South African Honey: Anti-Helicobacter pylori Activity and Combined Effect With the Gut Microbiome

Honey has been revered for its medicinal properties for thousands of years, with medicinal uses including treating inflammation and gastric ulcers. The gut pathogen Helicobacter pylori is known to cause inflammation and gastric ulcers. Current treatment options for infection with H. pylori present several concerns due to the rapid gain in resistance and dysbiosis caused to the gut microbiome. While the anti-H. pylori properties of honey have been studied globally, a comprehensive range of southern African honeys has yet to be explored against this pathogen. This study is aimed at investigating South African honey for its anti-H. pylori activity and interaction with gut microbiome species. A total of 76 raw honey samples derived from South African apiarists were investigated, along with Manuka honey included for comparison. The anti-H. pylori activity and interaction with the gut microbiome species were assessed using the minimum inhibitory concentration (MIC) agar dilution assay. The hydrogen peroxide (H₂O₂) concentration of antimicrobially active samples was determined using colorimetric test strips. A third of the investigated honeys showed activity comparable with that of Manuka honey. Honey derived from fynbos, citrus, coriander, and buchu floral sources demonstrated the best anti-H. pylori activity (MIC of 6.25%). An increase in anti-H. pylori activity was observed for up to 82.50% of combinations of honey and Lactobacillus/Lacticaseibacillus species. A positive correlation (R² = 0.76) between increased anti-H. pylori activity and increased H₂O₂ concentrations was observed. These results demonstrate not only the potential of South African honey as anti-H. pylori agents, but also the importance of their interactions with the gut microbiome to enhance inhibition of this ulcer-causing pathogen.