Propolis
  
Propolis
Background
Propolis is a natural resin created by bees, used in the construction of hives. Propolis is produced from the buds of conifer and poplar tress, in combination with beeswax and other bee secretions. Historically, propolis was used in Greece to treat abscesses, by the Assyrians to heal wounds and tumors, and by the Egyptians for mummification. Today, propolis is commonly found in chewing gum, cosmetics, creams, lozenges, and ointments.
Propolis has shown promise in dentistry for dental caries, as a natural sealant and enamel hardener. Effectiveness of propolis against herpes simplex virus types 1 and 2 and parasitic infections has been demonstrated in preliminary studies. However, properly controlled randomized human trials are lacking, and further evidence is warranted in order to establish the therapeutic efficacy of propolis for any indication.
Numerous case reports have demonstrated propolis to be a potent allergen and sensitizing agent, and therefore it should be used cautiously in hypersensitive individuals. Toxicity with propolis is rare, although there are multiple case reports of contact dermatitis, erythema, eczema, vesiculitis, and pruritis.
Synonyms
Bee glue, bee propolis, bee putty, Bienenharz (German), hive dross, propolisina (Spanish), propolis balsam, propolis resin, propolis wax, Russian penicillin.
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidenceGrade*Dental plaque and gingivitis (mouthwash)
Propolis is a natural resin created by bees, used in the construction of hives. Propolis is produced from the buds of conifer and poplar tress, in combination with beeswax and other bee secretions. Propolis has been suggested for multiple oral problems, including reduction of pain, treatment of infection, and sealing/helping bone to re-form. Laboratory studies suggest activity of propolis against bacteria found in the mouth. Although preliminary human studies report reduction in oral bacterial counts and short-term reduction of plaque formation, these experiments have been poorly designed. Without additional research in this area, the evidence cannot be considered conclusive.
C
Dental pain
There is preliminary evidence that propolis may reduce dental pain, for example with the use of a propolis gel. Additional research is needed before a clear recommendation can be made.
C
Dental wound healing
Propolis has been reported to assist in repair after tooth extraction in animal studies. Reliable human research is needed before a recommendation can be made.
C
Acute cervicitis
Laboratory studies suggest anti-bacterial activity of propolis. Preliminary poor-quality research has examined the use of propolis (applied as a cream or ointment) for cervicitis. Further study is necessary before a recommendation can be made.
C
Genital herpes simplex virus (HSV) infection
Laboratory studies report anti-viral activity of propolis, including against herpes simplex virus types 1 and 2. Preliminary results from poorly designed human studies suggest propolis used on the skin may improve lesions from genital herpes virus infections. However, without better human study, including comparisons to prescription drugs, firm conclusions cannot be drawn.
C
Rheumatic diseases
Based on anti-inflammatory action observed in laboratory research, propolis has been proposed as a possible treatment for rheumatic and other inflammatory diseases. However, there is currently not enough scientific human study to make a clear recommendation.
C
Infections
Animal and laboratory studies suggest activity of propolis in the treatment of various types of infections. Initial human research reports possible benefits against oral/dental bacteria, genital herpes, urine bacteria, intestinal giardia infections, or H. pylori . Additional research is needed before a recommendation can be made.
C
Legg-Calve-Perthes disease/avascular hip necrosis
These diseases are characterized by the death of bone at the hip joint (femoral head). There is limited human study of injection of propolis into the joint following hip replacement surgery for these conditions. However, without additional human study of safety and effectiveness, no clear conclusions can be drawn.
C
Cornea complications from zoster
Laboratory studies suggest anti-viral and anti-inflammatory activity of propolis. There is limited poor-quality study of propolis for the treatment of corneal complications of varicella zoster, reporting faster healing and improvement of sight. Better human research is needed before a recommendation can be made.
C
Prevention of colds
Laboratory studies suggest anti-infectious activity of propolis. Limited research in humans does not provide clear conclusions.
C
Burns
Preliminary research reports that propolis may have a beneficial effect on the healing of partial thickness burn wounds.
