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Sherman RA. Response to practice article, 'Phantom pain as an adverse effect after maggot ( Lucilia sericata) debridement therapy: a case study'. J Wound Care 2023; 32:193-194. [PMID: 36930192 DOI: 10.12968/jowc.2023.32.3.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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2
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Sahin E, Karaismailoglu B, Tutuncu MN, Polat E, Botanlioglu H. Maggot Treatment of Necrotic Toe Developed After Traumatic Subtotal Amputation. THE INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS 2023; 22:174-178. [PMID: 33626955 DOI: 10.1177/1534734621997283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Maggot debridement therapy (MDT) has been used for years in the treatment of chronic wounds and necrotic tissues. We report a case of subtotally amputated third toe that was treated with MDT after reattachment and developing complete necrosis. The necrotic toe was replaced with viable tissue and the wound healed completely after 2 weeks of MDT application. This case points out the regenerative effects of MDT besides its mechanical debridement effect on the necrotic tissue.
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Affiliation(s)
| | | | | | - Erdal Polat
- Istanbul University-Cerrahpasa, Istanbul, Turkey
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3
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Giacaman AG, Styliari ID, Taresco V, Pritchard D, Alexander C, Rose FRAJ. Development of bioactive electrospun scaffolds suitable to support skin fibroblasts and release Lucilia sericata maggot excretion/secretion. SN APPLIED SCIENCES 2022. [DOI: 10.1007/s42452-022-05209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractLarval therapy has been reported to be beneficial in the treatment of chronic wounds by promoting granulation tissue formation, due to its antimicrobial properties and by degrading necrotic tissue. However, the use of live maggots is problematic for patient acceptance, and thus there is a need to develop materials which can release therapeutic biomolecules derived from maggot secretions to the wound bed. Here we describe the fabrication of a novel bioactive scaffold that can be loaded with Lucilia sericata maggot alimentary excretion/secretion fluids (L. sericata maggot E/S), and which can also provide structural stability for mammalian cell-growth and migration to support wound repair. Electrospun scaffolds were prepared from a poly(caprolactone)-poly(ethylene glycol)–block copolymer (PCL-b-PEG) blended with PCL with average fibre diameters of ~ 4 μm. The scaffolds were hydrophilic and were able to support viable fibroblasts that were able to infiltrate throughout the extent of the scaffold thickness. L. sericata maggot (E/S) was subsequently adsorbed to the surface and released over 21 days with retention of the protease activity that is responsible for supporting fibroblast migration. The incorporation of L. sericata maggot E/S on the surface of the electrospun fibres of PCL-PEG/PCL fibres is a novel approach with potential for future application to support skin wound healing within a clinical setting.
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Lema C, Baidouri H, Sun M, Pohl S, Cookson S, Redfern R, McDermott AM. Anti-inflammatory and wound healing potential of medicinal maggot excretions/secretions at the ocular surface. Ocul Surf 2022; 26:244-254. [PMID: 36130696 DOI: 10.1016/j.jtos.2022.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE In the skin, Lucilia sericata maggot excretions/secretions (ES) accelerate wound healing and limit inflammation. This study aimed to determine whether ES have similar beneficial effects at the ocular surface. METHODS Human corneal epithelial cells (HCEC) were cultured with ES and cell viability was determined by the MTT assay. Additionally, mRNA expression of growth factors, antimicrobial peptides (AMPs) and cytokines was assessed by qPCR. ES ability to modulate TLR-induced IL-6 and IL-8 expression was determined by qPCR and ELISA. ES potential to promote corneal healing was evaluated in vitro by a migration assay in HCEC, and in vivo using a mouse model. RESULTS ES did not impair HCEC viability up to 25 μg/ml. Among the factors evaluated, only hBD-2 was upregulated (2.5-fold) by 1.5 μg/ml ES after 6 hrs (P = 0.04). In HCEC, ES reduced Poly I:C-induced IL-6 and IL-8 mRNA (P ≤ 0.001) and protein (P ≤ 0.0001) expression. A similar effect was observed with Flagellin (TLR5 agonist) but it was less robust for FSL-1 (TLR2/6 agonist) and Pam3CSK4 (TLR1/2 agonist). The greatest in vitro migration effect was observed with 6.2 μg/ml ES after 44 hrs where gap area compared to vehicle was 53.3 ± 3.7% vs. 72.6 ± 5.4% (P = 0.001). In the mouse model, the maximum healing effect was present with 1.5 μg/ml ES after 12 hrs with a wound area of 19.0 ± 2.7% vs. 60.1 ± 21.6% (P = 0.003) or 77% reduction of the wound area compared to the negative control. CONCLUSIONS ES significantly reduce in vitro TLR-induced production of inflammatory cytokines and promote corneal wound healing.
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Affiliation(s)
- Carolina Lema
- University of Houston, College of Optometry, Houston, TX, 77204, USA
| | - Hasna Baidouri
- University of Houston, College of Optometry, Houston, TX, 77204, USA
| | - Mingxia Sun
- University of Houston, College of Optometry, Houston, TX, 77204, USA
| | - Susanne Pohl
- Department of Applied Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Sharon Cookson
- Department of Applied Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Rachel Redfern
- University of Houston, College of Optometry, Houston, TX, 77204, USA.
