18 Sep 2022

Dr Jonathan Cox – Manuka honey

From Sunday Morning, 8:45 am on 18 September 2022

For centuries, mānuka honey has been known for its antibacterial, anti-inflammatory and antioxidant properties.

Now UK researchers have discovered it can help soothe serious drug-resistant lung conditions.

No caption

Photo: 123rf

When combined with antibiotics, natural mānuka honey can greatly reduce the suffering associated with Mycobacterium abscessus complex (MABC) - an environmental pathogen found in people with underlying respiratory conditions like cystic fibrosis and bronchiectasis.

Mycobacterium abscessus is extremely difficult to treat, microbiologist Dr Jonathan Cox tells Sunday Morning.

“[Mycobacterium abscessus is] currently treated with a 13-month treatment course that involves some very aggressive antibiotics. And one of those antibiotics is called amikacin and we deliver it into the patients through nebulisation, where it's aerosolised into their lungs.

“The problem with amikacin is it has some very nasty side effects, which include hearing loss… life-altering side effects as a consequence of the treatment.

“What we found we can use mānuka honey for is we can reduce the concentration, the amount of amikacin that you need to nebulise into people's lungs to sterilise this infection.

“If you include mānuka honey in the formulation, you can reduce the amount [of amikacin] eight-fold. So, what we hope down the line is that this is going to have a significant impact on patients that have these nasty side effects."

Mycobacterium abscessus, which is from the same family as tuberculosis, is one of the predominant pathogens in a wide spectrum of infections, including 50 percent of those involving the lungs.

Cr Jonathan Cox, Aston University, Birmingham, UK

Dr Jonathan Cox Photo: Aston University

Mānuka honey is already being used to help soothe the lungs of people with chronic asthma, and Cox hopes it may prove useful in fighting other serious lung conditions.

“With the inclusion of mānuka honey within the treatment, what we hope is we reduce something as well, called bronchospasm, which is where a patient's lungs get so irritated with the nebulisation that it causes them to cough and be very short of breath for a period of time.

“That can be quite unpleasant and distressing, so one of the things that we hope to achieve with this as we move this forward is to look to see whether or not we get the improvement of the nebulisation treatment, not just from an anti-microbial perspective, not just about killing the bacteria, but also, making the treatment a little more pleasant for the patients.”

The antibacterial effects of mānuka honey are distinct from the effects of its active component methylglyoxal (MGO), Cox says.

These work together to make it a potentially powerful ingredient in any medical treatment.

“All of these different components work together to create this multi-valiant inhibitory effect. So, you're not just tackling the bacteria in one way, you're killing them in multiple different ways, and from an antibiotic resistance point of view, that's really valuable.

“Because to become resistant to mānuka honey, the bacteria doesn't just have to change in one way that it's being inhibited, it has to change in multiple different ways, which reduces the chance that that's going to happen."

The limitations of mānuka honey as a medical treatment are that it can’t be taken like an antibiotic tablet, but must be administered directly to the area needing attention.

“Mānuka honey is a really fantastic antimicrobial, but it is very much limited to topical delivery.

“That means you need to apply it directly to the site of infection. Mycobacterium abscessus can also cause infections in the skin and soft tissue as well as in the lungs so that some people do get a disseminated infection, but it is most commonly associated with respiratory infections.

“So, people that have either cystic fibrosis or bronchiectasis, where they've got long-term inflammation of the bronchial walls - those are the two main [conditions that predispose someone] to mycobacterium abscessus colonisation in the lungs.

"Mycobacterium abscessus is such a difficult micro-organism to treat, and I hope that this research will lay the foundation using this for many other respiratory pathogens. I think if you can kill mycobacteria, you stand a good chance of being able to kill other microbes as well. And I hope that people will pick up the mantle and follow on with their other bugs of interest.”

Dr Jonathan Cox is a senior lecturer in microbiology at Aston University in Birmingham, UK.