Effects of propolis on inflammation markers in patients undergoing hemodialysis: A randomized, double-blind controlled clinical trial

Background and aims: Several studies have been performed in vitro and in animals showing that propolis (a resin made by bees) has excellent anti-inflammatory properties, but no study has been performed in patients with chronic kidney disease (CKD) on hemodialysis (HD). The present study aimed to evaluate the effects of propolis supplementation on inflammatory markers in patients with CKD on HD. Methods: This is a longitudinal, double-blind, placebo-controlled trial with patients randomized into two groups: propolis (4 capsules of 100 mg/day containing concentrated and standardized dry EPP-AF (R) green propolis extract) or placebo (4 capsules of 100 mg/day containing microcrystalline cellulose, magnesium stearate and colloidal silicon dioxide) for two months. Routine parameters were analyzed using commercial kits. The plasma levels of inflammatory cytokines were evaluated by flow luminometry. Results: Forty-one patients completed the follow-up, 21 patients in the propolis group (45 +/- 12 years, 13 women, BMI, 22.8 +/- 3.7 kg/m2) and 20 in the placebo group (45.5 +/- 14 years, 13 women, BMI, 24.8 +/- 6.8 kg/m2). The obtained data revealed that the intervention with propolis significantly reduced the serum levels of tumour necrosis factor alpha (TNF alpha) (p = 0.009) as well as had the tendency to reduce the levels of macrophage inflammatory protein-1 beta (MIP-1 beta) (p = 0.07). There were no significant differences in the placebo group. Conclusion: Short-term EPP-AF (R) propolis dry extract 400 mg/day supplementation seems to mitigate inflammation, reducing the plasma levels of TNF alpha and MIP-1 beta in patients with CKD on HD. This study was registered at clinicaltrials.gov (NCT04411758).