| | - Alison M McDermott
- University of Houston, College of Optometry, Houston, TX, 77204, USA; Department of Applied Sciences, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
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Yoshida T, Aonuma H, Otsuka S, Ichimura H, Saiki E, Hashimoto K, Ote M, Matsumoto S, Iwadate K, Miyawaki T, Kanuka H. A human tissue-based assay identifies a novel carrion blowfly strain for maggot debridement therapy. Sci Rep 2022; 12:12191. [PMID: 35842442 PMCID: PMC9288425 DOI: 10.1038/s41598-022-16253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
Maggot debridement therapy (MDT) is a form of therapeutic wound treatment in which live fly larvae are used intentionally to debride necrotic tissues. MDT has been widely used to treat chronic wounds in humans or animals, such as diabetic foot ulcers. Larvae of a carrion blowfly, Lucilia sericata (green bottle fly), debride wounds by consuming necrotic tissue and removing pathogenic bacteria, promoting effective wound healing. Most medical L. sericata strains were initially collected from natural environments using animal meat as bait and reared on artificial protein-rich media or ground meat. It remains to be examined which strain would be more appropriate for MDT, whereas any method for evaluating the fly’s therapeutic potential in humans has not been available. A feeding assay was developed using minced human tissues obtained from surgical waste. To establish L. sericata strains highly eligible for MDT, carrion fly larvae were collected from 45 corpses subjected to forensic autopsy (such as decomposed bodies). Four corpse-derived L. sericata strains were obtained and evaluated using the feeding assay. One strain showed that its feeding activity was 1.4 times higher than the control strain used in conventional MDT. The body length of the adult fly of the corpse-derived strain was longer than the control, which was consistent with the observation that its cell size was enlarged. The human tissue-based assay developed in this study accurately evaluated the ability of fly larvae to debride necrotic wounds. The L. sericata strain newly established from human corpses harboring high feeding activity may offer a clinically significant improvement in MDT.
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Affiliation(s)
- Takuma Yoshida
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroka Aonuma
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan
| | - Saori Otsuka
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetoshi Ichimura
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan
| | - Erisha Saiki
- Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan.,Laboratory Animal Facilities, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosei Hashimoto
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan
| | - Manabu Ote
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan
| | - Sari Matsumoto
- Department of Forensic Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kimiharu Iwadate
- Department of Forensic Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Miyawaki
- Department of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hirotaka Kanuka
- Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan. .,Center for Medical Entomology, The Jikei University School of Medicine, Tokyo, Japan.
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Limb Salvage with Multiple Modalities: A Case Report of a Diabetic Heel Ulcer Associated with Peripheral Arterial Disease. Adv Skin Wound Care 2022; 35:1-5. [PMID: 35723963 DOI: 10.1097/01.asw.0000831072.30829.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A large diabetic heel ulcer with peripheral arterial disease is an independent predictor of limb loss; below-knee amputation is not uncommon in such cases. One treatment is multimodal therapy, which includes partial calcanectomy. Because there is a limit to the ulcer surface area that can be sutured after partial calcanectomy, the remaining raw surface is treated with another method. In this case report, the authors describe a patient with peripheral arterial disease who had a 7 × 9-cm diabetic heel ulcer. The patient was treated with partial calcanectomy after catheter-based endovascular therapy revascularization and then maggot therapy after residual-wound dimensions were reduced by negative-pressure wound therapy.
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7
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Ongarora BG. Recent technological advances in the management of chronic wounds: A literature review. Health Sci Rep 2022; 5:e641. [PMID: 35601031 PMCID: PMC9117969 DOI: 10.1002/hsr2.641] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Wound treatment comprises a substantial portion of the healthcare budgets in developed countries. Studies suggest that about 50% of patients admitted to hospitals have wounds, while 1%−2% of the general population in the developed world suffers from chronic wounds. Chronic wounds fail to repair themselves within the expected period of 30 days. Technologies have been developed to address challenges encountered during wound care with the aim of alleviating pain, promoting healing, or controlling wound infections. Objective The objective of this study was to explore the technological improvements that have been made in this field over time. Methods To gain insight into the future of wound management, a systematic review of literature on the subject was conducted in scientific databases (PubMed, Scopus, Web of Science, Medline, and Clinical Trials). Results and Discussion Results indicate that wound dressings have evolved from the traditional cotton gauze to composite materials embedded with appropriate ingredients such as metal‐based nanoparticles. Studies on biodegradable dressing materials are also underway to explore their applicability in dressing large and irregular wounds. On the other hand, conventional drugs and traditional formulations for the management of pain, inflammation, infections, and accelerating healing have been developed. However, more research needs to be carried out to address the issue of microbial resistance to drugs. Drugs for managing other ailments also need to be designed in such a way that they can augment wound healing. In addition, it has been demonstrated that a coordinated integration of conventional and traditional medicine can produce laudable results in chronic wound management. Conclusion Accordingly, collaborative efforts and ingenuity of all players in the field can accelerate technological advances in the wound care market to the benefit of the patients. Wounds affect about 50% of patients admitted to hospitals.
Technologies have been developed including biodegradable dressing materials to address underlying challenges.
Technological advancement, rising incidences of chronic wounds, growing government support, and a rising elderly population will drive wound market growth.
A careful combination of recent research outputs can greatly change wound care technologies.
This review highlights the recent research advances and opportunities in the wound care field.
The future lies in biodegradable dressing materials, probably embedded with selected nanoparticles and which shall be combined in predetermined ratios.
