CLINICS 2012;67(11):1345 READERS OPINION Systemic benefits and potential uses of tualang honey in addition to its beneficial effects on post- menopausal bone structure DOI:10.6061/clinics/2012(11)20 Shailendra Kapoor University of Illinois at Chicago, Chicago, Illinois, USA. Email: shailendrakapoor@yahoo.com Tel.: 865 607 1014 To the Editor, I read the recent article by Zaid et al. (1) with great interest. Recent research has shown that tualang honey may have a number of systemic benefits in addition to its protective effect on bone structure in post-menopausal animal models. Tualang honey has considerable potential as an anti-cancer agent. For example, it exerts anti-proliferative activities against breast cancer tissue, attenuating tumor growth in MDA-MB- 231 and MCF-7 cell lines (2). These anti-neoplastic effects are mediated by caspase 2 and caspase 9 activation and a reduction of the mitochondrial membrane potential in cancer cells, reflecting an increase in apoptosis. Tualang honey administration also produces early apoptosis in osteosarcomas in a dose-dependent manner (3) and attenuates proliferation in HeLa cell lines (2). Apoptosis is also enhanced in oral squamous cell carcinomas following exposure to tualang honey (3). Furthermore, tualang honey reduces photo-carcinogen- esis secondary to ultraviolet B radiation exposure (4). These anti-carcinogenic effects are mediated by an attenuation of PGE-2 synthesis and inhibition of the nuclear translocation of NF-kB in keratinocytes. Methanol extracts of tualang honey also decrease proliferation in keloid fibroblasts and may thus be of clinical use in the dermatological treatment of keloids (5). Interestingly, gamma radiation enhances the anti-oxidant potential of tualang honey (6). Tualang honey is considered by some to be the natural equivalent of ‘‘hormone replacement therapy’’. For exam- ple, short-term memory is improved in post-menopausal women following the administration of tualang honey (7), which is comparable to the increase in short-term memory observed after the administration of estrogen/progesterone combination therapy. The administration of tualang honey also attenuates atrophy in uterine tissue and increases vaginal epithelium thickness (8). It is also associated with a lower post-menopausal increase in body weight. Tualang honey also decreases the wound size of burns and provides enhanced control and containment of burn infec- tions, especially by bacteria such as Pseudomonas aeruginosa Copyright 2012 CLINICS – This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. No potential conflict of interest was reported. 1345 (9). Tualang honey also exerts anti-oxidant activities against pancreatic cells, thus reducing hyperglycemia in diabetic models (10). The above examples clearly illustrate the various potential uses of tualang honey and the need for further studies to fully elaborate the extent of its properties. REFERENCES 1. Zaid SS, Sulaiman SA, Othman NH, Soelaiman IN, Shuid AN, Mohamad Net al. Protective effects of Tualang honey on bone structure in experimental postmenopausal rats. Clinics. 2012;67(7):779-84, http:// dx.doi.org/10.6061/clinics/2012(07)13. 2. Fauzi AN, Norazmi MN, Yaacob NS. Tualang honey induces apoptosis and disrupts the mitochondrial membrane potential of human breast and cervical cancer cell lines. Food Chem Toxicol. 2011;49(4):871-8. 3. Ghashm AA, Othman NH, Khattak MN, Ismail NM, Saini R. Antiproliferative effect of Tualang honey on oral squamous cell carcinoma and osteosarcoma cell lines. BMC Complement Altern Med. 2010;10:49. 4. Ahmad I, Jimenez H, Yaacob NS, Yusuf N. Tualang Honey Protects Keratinocytes from Ultraviolet Radiation-Induced Inflammation and DNA Damage(dagger). Photochem Photobiol. 2012;88(5):1198-204, http://dx.doi.org/10.1111/j.1751-1097.2012.01100.x. 5. Nurul Syazana MS, Halim AS, Gan SH, Shamsuddin S. Antiproliferative effect of methanolic extraction of tualang honey on human keloid fibroblasts. BMC Complement Altern Med. 2011;11:82, http:// dx.doi.org/10.1186/1472-6882-11-82. 6. Khalil MI, Sulaiman SA, Alam N, et al. Gamma irradiation increases the antioxidant properties of Tualang honey stored under different condi- tions. Molecules. 2012;17(1):674-87, http://dx.doi.org/10.3390/ molecules17010674. 7. Othman Z, Shafin N, Zakaria R, Hussain NH, Mohammad WM. Improvement in immediate memory after 16 weeks of tualang honey (Agro Mas) supplement in healthy postmenopausal women. Menopause. 2011;18(11):1219-24, http://dx.doi.org/10.1097/gme.0b013e31821e2044. 8. Zaid SS, Sulaiman SA, Sirajudeen KN, Othman NH. The effects of Tualang honey on female reproductive organs, tibia bone and hormonal profile in ovariectomised rats–animal model for menopause. BMC Complement Altern Med. 2010;10:82, http://dx.doi.org/10.1186/1472-6882-10-82. 9. Khoo YT, Halim AS, Singh KK, Mohamad NA. Wound contraction effects and antibacterial properties of Tualang honey on full-thickness burn wounds in rats in comparison to hydrofibre. BMC Complement Altern Med. 2010;10:48, http://dx.doi.org/10.1186/1472-6882-10-48. 10. Erejuwa OO, Sulaiman SA, Wahab MS, Sirajudeen KN, Salleh MS, Gurtu S. Antioxidant protection of Malaysian tualang honey in pancreas of normal and streptozotocin-induced diabetic rats. Ann Endocrinol (Paris). 2010;71(4):291-6, http://dx.doi.org/10.1016/j.ando.2010.03.003.