Bee Venom Therapy (BVT)

Neethu Jose*

Assistant Professor, Jubilee Mission College of Nursing, Thrissur, Kerala

Corresponding Author Email: agnesfeb9@gmail.com

ABSTRACT:

Bee venom therapy is the specialized form of apitherapy. Apitherapy is a medical concept for treating systemic immune disease, allergic disease, viral and organic specific inflammatory disease.bee venom therapy uses honeybee products.bee venom has been used traditionally by ancient Egyptians as a remedy for the control of pain and inflammation in arthritis. Bee venom also known as apitoxin contains more than 40 biologically and pharmacologically active compound. The average life span of ahoney bee is 4-6 weeks. In BVT healthy female honey bees of 20days of age is used, from the species Scerana Indica. BVT is now practicing in Kerala in Idukki and Wayanad district. BVT is the therapeutic application of honeybee venom, through live bee stings, to bring relief and healing for various spinal, neural, joint or other musculo-skeletal ailments. The bee stings stimulates the immune system of the body and stimulates the production of cortisol-the natural steroid. BVT should be started with allergic test, which is with a single bee sting. If there is no untoward reactions occurs the therapy continuous. Recent studies have shown that bee venom produces both anti-inflammatory and anti-nociceptive effects via different mechanisms.

KEYWORDS: Bee Venom Therapy, bee sting therapy, Melittin, Apamin, Rheumatoid arthritis, Beevenom acupuncture.

INTRODUCTION:

Bee Venom Therapy (BVT) also called bee sting therapy, is one type of Apitherapy or the therapeutic use of beehive products such as honey, royal jelly or bee venom. The use of bees and bee products goes back to ancient Egypt, Greece, and China but Hungarian doctor Bodog Beck popularized the treatment.

Bee venom also known as Apitoxin contains more than 40 biologically and pharmacologically active compound-phospholipaseA2, histamine, epinephrine, free aminoacids and the peptides melittin and apamin. Melittin, major component of bee venom, has anti-tumor, antimicrobial, anti-nociceptive and anti inflammatory activities.

BVT is the therapeutic application of honeybee venom, through live bee stings, to bring relief and healing for various spinal, neural, joint or other musculo-skeletal ailments. It is believed that bee stings stimulates the body’s immune system in specific locations. it may also increase the body’s production of cortisol.

Figure 1: Honey bee with its sting (posteriorly placed) embedded in the patient’s skin

How it works? ^4-6

Healing potency of bee venom stimulates the Adrenal gland to produce cortisol.BVT also starts the immune system to produce a healing response in the injured area, and also spurs the production of endorphins, the natural pain killers. The antibacterial and antiviral properties make the venom in fighting bacterial and viral ailments in CNS and elsewhere.

The presence of neurotransmitters dopamine, serotonin and nor-epinephrine which facilitates nerve transmission and healing in condition involving nerve disorders. This give bee venom the ability to travel along neural pathways from the spine to various trigger points and injured areas to help repair nerve damage and restore mobility.

Lastly, bee venom has the ability to kill cancer cells and can make malignant tumors close to skin surface disappears. Bee venom contains peptides- melittin and apamin, which have the ability to destroy cancerous cells. when melittin binds with our antibodies, immunotoxins are created, they penetrate to the DNA of infected cell and destroy them. Apamin can travel from blood stream and can cross blood-brain barrier into the CNS thus facilitating healing process of neural disorder.

Indication¹

Disease type	Application, details
Arthritis	Both osteoarthritis and rheumatic arthritis Rheumatic arthritis being more susceptible to BVT
Diseases of the central and peripheral nervous system (CNS, PNS)	· Multiple sclerosis · Dementia · Post stroke paralysis · Polyneuritis · Ganglion nerve inflammation · Cerebellar ataxy (muscular disfunction) Syringomyelia (pain of extremeties, headache), Inflammation of facial nerve · Myopathy (neuromuscular disease) · Trigeminal neuralgia · Posttraumatic inflammation of plexus nerve Inflammation of arachnoid CNS membrane · Parkinson’s disease
Heart and blood system	· Hypertension · Arteriosclerosis · Endarteritis (chronic inflammation of the inner layer of arteries) · Angina pectoris · Arrhythmia
Skin diseases	· Eczema, dermatitis, psoriasis · Furunculosis (recurring boil) · Healing of cicatrices · Baldness
Other disease	· Ophthalmology · Gastroenterology: colitis, ulcers, IBS · Pulmonology: asthma, bronchitis, Otorinolaringology: pharingytis, tonsillitis, ear nerve neuritis · Endocrinology · Urology, gynecology · bursitis · tendenitis · dissolving scar tissue(keloids) · Herpes zooster

About 2% of the population may have allergic reactions to bee stings, the first step is to test the risk factor by injecting a very small amount of bee venom underneath the skin or with a single sting. if no allergic reactions the therapy continuous.