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Affiliation(s)
- Benson G. Ongarora
- Department of Chemistry Dedan Kimathi University of Technology Nyeri Kenya
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Abdel-Samad MRK, Taher FA. Wound healing and antibacterial activities of water-soluble chitosan nanoparticles and excretion/secretion as a natural combination from medicinal maggots, Lucilia cuprina. J BIOACT COMPAT POL 2021. [DOI: 10.1177/08839115211053921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Wounds management takes a high interest in the medical field and the addition of antimicrobial agents in an assortment of wound dressings leads to delay the wound healing. This study aimed at preparing natural combination between excretion/secretion (ES) and water-soluble chitosan nanoparticles (from Lucilia cuprina maggots) and investigating its antibacterial and wound healing activities. ES of maggots was collected, and the water-soluble chitosan nanoparticles (WSCNPs) were prepared and characterized. Antibacterial activities of combinations were evaluated against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Proteus vulgaris. ES-WSC-2 combination that contains 50% ES and 1% WSCNPs showed highest antibacterial activity against all tested bacteria compared to the other combinations. In vitro, the ES-WSC-2 combination was used to study the wound healing activity by scratch assay. The synergism between ES and WSCNPs (in ES-WSC-2 combination) accelerated the wound healing rate which suggests the use of this combination as an effective natural antibacterial and wound healing agent.
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Affiliation(s)
- Mohammad RK Abdel-Samad
- Department of Zoology and Entomology, Faculty of Science, Al-Azhar University, Cairo, Egypt
- Al-Azhar Technology Incubator (ATI), Al-Azhar University, Cairo, Egypt
| | - Fatma A Taher
- Al-Azhar Technology Incubator (ATI), Al-Azhar University, Cairo, Egypt
- Department of Chemistry, Faculty of Science, Al-Azhar University (Girls), Cairo, Egypt
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Gazi U, Taylan-Ozkan A, Mumcuoglu KY. The effect of Lucilia sericata larval excretion/secretion (ES) products on cellular responses in wound healing. MEDICAL AND VETERINARY ENTOMOLOGY 2021; 35:257-266. [PMID: 33314340 DOI: 10.1111/mve.12497] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Chronic wounds are still regarded as a serious public health concern, which are on the increase mainly due to the changes in life styles and aging of the human population. There are different types of chronic wounds, each of which requires slightly different treatment strategies. Nevertheless, wound bed preparation is included in treatment of all types of chronic wounds and involves tissue debridement, inflammation, and infection control, as well as moisture balance and epithelial edge advancement. Maggot therapy (MT) is a form of biological debridement which involves the application of live medical grade Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae) larvae. Whereas it was initially thought to act mainly through debridement, today MT is known to influence all four overlapping physiological phases of wound repair: homeostasis, inflammation, proliferation, and remodelling/maturing. During MT, medical-grade larvae are applied either freely or enclosed in tea-bag like devices (biobag) inside the wounds, which suggests that larva excretion/secretion (ES) products can facilitate the healing processes directly without the need of direct contact with the larvae. This review summarizes the relevant literature on ES-mediated effects on the cellular responses involved in wound healing.
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Affiliation(s)
- U Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - A Taylan-Ozkan
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - K Y Mumcuoglu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Tombulturk FK, Kanigur-Sultuybek G. A molecular approach to maggot debridement therapy with Lucilia sericata and its excretions/secretions in wound healing. Wound Repair Regen 2021; 29:1051-1061. [PMID: 34343386 DOI: 10.1111/wrr.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/15/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing by initiating a direct signal cascade with cells in the wound area. However, the enzymes and peptides in ES are mostly still undefined. Examining the molecular content of ES and the biological effects of these ingredients is quite important to illuminate the molecular mechanism underlying MDT. More importantly, ES has the potential to have positive effects on wound healing and to be used more as a therapeutic agent in the future, so it can be applied as an alternative to MDT in wound healing.
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Affiliation(s)
- Fatma Kubra Tombulturk
- Medical Laboratory Techniques, Vocational School of Health Services, Istinye University, Istanbul, Turkey
| | - Gonul Kanigur-Sultuybek
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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11
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Maeda T, Yamamoto Y, Murao N, Hayashi T, Kimura C, Matsui S, Saito T, Matsui H, Osawa M, Funayama E. Maggot debridement therapy in critical limb ischaemia: a case study. J Wound Care 2021; 29:S28-S32. [PMID: 33320762 DOI: 10.12968/jowc.2020.29.sup12.s28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In critical limb ischaemia (CLI), first-line therapy is revascularisation, but alternative treatment options are needed in certain cases. Maggot debridement therapy (MDT) is historically considered to be contraindicated in ischaemic ulcers. Wound care in patients with CLI is becoming increasingly diverse with the development of novel revascularisation strategies; therefore, CLI now needs to be reconsidered as an indication for MDT. METHOD We retrospectively reviewed five legs with CLI (five male, one female) treated with MDT between January 2013 and December 2017. Changes in skin perfusion pressure (SPP) around the ulcer before and after MDT were evaluated. One or two cycles of MDT were performed (eight in total). We also evaluated the proportion of necrotic tissue in the ulcer and the presence of exposed necrotic bone. The proportion of necrotic tissue in the ulcer was classified as NT 1+ (<25%), NT 2+ (25-50%), NT 3+ (50-75%) or NT 4+ (>75%). RESULTS When the proportion of necrotic tissue was >50%, with no exposed necrotic bone in the wound, an increase in SPP was observed after five (62.5%) of eight cycles of MDT. And with a proportion of necrotic tissue of <25% and/or exposed necrotic bone in the wound, a decrease in SPP was observed after three (37.5%) of eight cycles. Wound healing was accelerated in the presence of increased SPP. CONCLUSION Effective MDT with increased SPP requires an ulcerative state of necrotic tissue grade > NT 3+, with no exposed necrotic bone.
