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Bee Venom Therapy Update

I wrote previously about bee venom therapy (BVT), also called apitherapy or bee sting therapy, as an emerging “alternative” therapy. Both use and research into BVT continue, providing an excellent example of the many things that are wrong with the CAM movement.

A recent Reuters article on the topic is also an excellent example of the frequent complete failure of the mainstream media in dealing with such topics. The articles discusses a Filipino bee keeper who decided to practice medicine based upon his personal anecdotal experience. Joel Magsaysay suffered a stroke and right-sided weakness. He attributes his recovery from the stroke partly to bee stings.

He admits he is not a physician and has no medical or scientific background. He has concluded that BVT works based upon anecdote along. He seems to be unaware of the unreliability of individual anecdotes in stroke recovery. Most patients will improve following a stroke. There are also two kinds of recovery, including neurological recovery from brain plasticity.

But there is also functional recovery separate from repairing some of the brain damage itself. After being hospitalized with a stroke and then having a prolonged recovery, there is likely going to be a degree of debility from the loss of normal activity.  Depression is also common following a stroke. Patients deciding they are going to do something to improve their function, no matter they decide to do, is likely going to be accompanied by greater physical activity and perhaps elevated mood. Stroke researchers are careful to control for this so-called “cheerleader effect” (a type of placebo effect) when trying to determine if a specific intervention is having a physiological effect.

Magsaysay, in other words, has no idea what the effect of bee stings was on his recovery. He likely would have recovered to the same degree without the stings. But now he feels qualified to treat a range of conditions with his bees. The Reuters report, for example, shows him treating a woman with an enlarged thyroid. She was hopeful that it would help because “people are saying it helps” and because it’s “natural.”

Bee venom is an interesting compound because it is a mixture of powerful chemicals. Venoms as a category are usually highly biological active – they evolved to be highly active, either inducing pain, paralysis, or death. So it is no surprise that they are a resource of potentially powerful drugs. The question, of course, is if they can be exploited for therapeutic effect. The best way to approach this is to isolate and purify specific components of  a venom and then go through the normal process of drug testing to find a safe and effective therapeutic dose for a specific indication. This has not happened, but there is some interesting basic science and animal research being done.

Ultimately, whether purified, diluted, or simply given as bee stings, we need rigorous clinical trials to assess ultimate safety and efficacy. My previous article focused mainly on BVT for multiple sclerosis. In the last four years there has been no new published research on this question – it seems to be a dead end. BVT is not effective for MS.

There are no published clinical studies of BVT and stroke recovery (however I did find a case report of a stroke following bee stings). There is also no legitimate scientific reason to suspect that BVT would be effective in stroke recover. Magsaysay gives his own explanation for how he thinks it works. His description is pure pseudoscience, just made up science-sounding nonsense. He claims that the pain induced by BVT causes neurons to synapse and reconnect to the brain. This does not even make basic anatomical sense. The problem with stroke is not with the peripheral nerves connecting to the brain, but to neurons in the brain itself that have been damaged.

The area of BVT research that seems the most promising is with neuropathic pain. Bee venom induces pain and inflammation acutely. A number of studies show that it also decreases markers of pain and inflammation following the exposure. This can simply be the effect of compensatory mechanisms kicking in. We see this as a general phenomenon – after any stimulus that causes pain and inflammation the body mobilizes mechanisms to counteract the pain and inflammation and reestablish the normal baseline. This effect is also temporary. Perhaps, however, the duration of the decrease in pain and inflammation is longer than that induced acutely by the sting.

This is still a matter of investigation, and it is not clear if any useful therapy will emerge from this. There are some interesting animal studies working with injecting diluted bee venom into a rat model of neuropathic pain. This is a long way from a specific clinical application, however.

Conclusion

After years of research there is still no proven application for bee venom therapy. The most encouraging preliminary data is with pain, and I would not be surprised if a component of bee venom is isolated that is useful for neuropathic (nerve induced) or nociceptive (tissue) pain. There is still a focus on rheumatoid arthritis, because of the alleged anti-inflammatory effects of BVT, but the data so far may just be reflecting the pain effects of BVT.

There are no neurological uses of BVT that are backed by any reasonable evidence. At this point I think we can say that it is not effective for multiple sclerosis. For other neurological conditions there is no clinical data, only the most preliminary basic science (looking at specific biochemical effects of bee venom).

While it is still unclear if any legitimate treatment will emerge from the study of bee venom, it is a mixture of powerfully biological active chemicals and is a potentially fruitful target of research. This does not justify, however, the exploitation of bee venom by the CAM community, who are making claims that go beyond the basic science evidence and are not supported by clinical evidence.

In fact we can see, side by side, the legitimate scientific approach to bee venom and the CAM approach. The scientific approach is reductionist, methodical, and rigorous and actually has the potential to develop something useful. The CAM approach is to make appeals to nature and antiquity, to make nonsensical hand-waving pseudoscientific justifications, to call it “therapy” before any proven therapeutic effect, and to use it carelessly for a wide range of different conditions.