Beneficial and toxic biological effects of whole bee venom in animal and cell experiments¹

Overall effect or target	Specific effects
Anti-inflammatory and anti- arthritis action	Glucocorticoid-and aspirin like effects.
Anti-cancer effects	Antitumor effects on ovary, hepatoma, prostate, bladder, melanoma and renal cancers cells by different mechanisms of action depending on the tumor type
Affects the central and peripheral nervous system (CNS, PNS)	· Stimulates many peripheral chemoreceptors, e.g of heart, sinocarotid, intestinal systems, affecting flow to the CNS · Has cholinolytic action (against acetylcholine) · Blocks transmission of the vegetative synapse and the polysynaptic neuronal paths · Pain-soothing aspirin-like action · Influence of brain EEG and behaviour patterns of animals, inhibiting their conditioned reflex patterns. · Increases brain blood circulation
Anti-addictive effects	BV acupuncture may modulate methamphetamine- induced hyperactivity, hyperthermia through activation of the peripheral nerve and the central alpha (2)- adrenergic activation.
Heart and blood system	· Increases coronary and peripheral blood circulation, improves the microcirculation of blood in the tissues, · Slows down heart at lower doses and stimulates it at higher ones, lowers blood pressure, antiarhythmic · Against blood coagulation fibrinolytic, stimulates the building of erythrocytes
Action on the immune system	Immunosuppressive and immunoactivating
Protection from radioation	Improves regeneration of leucocytes and erythrocytes
Antibiotic fungicide and antiviral action	Bactericide action against different pathogens Action against Candida albicans, and inactivation of Herpes, Leukaemia and HIV viruses
Antihyperthermic	Activates specific body systems to overcome hyperthermia
Gall bladder-intestine system	Increases fall flow and cholesterine and bilirubin concentrations
Endocrinological system	Increases secretion of thyroid, hypophysis and of the hypothalamus hormones
Metabolic effects	Increases protein and nucleotide metabolism
Liver protecting	Potent suppressive effect on anti-apoptotic responses of TNF-alpha/Act D-treated hepatocytes
Growth increasing	Increase of growth of chicken broilers
Toxic effects	Allergenic, induces pain, cytotoxic, inhibits respiration, neurotoxic

Main biological and therapeutic effects of bee venom and its components¹

Fonts in red: potentially toxic effects

Component, % of total	Effect
Melittin Biologically active peptide 50-55 %	Main biologically active component Membrane-active, diminishes surface tension of membranes Anti-inflammatory in very small doses; Stimulates smooth muscles; Increases capillary permeability increasing blood circulation and lowering the blood pressure, lowers blood coagulation, immuno stimulatory and immunosuppressive, Radiation protective, influences the central nervous system, Anticancer, Antibacterial, antifungal, antiviral Higher doses are inflammatory and haemolytic
Phospholipase A Enzyme hydrolysing phospholipids 10-12 %	Destroys phospholipids and dissolves the cell membrane of blood bodies; lowers the blood coagulation and blood pressure Induces inflammation, the strongest allergen and thus the most harmful BV component
Phospholipase B cleavage of the toxic lysolecetin 1 %	Detoxicating activity
Hyaluronidase Catalyses hydrolysis of hyoloronic acid, the tissue cement 1-2 %	Catalyses the hydrolysis of proteins, thus enabling the penetrating of BV into the tissue; dilates blood vessels and increases their permeability, causing an increase of blood circulation; allergenic
Apamine Biologically active peptide 2-3 %	Anti-inflammatory stimulating the release of cortisone, antiserotonine action Increases the defence capability Immuno-supressor, stimulates the central nervous system in very small doses Higher doses are neurotoxic
MCD, mast cell degranulating- peptide 401 2-3 %	Lyses mast cells, releasing histamine, serotonine and heparine Melittine-like effect increasing capillary permeability increasing Anti-inflammatory simulates the central nervous system
Adolapine Biologically active peptide 1 %	Inhibits the specific brain enzymes cyclooxigenase and lipooxigenase Decreases inflammations by, anti-rheumatic, decreases pain Inhibits the aggregation of erythrocytes Relatively low toxicity
Protease-Inhibitors Biologically active peptides 3-4 %	Inhibits the activity of different proteases like trypsin., chymotprypsin, plasmin, thrombin, thus decreasing inflammation, anti-rheumatic Low toxicity
Secapin, tertiapin, cardiopep, minimin, procamine 3-5 %	Peptides, with an uncertain role in the physiological action of BV Antiradiation effects cardiopep has antiarhythmic effects
Histamine Neurotransmitter 0.7-1.5 %	Dilates blood vessels, increasing the permeability of blood capillaries and increases blood circulation; Stimulates smooth muscles; Allergenic
Dopamine, Noradrenaline Neurotransmitters 0.2-1.5 %	The low concentrations in BV do not cause physiological effects in mammals, but active when injected in invertebrates
Alarm pheromones 4-8 %	Complex ethers, causing alarm of the bee colony and its defensive behaviour

Counter-indications and allergy¹

· The main counter indication to BVT is bee venom allergy. Apitherapy should be used only after a BV allergy test.