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Affiliation(s)
- Taku Maeda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Yuhei Yamamoto
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Naoki Murao
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Toshihiko Hayashi
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Chu Kimura
- Department of Plastic and Reconstructive Surgery, Hakodate General Central Hospital, Hokkaido, Japan
| | - Suguru Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Tatsuya Saito
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Hotaka Matsui
- Center of Limb Salvage and Wound Care, Souen Central Hospital, Sapporo, Hokkaido, Japan
| | - Masayuki Osawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Emi Funayama
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
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Sayed AM, Saleh NM, El‐Gaby MSA, Abdel‐Samad MRK, Taher FA. Synthesis and in vivo evaluation of novel benzimidazole‐sulfonamide hybrids and
Lucilia cuprina
maggots' excretion/secretion topical gels for wound healing. J CHIN CHEM SOC-TAIP 2021. [DOI: 10.1002/jccs.202000418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Asmaa M. Sayed
- Department of Chemistry, Faculty of Science Al‐Azhar University (Girls) Cairo Egypt
| | - Nashwa M. Saleh
- Department of Chemistry, Faculty of Science Al‐Azhar University (Girls) Cairo Egypt
| | - Mohamed S. A. El‐Gaby
- Department of Chemistry, Faculty of Science Al‐Azhar University at Assiut Assiut Egypt
| | - Mohammad R. K. Abdel‐Samad
- Department of Zoology and Entomology, Faculty of Science Al‐Azhar University Cairo Egypt
- Al‐Azhar Technology Incubator (ATI) Al‐Azhar University Cairo Egypt
| | - Fatma A. Taher
- Department of Chemistry, Faculty of Science Al‐Azhar University (Girls) Cairo Egypt
- Al‐Azhar Technology Incubator (ATI) Al‐Azhar University Cairo Egypt
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13
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Isabela Avila-Rodríguez M, Meléndez-Martínez D, Licona-Cassani C, Manuel Aguilar-Yañez J, Benavides J, Lorena Sánchez M. Practical context of enzymatic treatment for wound healing: A secreted protease approach (Review). Biomed Rep 2020; 13:3-14. [PMID: 32440346 PMCID: PMC7238406 DOI: 10.3892/br.2020.1300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
Skin wounds have been extensively studied as their healing represents a critical step towards achieving homeostasis following a traumatic event. Dependent on the severity of the damage, wounds are categorized as either acute or chronic. To date, chronic wounds have the highest economic impact as long term increases wound care costs. Chronic wounds affect 6.5 million patients in the United States with an annual estimated expense of $25 billion for the health care system. Among wound treatment categories, active wound care represents the fastest-growing category due to its specific actions and lower costs. Within this category, proteases from various sources have been used as successful agents in debridement wound care. The wound healing process is predominantly mediated by matrix metalloproteinases (MMPs) that, when dysregulated, result in defective wound healing. Therapeutic activity has been described for animal secretions including fish epithelial mucus, maggot secretory products and snake venom, which contain secreted proteases (SPs). No further alternatives for use, sources or types of proteases used for wound healing have been found in the literature to date. Through the present review, the context of enzymatic wound care alternatives will be discussed. In addition, substrate homology of SPs and human MMPs will be compared and contrasted. The purpose of these discussions is to identify and propose the stages of wound healing in which SPs may be used as therapeutic agents to improve the wound healing process.
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Affiliation(s)
| | - David Meléndez-Martínez
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León 64849, Mexico
| | | | - José Manuel Aguilar-Yañez
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León 64849, Mexico
- Scicore Medical SAPI de CV, Monterrey, Nuevo León 64920, Mexico
| | - Jorge Benavides
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo León 64849, Mexico
| | - Mirna Lorena Sánchez
- Laboratorio de Materiales Biotecnológicos, Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes-Imbice-Conicet-Cicpba, Bernal, Buenos Aires B1876BXD, Argentina
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Jonika MM, Hjelmen CE, Faris AM, McGuane AS, Tarone AM. An Evaluation of Differentially Spliced Genes as Markers of Sex for Forensic Entomology,. J Forensic Sci 2020; 65:1579-1587. [PMID: 32501598 DOI: 10.1111/1556-4029.14461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022]
Abstract
Blow flies (Calliphoridae) are important medically and economically and are commonly used in forensics as temporal markers in death investigations. While phenotypic traits in adult flies can be sexually dimorphic, sex identification in immatures is difficult. Consequently, little is known about how sex may result in developmental disparities among sexes even though there are indications that they may be important in some instances. Since genetic mechanisms for sex are well studied in model flies and species of agricultural and medical importance, we exploit the sex-specifically spliced genes transformer (tra) and doublesex (dsx) in the sex determination pathway to optimize a sex identification assay for immatures. Using known primer sets for tra and with a novel one for dsx, we develop PCR assays for identifying sex in four forensically relevant Calliphoridae species: Lucilia sericata (Meigen), Lucilia cuprina (Wiedemann), Cochliomyia macellaria (Fabricius), and Chrysomya rufifacies (Macquart) and evaluated their performance. Band detection rates were found to range from 71 to 100%, call rates ranged from 90 to 100%, and no error was found when bands could be called. Such information is informative for purposes of testimony and in preparation for development studies. The developed assays will assist in further differentiating sexually dimorphic differences in development of the Calliphoridae and aid in more accurately estimating insect age when age predictive markers (size, development time, molecular expression) are sexually dimorphic.
