-237.
Márquez N, Sancho R, Macho A, Calzado MA,
Fiebich BL, Muñoz E. 2004. Caffeic acid
phenethyl ester inhibits T-cell activation by
targeting both nuclear factor of activated Tcells and NF-κB transcription factors. J
Pharmacol Exp Therap, 308:993-1001
Miller MR, Hankinson J, Brusasco V, Burgos
F, Casaburi R, Coates A, et al. 2005.
Standardisation of spirometry. Eur res j,
26:319-338.
Mirzoeva O, Calder P. 1996. The effect of
propolis and its components on eicosanoid
production during the inflammatory
response. Prostaglandins, Leukotrienes and
Essential Fatty Acids, 55:441-449.
Park H-j, Lee C-M, Jung ID, Lee JS, Jeong Yi, Chang JH, Park YM. 2009. Quercetin
regulates Th1/Th2 balance in a murine
model of asthma. Int
immunopharmacology, 9:261-267.
Sakai-Kashiwabara M, Asano K. 2013.
Inhibitory action of quercetin on eosinophil
activation in vitro. Evid- Based
Complement Alternat Med. 2013:127105.
Salari H, Braquet P, Borgeat P. 1984.
Comparative effects of indomethacin,
acetylenic acids, 15-HETE,
nordihydroguaiaretic acid and BW755C on
the metabolism of arachidonic acid in
human leukocytes and platelets.
Prostaglandins, Leukotrienes and Medicine
13:53-60.
Sanz VS, López AN, Almería EG, Villa JA.
2013. Spirometry patterns in vocal cord
dysfunction. In: Anales de pediatria
(Barcelona, Spain: 2003), 78: 173-177
Sforcin J. 2007. Propolis and the immune
system: a review. J ethnopharmacol, 113:1-
14.
Shi Y, Dai J, Liu H, Li R-R, Sun P-L, Du Q,
Pang LL, Chen Z, Yin KS. 2009.
Naringenin inhibits allergen-induced
airway inflammation and airway
responsiveness and inhibits NF-κB activity
in a murine model of asthma. Canadian j
physiol pharmacol, 87:729-735.
Simpson JL, Scott R, Boyle MJ, Gibson PG.
2006. Inflammatory subtypes in asthma:
assessment and identification using
induced sputum. Respirology, 11:54-61.
Sy LB, Wu Y-L, Chiang B-L, Wang Y-H, Wu
W-M. 2006. Propolis extracts exhibit an
immunoregulatory activity in an OVAsensitized airway inflammatory animal
model. Int Immunopharmacol, 6:1053-
1060.
Wang L-C, Lin Y-L, Liang Y-C, Yang Y-H,
Lee J-H, Yu H-H, Wu WM, Chiang BL.
2009. The effect of caffeic acid phenethyl
ester on the functions of human monocytederived dendritic cells. BMC Immunol, 16;
10:39.