Editors' ChoiceWound Healing

Wounds getting the royal treatment

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Science Translational Medicine  16 Aug 2017:
Vol. 9, Issue 403, eaao4206
DOI: 10.1126/scitranslmed.aao4206

Abstract

Insect defensin-1 improves wound healing by inducing production of matrix metalloproteinase-9.

Honey has been long known to improve wound healing. Less is known about the wound healing properties of royal jelly, the worker bee secretion that differentiates “simpleton” larva to become a queen. Given the enormous burden of nonhealing wounds on society and the ever growing interest in natural products, understanding how royal jelly improves healing may be an important stepping stone toward effective and safe interventions for wounds. Bucekova et al. studied the effects of royal jelly on in vitro and in vivo wound models. They demonstrated that royal jelly was not toxic to human cells and increased cell migration in vitro. In vivo, in an acute wound rat model, royal jelly increased healing rates and the proportion of completely healed wounds. Using zymography and Western blot studies, the investigators demonstrated that the effect is mediated by matrix metalloproteinase-9. Using reverse phase high performance liquid chromatography, they also identified defensin-1 as the main protein mediating the effect. The investigators proceeded to create a recombinant defensin molecule and demonstrated its positive effects on healing rate in a rat acute wound model.

In this study, the effects of royal jelly appear consistently better than the effects of recombinant defensin alone—but only slightly. Additionally, different brands of royal jelly all increased matrix metalloproteinase-9 amounts and activity but not in a uniform manner. This may demonstrate a synergistic effect of different components in natural products. This heterogeneous composition cannot only make natural remedies effective but also makes their effects notoriously difficult to reproduce with precision. Defensin-1 is an antimicrobial peptide and is thought to enhance wound healing by its cationic charge that makes it and other defensins effective antimicrobials. Human antimicrobial peptides have been shown to positively affect wound healing, but less is known about insect-derived defensins. Therefore this study may open the door for a new class of healing molecules.

This study is small and lacks human in vivo data. Thus, additional studies are needed to build a body of evidence for the use of natural products in wound healing. Accurate descriptions of the active components in natural products and their exact mechanism of action not only increases the chances of translation to clinical practice but may also help to achieve standardization between products by identifying and quantifying their active components. These appear to be necessary steps the research community needs to take in order to crescendo the buzz about bee-derived remedies and other natural products for treatment of wounds, as well as other ailments.

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