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Affiliation(s)
- Michelle M Jonika
- Department of Entomology, Texas A&M AgriLife Extension Service, Texas A&M University, 2475 TAMU, 370 Olsen Blvd., College Station, TX, 77843.,Department of Biology, Texas A&M University, 3258 TAMU, 525 Lubbock St., College Station, TX, 77843.,Genetics Interdisciplinary Program, Texas A&M University, 2128 TAMU, 300 Olsen Blvd., College Station, TX, 77843
| | - Carl E Hjelmen
- Department of Entomology, Texas A&M AgriLife Extension Service, Texas A&M University, 2475 TAMU, 370 Olsen Blvd., College Station, TX, 77843.,Department of Biology, Texas A&M University, 3258 TAMU, 525 Lubbock St., College Station, TX, 77843
| | - Ashleigh M Faris
- Department of Entomology, Texas A&M AgriLife Extension Service, Texas A&M University, 2475 TAMU, 370 Olsen Blvd., College Station, TX, 77843.,Texas A&M AgriLife Research and Extension Center, Texas A&M University, 10345 TX-44, Corpus Christi, TX, 78406
| | - Alexander S McGuane
- Department of Entomology, Texas A&M AgriLife Extension Service, Texas A&M University, 2475 TAMU, 370 Olsen Blvd., College Station, TX, 77843.,Harris County Institute of Forensic Sciences, 1861 Old Spanish Trail, Houston, TX, 77054
| | - Aaron M Tarone
- Department of Entomology, Texas A&M AgriLife Extension Service, Texas A&M University, 2475 TAMU, 370 Olsen Blvd., College Station, TX, 77843
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15
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Bazaliński D, Kózka M, Karnas M, Więch P. Effectiveness of Chronic Wound Debridement with the Use of Larvae of Lucilia Sericata. J Clin Med 2019; 8:E1845. [PMID: 31684038 PMCID: PMC6912827 DOI: 10.3390/jcm8111845] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023] Open
Abstract
The process of successful wound healing depends on effective debridement and infection control. One method of wound debridement, known since antiquity, is based on the use of fly larvae. Solid scientific evidence proves that maggot debridement therapy (MDT), like surgical intervention, can be effectively and safely used to remove necrotic tissue. Based on a review of the related literature, this study was designed to assess the effectiveness of chronic wound cleansing with the use of larvae of Lucilia sericata (Phaenicia sericata). Maggot therapy, applied in wound debridement and treatment, is a safe and effective method. Its benefits are associated with debridement, disinfection and faster tissue growth. MDT may reduce the duration of antibiotic therapy and the need for hospitalization, or it may decrease the number of outpatient visits required. It is a relatively cost-effective method, and, in addition to financial gains, it may reduce the frequency of inpatient treatment. In the literature, an increasing amount of scientific evidence confirms that such treatment can effectively reduce the biofilm and bacterial load in a wound.
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Affiliation(s)
- Dariusz Bazaliński
- Father B. Markiewicz Podkarpackie Specialist Oncology Centre, Specialist Hospital in Brzozów, 36-200 Brzozów, Poland.
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland.
| | - Maria Kózka
- Department of Clinical Nursing, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, 31-501 Krakow, Poland.
| | - Magdalena Karnas
- New Medical Technologies, Holy Family Specialist Hospital, 36-060 Rudna Mała, Poland.
| | - Paweł Więch
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland.
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16
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Yakovlev AY, Kruglikova AA, Chernysh SI. Calliphoridae Flies in Medical Biotechnology. ACTA ACUST UNITED AC 2019. [DOI: 10.1134/s0013873819030023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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17
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Nishijima A, Gosho M, Yoshida R, Yanagibayashi S, Takikawa M, Nishijima J, Sekido M, Yamamoto N. Effective wound bed preparation using maggot debridement therapy for patients with critical limb ischaemia. J Wound Care 2019; 26:483-489. [PMID: 28795888 DOI: 10.12968/jowc.2017.26.8.483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Patients with critical limb ischaemia (CLI) lack sufficient blood flow in to the limb, which leads to difficulties in the normal wound healing process. Therefore, maggot debridement therapy (MDT) has not generally been recommended for CLI patients. We evaluated the effectiveness of wound bed preparation by MDT in CLI patients who had undergone mid-foot amputation. METHODS Patients who underwent mid-foot amputation after angioplasty between April 2014 and October 2016 were retrospectively investigated by classifying them into an MDT group or a conventional treatment group. The primary outcome was defined as achievement of wound healing. Secondary outcomes were the proportions of amputation-free survival (AFS) and successful ambulatory improvement. Propensity scores were used to evaluate treatment outcomes based on five factors: ankle-brachial index, skin perfusion pressure of the foot, nutritional status, experience with dialysis and age. RESULTS A total of 39 patients (39 legs) were included, seven within the MDT group and 32 in the conventional treatment group. Clinical backgrounds of the two groups showed no significant differences except for higher albumin levels for the MDT group (3.5±0.4g/dl; p=0.014). The wound healing proportion was significantly higher in the MDT group (86%) than in the control group (38%) (p=0.035). At 6 months after amputation, no significant differences were found between the two groups for AFS (71% versus 47%; p=0.41) or ambulatory capability (43% versus 28%; p=0.65). This result was also similar to the propensity score adjustment analysis. CONCLUSIONS The efficacy of MDT with favourable wound bed preparation was shown in our CLI patients based on effective debridement and granulation formation by maggots, avoiding the loss of their heels. Wound-healing rates after MDT were higher for patients than for those receiving conventional treatment. MDT is considered a valid adjuvant treatment strategy for patients with CLI after revascularisation treatment is conducted. More favourable wound bed preparation and successful graft take were achieved in the MDT group, suggesting the effectiveness of MDT for wound healing in CLI patients.
