Tissues are preserved and protected from putrefaction and autolysis by the process of fixation. The key objective of fixation is to retain cellular components in their respective compartments and to present cells with a distinct and detailed microscopical appearance.
Formaldehyde was discovered by the Russian chemist Alexander M. Butlerov in 1859, and since then it is widely used in a concentration of 4%, 10%, and 15% as a fixative in histopathology. Out of which, 10% formalin (10% solution of formalin v/v; actually contains 4% formaldehyde w/v) is frequently employed in histopathology as a tissue fixative. 10% Formalin Fixed Paraffin Embedded Tissue (FFPET) stained with Hematoxylin and Eosin (H & E) has become the “gold standard” in histopathology, having an advantage of being quick and cost effective. Despite of its various advantages, attempts have been made to explore other substitutes for formaldehyde. The major limitations of formaldehyde as a fixative i.e., toxic nature of formaldehyde has been explored and is well documented by the number of International Agencies (European Union, International Agency for Research on Cancer, and World Health Organization). It has been proven as Group 1 carcinogen by International Agency for Research on Cancer. The Occupational Safety and Health Administration (OSHA) regulations declared it hazardous and have advocated its substitute.
In order to overcome various limitations of formaldehyde, many attempts were undertaken to explore a safer formalin substitute. Numerous commercially available substitutes were explored i.e., alcoholic formalin substitutes (Boon-fix, EthMeth, Kryo Fix, RCL 2, UMFix, etc.) and non-alcoholic formalin substitutes (DMS, Glyo-Fixx, HistoCHOICE, Safe Fix II, etc.). Most of these were expensive, flammable, or even toxic, and found inadequate for the demonstration of critical cellular components.
Honey is a natural product that has been valued for its unique nutritional and traditional medicinal properties since centuries. It is a natural product which constitutes about 200 constituents and is chiefly composed of sugar and water, of which sugar accounts for 95–99% of honey dry matter. The principal carbohydrate constituents of honey are fructose (32.56 to 38.2%) and glucose (28.54 to 31.3 %), others include many amino acids, vitamins, several minerals, trace elements, enzymes, ascorbic acid, hydrogen peroxide, etc. These constituents are responsible for the honey’s anti-oxidant, anti-microbial and anti-autolytic properties, and can prevent autolysis and putrefaction. It has been widely used for its therapeutic effects i.e., anti-microbial, anti-viral, anti-inflammatory, anti-oxidant effect, and also in wound healing, gastrointestinal tract & cardiovascular disease, diabetic patients, and certain neoplastic states. Honey has also been used for an embalming purpose since ancient times, and its high concentrations are observed suitable for museum studies.
Being natural, eco-friendly, and economical, the present research work was undertaken in the department to evaluate and explore the tissue fixative ability of honey and to determine its role in routine diagnostic pathology (histopathology and cytology).