C
* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Acne, anticoagulant, antioxidant, anti-spasm, blood clots, bowel diseases, cancer, Crohn's disease, dermatitis, dilation of veins (vasorelaxant), diverticulitis, eczema, eye infections/inflammation, fungal infections, hepatoprotection, HIV, immune stimulation, stomach ulcer, laryngitis, low blood pressure, nasopharyngeal carcinoma, osteoporosis, pruritis (itching), psoriasis, rheumatoid arthritis, skin rejuvenator, thyroid disease, tuberculosis, ulcerative colitis, viral infections, wound healing.
Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
Dental plaque : 10 milliliters of 0.2% to 10% propolis ethanol extract mouthwash has been used in studies, swished in the mouth for 60 to 90 seconds, then spit, used once or twice daily.
Acute cervicitis : 5% ointment/cream of propolis applied in the form of vaginal dressings daily for ten days has been studied.
Infections : Two 250 milligram propolis capsules taken by mouth, three times daily for three days has been used for treating bacteria in the urine. 20% to 30% propolis extract taken by mouth for five days has been studied for giardiasis (milligram dosing not clearly described). Safety and effectiveness have not been established.
Genital herpes simplex virus infection : 3% propolis ointment (made from 75% to 85% concentrated propolis extract) applied topically four times daily for 10 days has been studied. In cases of cervical or vaginal lesions, the same amount of ointment has been applied to the tip of a tampon and inserted vaginally four times daily for 10 days. Safety and effectiveness have not been established.
Children (younger than 18 years)
Infections : 10% ethanol extract of propolis taken by mouth over five days has been studied for giardiasis (milligram dosing not established). Note that ethanol (alcohol) preparations should be used cautiously in children. Safety and effectiveness have not been established.
Rhinopharyingitis : 0.5 milliliter propolis nasal spray (NivcrisolŽ), once weekly for five months has been used in preschool children (mean age 6 years) and school-age children (mean age 9 years), over a five-month period. Safety and effectiveness have not been established.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
Patients should avoid propolis who have had an allergic/hypersensitivity reaction to propolis, Populus nigra L. (black poplar), poplar bud, bee stings/bee products (including honey), or balsam of Peru. There are multiple reports of swelling, fluid collection, redness, burning, eczema, swelling, fever and other allergic reactions with repeated use of propolis on the skin.
Side Effects and Warnings
The safety of propolis has not been thoroughly studied. Although there are several case reports of allergic reactions to propolis, it is generally believed to be well tolerated in most adults. Case reports of irritation in and around the mouth have occurred after use of propolis lozenges or extract taken by mouth.
Toxicity data for propolis are limited. Preliminary animal studies have found propolis to be relatively non-toxic.
Pregnancy and Breastfeeding
There is not enough scientific evidence to recommend use of propolis during pregnancy or breastfeeding. Many tinctures contain high levels of alcohol, and should be avoided during pregnancy.
References
1. Abd El Hady FK, Hegazi AG. Egyptian propolis: 2. Chemical composition, antiviral and antimicrobial activities of East Nile Delta propolis. Z Naturforsch [C] 2002;57 (3-4) :386-394.
2. Akao Y, Maruyama H, Matsumoto K, et al. Cell growth inhibitory effect of cinnamic acid derivatives from propolis on human tumor cell lines. Biol Pharm Bull 2003;26(7):1057-1059.
3. Almas K, Mahmoud A, Dahlan A. A comparative study of propolis and saline application on human dentin: a SEM study. Indian J Dent Res 2001;12(1):21-27.
4. Ansorge S, Reinhold D, Lendeckel U. Propolis and some of its constituents down-regulate DNA synthesis and inflammatory cytokine production but induce TGF-beta1 production of human immune cells. Z Naturforsch [C] 2003;58(7-8):580-589.
5. Banskota AH, Nagaoka T, Sumioka LY, et al. Antiproliferative activity of the Netherlands propolis and its active principles in cancer cell lines. J Ethnopharmacol 2002;80(1):67-73.
6. Barak V, Birkenfeld S, Halperin T, et al. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. Isr Med Assoc J 2002;4(11 Suppl):919-922. Comment in: Isr Med Assoc J 2002;4(11 Suppl):944-946.
7. Bazo AP, Rodrigues MA, Sforcin JM, et al. Protective action of propolis on the rat colon carcinogenesis. Teratog Carcinog Mutagen 2002;22(3):183-194.