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Affiliation(s)
- A Nishijima
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
| | - M Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8576, Japan
| | - R Yoshida
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
| | - S Yanagibayashi
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
| | - M Takikawa
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
| | - J Nishijima
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
| | - M Sekido
- Department of Plastic and Reconstructive Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
| | - N Yamamoto
- Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
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18
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Téllez GA, Zapata JA, Toro LJ, Henao DC, Bedoya JP, Rivera JD, Trujillo JV, Rivas-Santiago B, Hoyos RO, Castano JC. Identification, Characterization, Immunolocalization, and Biological Activity of Lucilin Peptide. Acta Trop 2018; 185:318-326. [PMID: 29890152 DOI: 10.1016/j.actatropica.2018.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
Maggots from the Lucilia sp. genus are used for debridement of infected and necrotic wounds. Broad-spectrum antimicrobial activity has been described in the excretion/secretions (ES1) of these larvae. This study identifies the genetic sequence of a cecropin-like antimicrobial peptide from Lucilia eximia. Total RNA was extracted and used for PCR-RACE amplification of a cecropin, the native peptide was immunolocalized in the tissues and secretions of the larvae, and a synthetic analog was used to explore its antimicrobial, cytotoxic, LPS neutralizing and wound-healing activities in vitro. The genetic cDNA sequence of a cecropin-like antimicrobial peptide in L. eximia called "Lucilin" was amplified, corresponding to 63 aa completed protein and 40 aa mature peptide; the structure of the mature peptide was predicted as an α-helix. The peptide was immunolocalized in the salivary glands, fat body, the ES, and hemolymph of the maggots. Lucilin synthetic peptide analog was active against E. coli DH10B with a MIC2 of 7.8 μg/mL, E. coli extended spectrum b-lactamase (ESBL) (MIC: 15.6 μg/mL), and Enterobacter cloacae (MIC: 125 μg/mL), but it was not active against Pseudomonas aeruginosa and Staphylococcus epidermidis; and had no cytotoxic or hemolytic activity. It showed immunomodulatory activity against human peripheral blood mononuclear cells (PBMCs) stimulated with LPS, reducing the TNF-α production when treated at 17 μg/mL and induces cell migration of Hacat at 5 and 50 μg/mL. Lucilin is a cecropin-like peptide from L. eximia with antimicrobial activity against Gram negative bacteria and immunomodulatory activities, decreasing the TNF-α production in PBMCs and inducing cellular migration in human keratinocytes.
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19
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Pharmacological Properties of the Medical Maggot: A Novel Therapy Overview. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:4934890. [PMID: 29853956 PMCID: PMC5960508 DOI: 10.1155/2018/4934890] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/05/2018] [Indexed: 02/01/2023]
Abstract
In the last decade, maggot has been hailed as the miraculous “medicinal maggot” for its diverse properties, including antimicrobial, antibiofilm, anti-inflammatory, and wound healing activities. The fact that maggots show so many beneficial properties has increased the interest in these tiny larvae dramatically. Whilst there is relatively abundant clinical evidence to demonstrate the success of maggots as debridement agents, not so much emphasis has been placed on the basic science evidence, which was a combination of physical and biochemical actions. This review differs from those earlier works in that it is undertaken to provide an update of the latest scientific basis published on maggot, particularly active ingredients within maggot excretions/secretions (ES). Further investigations should focus on the isolation, identification, recombination, transgenosis, and mass production of the beneficial molecules within maggots.
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20
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Dauros Singorenko P, Rosario R, Windsor JA, Phillips AR, Blenkiron C. The transcriptional responses of cultured wound cells to the excretions and secretions of medicinal Lucilia sericata larvae. Wound Repair Regen 2018; 25:51-61. [PMID: 27868332 DOI: 10.1111/wrr.12499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/10/2016] [Accepted: 11/18/2016] [Indexed: 12/17/2022]
Abstract
Maggots, through their excretions and secretions (ES), promote wound healing by removing necrotic tissue, counter bacterial infection, and activate wound associated cells. We investigated the effects of a physiological dose of maggot ES on four wound-associated cell types in vitro with Affymetrix gene expression arrays; keratinocytes, endothelial cells, fibroblasts, and monocytes. Keratinocytes showed the fewest (n = 5; p < 0.05, fold-change ±2) and smallest fold-changes (up to 2.32×) in gene expression and conversely THP1 monocytes had the most (n = 233) and greatest magnitude (up to 44.3×). There were no genes that were altered in all four cell-lines. Gene pathway analysis identified an enrichment of immune response pathways in three of the treated cell-lines. Analyses by quantitative RT-PCR found many genes dynamically expressed in ES dose dependent manner during the three day treatments. Phenotype analyses, however, found no effects of ES on cell viability, proliferation, migration and angiogenesis. ES was 100× less potent at triggering IL-8 secretion than fibroblasts treated with purified bacterial lipopolysaccharide (LPS; in equivalent amounts to that found in ES; ∼40 EU/ml). Furthermore, co-treatment with LPS and ES decreased the LPS-alone triggered IL-8 secretion by 13%. Although ES had no direct effect on wound cell phenotypes it did partially reduce the immune response to bacterial LPS exposure. These observations were consistent with the profile of transcriptional responses that were dominated by modulation of immune response genes. Maggot therapy may therefore improve wound healing through the secondary effects of these gene changes in the wound cells.