· During acute and chronic infections

· After vaccinations

· Chronic tuberculosis and hepatitis

· Acute cancer

· Children under 5 years old

· Pregnancy, breast feeding

· Type 1 pancreatic diabetes

· Renal insufficiency

· hepatic failure

· impaired cardiac functions and respiratory problems

Complications²

Ø Hemolysis

Ø Kidney injury

Ø Hepatotoxicity

Ø MI

Treatment and Prevention for Venom Allergy⁷

Anaphylaxis is diagnosed in a patient with suspected exposure to allergen bee venom, if there is an acute onset of illness with skin or mucosal involvement with one of the following:

· Respiratory compromise (dyspnea, bronchospasm, wheezing, hypoxemia, stridor)

· Hypotension (Systolic BP <90 mm of Hg or 30% decrease from the base line), syncope or evidence of end organ damage

Management

· Out of hospital: At the first signs of any clinical manifestations of anaphylaxis, the patient should self-administer epinephrine, if available (adult dose, 0.3 mL of 1:1000 intramuscular; pediatric dose, 0.01 mL/kg of 1:1000 intramuscular). Susceptible patients may even use aerosolized epinephrine from a metered-dose inhaler (10–20 doses) to counteract the effects of laryngeal edema, bronchoconstriction, and other manifestations of anaphylaxis

· In-hospital management

Ø Assess airway patency, breathing and circulation. Establish intravenous (IV) access

Ø Aqueous epinephrine (1:1000), in a dose of 0.3–0.5 mL is for adults and 0.01 mL/kg (not exceeding 0.3 mL) for children should be given. In case of profound hypotension, skin perfusion is hampered. In such cases, 2–5 mL of epinephrine (1:10,000) should be given slow IV or an IV infusion can be set up by mixing 1 mg of epinephrine in 250 ml saline and be given at the rate of 0.25–1 mL/min. If IV access cannot be established, epinephrine can be given through endotracheal tube, intralingually or intramuscularly

Ø In case of hypotension, intra venous crystalloids should be given. Vasopressors like dopamine and norepinephrine may be needed for persistent hypotension

Ø Antihistaminics should be used in addition to epinephrine and not as its substitute. Diphenhydramine in a dosage of 50 mg IV can be given

Ø Nebulized β2 agonist, salbutamol (2.5 mg diluted to 3 mL saline) can be used to relieve bronchospasm

Ø Methylprednisolone (125–250mgIV) or intravenous hydro- cortisone can be used

Ø Patients on beta blockers may respond poorly to epine-phrine; glucagon is given to such patients to counteract the beta blockade. Dose: 1–5 mg IV over 5 min followed by 5–15 mcg/min infusion

Ø Rapid removal of stinger is advocated. It should not be squeezed out as it will release more venom from the venom sac.

Ø For mild reactions, application of ice pack or diluted vinegar to the site of sting may be sufficient. Oral and topical antihistaminics can also be used

Ø Multiple beestings causing massive envenomation should be treated more aggressively with epinephrine, antihistaminics, steroids and calcium gluconate (10 mL of 10% solution slow IV) for hyperkalemia. Patient should be observed for 12–24 hours for coagulopathy, renal and neurological damage.

CONCLUSION:

The use of bee venom as a therapeutic agent for the relief of joint pains dates back to Hippocrates, and references to the treatment can be found in ancient Egyptian and Greek medical writings as well. Also known as apitherapy, the technique is widely used in Eastern Europe, Asia, and South America. The beneficial effects of bee stings can be attributed to melittin, an anti-inflammatory agent. There is no time frame with any ailment since people do respond differently because of the nature of the injury or disease or their body’s health status.

REFERENCE:

1. Stefan Bogdanov, Bee Venom: Composition, Health, Medicine: A Review, Bee Product Science, 11 April 2011 ,1-16

2. Adel Nazmi Alqutub, Ibrahim Masoodi, Khalid Alsayari, Ahmed Alomair: Bee sting therapy-induced hepatotoxicity: A case report, World Journal of Hepatology 2011 October 27; 3(10): 268-270

3. ALS untangles 13:Beevenom, report, Amyotrophic lateral sclerosis 2011; 12: 471-472

4. http/www.ncbi.nlm.nih.gov/pubmed22027265,22109081

5. www.cancer.gov/aboutnci/servingpeople/cancer-research-progress/advances/nanobees

6. http//www.en.wikipedia.org/wiki/Apamin

7. Tarun Kumar Dutta, V Mukta, Indian Guidelines and Protocols: Bee Sting, Toxicology,417-420 available from www.apiindia.org/medicine_update_2013/chap92.pdf

Received on 20.08.2014 Modified on 24.09.2014

Asian J. Nur. Edu. and Research 5(2): April-June 2015; Page 293-296

DOI: 10.5958/2349-2996.2015.00058.0