8. Borrelli F, Izzo AA, Di Carlo G, et al. Effect of a propolis extract and caffeic acid phenethyl ester on formation of aberrant crypt foci and tumors in the rat colon. Fitoterapia 2002;73 Suppl 1:S38-43.
9. Borrelli F, Maffia P, Pinto L, et al. Phytochemical compounds involved in the anti-inflammatory effect of propolis extract. Fitoterapia 2002;73 Suppl 1:S53-63.
10. Boyanova L, Derejian S, Koumanova R, et al. Inhibition of Helicobacter pylori growth in vitro by Bulgarian propolis: preliminary report. J Med Microbiol 2003;52(Pt 5):417-419.
11. Cardile V, Panico A, Gentile B, et al. Effect of propolis on human cartilage and chondrocytes. Life Sci 2003;73(8):1027-1035.
12. Ceschel GC, Maffei P, Sforzini A, et al. In vitro permeation through porcine buccal mucosa of caffeic acid phenetyl ester (CAPE) from a topical mucoadhesive gel containing propolis. Fitoterapia 2002;73 Suppl 1:S44-52.
13. Chen CN, Wu CL, Shy HS, et al. Cytotoxic prenylflavanones from taiwanese propolis. J Nat Prod 2003;66(4):503-506.
14. Cicala C, Morello S, Iorio C, et al. Vascular effects of caffeic acid phenethyl ester (CAPE) on isolated rat thoracic aorta. Life Sci 2003;73(1):73-80.
15. Cos P, Rajan P, Vedernikova I, et al. In vitro antioxidant profile of phenolic acid derivatives. Free Radic Res 2002;36(6):711-716.
16. Crisan I, Zaharia CN, Popovici F, et al. Natural propolis extract NIVCRISOL in the treatment of acute and chronic rhinopharyngitis in children. Rom J Virol 1995;46(3-4):115-133.
17. Eley BM. Antibacterial agents in the control of supragingival plaque: a review. Br Dent J 1999;186(6):286-296.
18. El-Khatib AS, Agha AM, Mahran LG, et al. Prophylactic effect of aqueous propolis extract against acute experimental hepatotoxicity in vivo. Z Naturforsch [C] 2002;57(3-4):379-385.
19. Gregory SR, Piccolo N, Piccolo MT, et al. Comparison of propolis skin cream to silver sulfadiazine: a naturopathic alternative to antibiotics in treatment of minor burns. J Altern Complement Med 2002;8(1):77-83.
20. Han S, Sung KH, Yim D, et al. Activation of murine macrophage cell line RAW 264.7 by Korean propolis Arch Pharm Res 2002;25(6):895-902.
21. Havsteen BH. The biochemistry and medical significance of the flavonoids. Pharmacol Ther 2002;96(2-3):67-202.
22. Hegazi AG, Abd El Hady FK. Egyptian propolis: 3. Antioxidant, antimicrobial activities and chemical composition of propolis from reclaimed lands. Z Naturforsch [C] 2002;57(3-4):395-402.
23. Henschel R, Agathos M, Breit R. Occupational contact dermatitis from propolis. Contact Dermatitis 2002;47(1):52.
24. Mahmoud AS, Almas K, Dahlan AA. The effect of propolis on dentinal hypersensitivity and level of satisfaction among patients from a university hospital Riyadh, Saudi Arabia. Indian J Dent Res 1999;10(4):130-137.
25. Murray MC, Worthington HV, Blinkhorn AS. A study to investigate the effect of a propolis-containing mouthrinse on the inhibition of de novo plaque formation. J Clin Periodontol 1997;24(11):796-798.
26. Park YK, Koo MH, Abreu JA, et al. Antimicrobial activity of propolis on oral microorganisms. Curr Microbiol 1998;36(1):24-28.
27. Steinberg D, Kaine G, Gedalia I. Antibacterial effect of propolis and honey on oral bacteria. Am J Dent 1996;9(6):236-239.
28. Vynograd N, Vynograd I, Sosnowski Z. A comparative multi-centre study of the efficacy of propolis, acyclovir and placebo in the treatment of genital herpes (HSV). Phytomed 2000;7(1):1-6.
January 01, 2004 
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