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Affiliation(s)
- Priscila Dauros Singorenko
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences.,Department of Surgery, Faculty of Medical and Health Sciences
| | - Roseanne Rosario
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences
| | - John A Windsor
- Department of Surgery, Faculty of Medical and Health Sciences.,Maurice Wilkins Centre for Biodiscovery, University of Auckland
| | - Anthony R Phillips
- Department of Surgery, Faculty of Medical and Health Sciences.,Maurice Wilkins Centre for Biodiscovery, University of Auckland.,School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Cherie Blenkiron
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences.,Department of Surgery, Faculty of Medical and Health Sciences.,School of Biological Sciences, University of Auckland, Auckland, New Zealand
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21
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YAMAN MEHMET, ZEREK AYKUT. MİYAZ SİNEKLERİ LARVALARININ YARA TEDAVİSİNDE KULLANILMASI. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2017. [DOI: 10.17944/mkutfd.311929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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22
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Nasoori A, Hoomand R. Maggot debridement therapy for an electrical burn injury with instructions for the use of Lucilia sericata larvae. J Wound Care 2017; 26:734-741. [DOI: 10.12968/jowc.2017.26.12.734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- A. Nasoori
- Student, Pasteur Institute of Iran, Production and Research Complex, Biotechnology Processes Developing Center, Alborz, Iran; Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - R. Hoomand
- General Surgeon, Department of General Surgery, Motahari Burn Hospital, Iran University of Medical Sciences, Tehran, Iran
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23
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Pickles SF, Pritchard DI. Endotoxin testing of a wound debridement device containing medicinal Lucilia sericata larvae. Wound Repair Regen 2017; 25:498-501. [PMID: 28419727 DOI: 10.1111/wrr.12539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/20/2017] [Indexed: 01/15/2023]
Abstract
Alimentary products of medicinal Lucilia sericata larvae are studied to determine their mechanisms of action, particularly in the contexts of wound debridement and disinfection. Furthermore, the larvae can be applied to patients in contained medical devices (such as the BioBag; BioMonde). Here, we tested the materials and larval content of the most commonly used debridement device (the "BB-50") to explore the possibility that endotoxins may be contributing to the bio-activity of the product, given that endotoxins are potent stimulants of cellular activation. Using standardised protocols to collect larval alimentary products (LAP), we proceeded to determine residual endotoxin levels in LAP derived from the device, before and after the neutralisation of interfering enzymatic activity. The debridement device and its associated larval content was not a significant source of lipopolysaccharide (LPS) activity. However, it is clear from these experiments that a failure to remove the confounding serine proteinase activity would have resulted in spuriously high and erroneous results. The residual LPS levels detected are unlikely to be active in wound healing assays, following cross-referencing to publications where LPS at much higher levels has been shown to have positive and negative effects on processes associated with wound repair and tissue regeneration.
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Affiliation(s)
- Samantha F Pickles
- The University of Nottingham, Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Boots Science Building, University Park Nottingham NG7 2RD
| | - David I Pritchard
- The University of Nottingham, Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Boots Science Building, University Park Nottingham NG7 2RD
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24
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Baumann A, Skaljac M, Lehmann R, Vilcinskas A, Franta Z. Urate Oxidase produced by Lucilia sericata medical maggots is localized in Malpighian tubes and facilitates allantoin production. INSECT BIOCHEMISTRY AND MOLECULAR BIOLOGY 2017; 83:44-53. [PMID: 28235562 DOI: 10.1016/j.ibmb.2017.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/20/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
Lucilia sericata maggots are the only species currently approved for maggot debridement therapy (MDT), an alternative treatment for chronic and recalcitrant wounds. Maggots promote wound debridement, disinfection and healing by producing a complex mixture of proteins, peptides and low-molecular-weight compounds in their secretions and excretions, but the individual components are not well characterized at the molecular level. Here we investigated the purine catabolism pathway in L. sericata, focusing on the production of allantoin by Urate Oxidase (UO), which is thought to promote wound healing. We produced recombinant L. sericata UO in Escherichia coli, and characterized the properties of the pure enzyme in terms of the optimum pH (7-10) and temperature (20-25 °C), its stability, sensitivity to inhibition and ion dependency. We used quantitative RT-PCR and RNA in situ hybridization to monitor the expression of the UO gene, and we used a guinea pig anti-UO antibody to detect the native enzyme by western blot and by florescence immunohistochemistry in larval tissues. We found that L. sericata UO is exclusively present in the larval excretion organ (the Malpighian tubes) and is freely available in the cytoplasm rather than restricted to a specific subcellular compartment. Allantoin is a final product of L. sericata purine catabolism. It is produced by UO in the Malpighian tubes to remove uric acid from the hemolymph and is consequently excreted via the hindgut. Our findings confirm the hypothesis that both actively secreted molecules and excretion products contribute to the beneficial effects of MDT.
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Affiliation(s)
- Andre Baumann
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstraße 2, 35394 Giessen, Germany
| | - Marisa Skaljac
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstraße 2, 35394 Giessen, Germany
| | - Rüdiger Lehmann
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstraße 2, 35394 Giessen, Germany
| | - Andreas Vilcinskas
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstraße 2, 35394 Giessen, Germany; Justus-Liebig-University of Giessen, Institute for Insect Biotechnology, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany
| | - Zdenӗk Franta
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstraße 2, 35394 Giessen, Germany.