 

Posted in: Science and Medicine

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10 thoughts on “Bee Venom Therapy Update

  1. cervantes says:

    I don’t know about bee venom, but wasp venom definitely cured me of using a push mower in my meadow.

  2. fledarmus1 says:

    I know of at least two decades of research that a major pharmaceutical company did on spider venom in the hopes of discovering a useful drug. Interesting compounds were discovered, interesting pathways were proposed and tested, and nothing ever came of it. The thing is, for biological defense mechanisms, promiscuous receptor binding is a good thing – a drug that interferes with more than one pathway can be more effective at deterring a threatening creature, and a complicated mixture of toxins that activates a host of nasty responses is even better. But unless you are trying to kill or disable things, it can be a little hard to tame the effects of a mixture of toxins to use as a pharmaceutical.

    If you are looking for chemical or biological weapons, this might be a good starting point.

  3. Janet Camp says:

    The PBS series, Nature, did a segment on venom. While the program didn’t completely go woo-y, it implied at times that what is very basic research holds tremendous promise for fabulous cures and treatments. The casual viewer would, when subsequently reading about Mr. Magsaysay, be easily inclined to equate things that really aren’t there. And so it goes….

  4. tmac57 says:

    I have been using Dale Darlin’s HTS ( Hammer-Thumb-Smash) method for pain relief for years,so BVT seems totally plausible to me.

  5. rork says:

    Nice post. I liked how fluent it was about why we really are interested in the compounds. When I worked in a proteomics lab, there was an epoch about 10 years ago when it seemed like every student and post-doc wanted to purify and characterize components of venom and learn about their binding characteristics (mostly from snakes it seemed). You get to play with mass spec, which is fun. As in modern pure math, we actually did not bother our heads too much about what practical applications there might be in the future. If you learn something important, those will come by themselves, and are often nothing like you predicted anyway. And they aren’t going to use the molecule you had in hand either. Nobody ever thought to use the unfractionated venom for anything, much less try it on MS patients. It’s old-fashioned slow science, piece by little piece. Stop playing around with bee stings and get to work.

  6. Alia says:

    Nothing new, really. I’ve heard about bee venom therapy (that is, bee stings controlled by protective clothing in some areas) used to treat rheumatoid arthritis like, 20 years ago? But since I have a fatal allergy, I wasn’t really interested in the topic.

  7. BillyJoe says:

    fledarmus: “unless you are trying to kill or disable things, it can be a little hard to tame the effects of a mixture of toxins to use as a pharmaceutical”.

    There are exceptions of course.

    One is botulinus toxin used in blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, migraine, as well as in cosmetic surgery.
    http://en.wikipedia.org/wiki/Botulinum_toxin

    Another is immunotherapy to desensitise allergic individuals. In fact, one example relvant to this thread is the use of bee venom to desenitise patients with bee venom anaphylaxis.
    Which possibly makes Steven Novella’s claim that “after years of research there is still no proven application for bee venom therapy” slightly inaccurate?

  8. fariza says:

    I’ve never heard of bee venom therapy. I looked it up on the Natural Standard database. There is much research that has been done on BVT. The database states: The mechanism by which all the components of bee venom might work together to alleviate symptoms is unknown. Contact with bee venom produces a complex cascade of reactions in the human body. Homeopaths theorize that bee sting therapy stresses the body’s immune system, thus getting it to come back stronger. Interesting, I wonder if stressing the body’s immune system would not be a good idea in some individuals.

  9. DevoutCatalyst says:

    “…Interesting, I wonder if stressing the body’s immune system would not be a good idea in some individuals.”

    Beekeepers. Sometimes they die when their little buddies act up with them, and it doesn’t always take much at the time it happens, sometimes just a single sting.

    http://www.telegraph.co.uk/news/uknews/1561801/Beekeeper-killed-by-one-sting.html

    http://www.telegraph.co.uk/news/uknews/7650866/Woman-beekeeper-dies-after-being-stung-on-face.html

    http://blog.corkyspest.com/2011/04/21/beekeeper-killed-in-san-diego-area/

    http://www.guardian.co.uk/uk/2010/apr/28/christopher-weaver-bees-sting

    And so on.

    Beekeeping is a fairly safe hobby; as a vocation, well, somebody’s got to do it. Exposing people to bee stings intentionally seems to me reckless. Homeopaths theorizing — that’s plain dangerous.

  10. Kultakutri says:

    I happened to step on a bee (so far for walking around barefoot). Now my foot is a bit swollen and sensitive and I’ll see tomorrow if this miracle works. Should I wake up tomorrow without wrinkles, asthma, acne, that slightly malformed toenail, depression and social phobia, I’ll let you know. I don’t hold hopes, though.

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