Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.

Introduction: This report aimed to assess the effects of administration of Tualang honey for six months duration on the haematological and immunological parameters in treatment-naïve HIV-infected patients who were asymptomatic. Methods: This was a randomised, controlled, open-labelled study. A total of 95 asymptomatic HIV-positive subjects with low CD4 counts of 250-600 cells/mm3 and not on antiretroviral therapy were recruited. Tualang honey was administered at 20 g each, once daily (HLD; total of 20 g honey), twice daily (HID; total of 40 g honey) or thrice daily (HHD; total of 60 g honey) for six months period. Control (CT) group did not receive any honey supplementation. Haematological and immunological parameters were measured at baseline, three-month and six-month follow-up. The differences within the group (time effect) and between the groups (regardless of time) for all four groups were analysed using Repeated Measures ANOVA followed by a post-hoc test. Results: A significant reduction in total white blood cell, neutrophil and lymphocyte counts were observed at six-month follow-up in CT and HLD groups when compared to baseline. The immunological parameters showed similar trend of reduction in the CT and HLD groups. Meanwhile, the measured parameters were relatively maintained in HID and HHD groups at six-month period when compared to baseline. Conclusion: Tualang honey supplementation at intermediate and high doses for six months delay the deterioration of haematological and immunological parameters in asymptomatic, treatment-naïve HIV subjects.