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25
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Mirabzadeh A, Ladani M, Imani B, Rosen S, Sherman R. Maggot therapy for wound care in Iran: a case series of the first 28 patients. J Wound Care 2017; 26:137-143. [DOI: 10.12968/jowc.2017.26.3.137] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Mirabzadeh
- Assistant Professor, Department of Entomology, Iranian Research Organization for Science And Technology (IROST), Tehran, Iran
| | - M.J. Ladani
- Assistant Professor of Orthopaedic Surgery, University of Medical Sciences, Tehran, Iran
| | - B. Imani
- Expert, Department of Entomology, Department of Entomology, Iranian Research Organization for Science And Technology (IROST), Tehran, Iran
| | - S.A.B. Rosen
- Medical Resident, University of California, San Diego, California, US
| | - R.A. Sherman
- Director BioTherapeutics, BioTherapeutics, Education & Research (BTER) Foundation, Irvine, California, US
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26
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Pereira RF, Bártolo PJ. Traditional Therapies for Skin Wound Healing. Adv Wound Care (New Rochelle) 2016; 5:208-229. [PMID: 27134765 DOI: 10.1089/wound.2013.0506] [Citation(s) in RCA: 243] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Significance: The regeneration of healthy and functional skin remains a huge challenge due to its multilayer structure and the presence of different cell types within the extracellular matrix in an organized way. Despite recent advances in wound care products, traditional therapies based on natural origin compounds, such as plant extracts, honey, and larvae, are interesting alternatives. These therapies offer new possibilities for the treatment of skin diseases, enhancing the access to the healthcare, and allowing overcoming some limitations associated to the modern products and therapies, such as the high costs, the long manufacturing times, and the increase in the bacterial resistance. This article gives a general overview about the recent advances in traditional therapies for skin wound healing, focusing on the therapeutic activity, action mechanisms, and clinical trials of the most commonly used natural compounds. New insights in the combination of traditional products with modern treatments and future challenges in the field are also highlighted. Recent Advances: Natural compounds have been used in skin wound care for many years due to their therapeutic activities, including anti-inflammatory, antimicrobial, and cell-stimulating properties. The clinical efficacy of these compounds has been investigated through in vitro and in vivo trials using both animal models and humans. Besides the important progress regarding the development of novel extraction methods, purification procedures, quality control assessment, and treatment protocols, the exact mechanisms of action, side effects, and safety of these compounds need further research. Critical Issues: The repair of skin lesions is one of the most complex biological processes in humans, occurring throughout an orchestrated cascade of overlapping biochemical and cellular events. To stimulate the regeneration process and prevent the wound to fail the healing, traditional therapies and natural products have been used with promising results. Although these products are in general less expensive than the modern treatments, they can be sensitive to the geographic location and season, and exhibit batch-to-batch variation, which can lead to unexpected allergic reactions, side effects, and contradictory clinical results. Future Directions: The scientific evidence for the use of traditional therapies in wound healing indicates beneficial effects in the treatment of different lesions. However, specific challenges remain unsolved. To extend the efficacy and the usage of natural substances in wound care, multidisciplinary efforts are necessary to prove the safety of these products, investigate their side effects, and develop standard controlled trials. The development of good manufacturing practices and regulatory legislation also assume a pivotal role in order to improve the use of traditional therapies by the clinicians and to promote their integration into the national health system. Current trends move to the development of innovative wound care treatments, combining the use of traditional healing agents and modern products/practices, such as nanofibers containing silver nanoparticles, Aloe vera loaded into alginate hydrogels, propolis into dressing films, and hydrogel sheets containing honey.
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Affiliation(s)
- Rúben F. Pereira
- Centre for Rapid and Sustainable Product Development (CDRsp), Polytechnic Institute of Leiria, Marinha Grande, Portugal
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Paulo J. Bártolo
- Centre for Rapid and Sustainable Product Development (CDRsp), Polytechnic Institute of Leiria, Marinha Grande, Portugal
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Pöppel AK, Kahl M, Baumann A, Wiesner J, Gökçen A, Beckert A, Preissner KT, Vilcinskas A, Franta Z. A Jonah-like chymotrypsin from the therapeutic maggot Lucilia sericata plays a role in wound debridement and coagulation. INSECT BIOCHEMISTRY AND MOLECULAR BIOLOGY 2016; 70:138-147. [PMID: 26773746 DOI: 10.1016/j.ibmb.2015.11.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/27/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
Lucilia sericata larvae are used in maggot debridement therapy, a traditional wound healing approach that has recently been approved for the treatment of chronic wounds. Maggot excretion products (MEP) contain many different proteases that promote disinfection, debridement and the acceleration of wound healing, e.g. by activating the host contact phase/intrinsic pathway of coagulation. In order to characterise relevant procoagulant proteases, we analysed MEP and identified a chymotrypsin-like serine protease with similarities to Jonah proteases from Drosophila melanogaster and a chymotrypsin from Lucilia cuprina. A recombinant form of the L. sericata Jonah chymotrypsin was produced in Escherichia coli. The activated enzyme (Jonahm) had a pH optimum of 8.0 and a temperature optimum of 37 °C, based on the cleavage of the chromogenic peptide s-7388 and casein. Jonahm reduced the clotting time of human plasma even in the absence of the endogenous protease kallikrein, factor XI or factor XII and digested the extracellular matrix proteins fibronectin, laminin and collagen IV, suggesting a potential mechanism of wound debridement. Based on these characteristics, the novel L. sericata chymotrypsin-like serine protease appears to be an ideal candidate for the development of topical drugs for wound healing applications.
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Affiliation(s)
- Anne-Kathrin Pöppel
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany
| | - Mareike Kahl
- Institute for Biochemistry, Medical School, Justus-Liebig-University, Friedrichstrasse 24, 35392, Giessen, Germany
| | - Andre Baumann
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany
| | - Jochen Wiesner
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany
| | - Anke Gökçen
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany
| | - Annika Beckert
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany
| | - Klaus T Preissner
- Institute for Biochemistry, Medical School, Justus-Liebig-University, Friedrichstrasse 24, 35392, Giessen, Germany
| | - Andreas Vilcinskas
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany; Institute for Insect Biotechnology, Justus-Liebig-University, Heinrich-Buff-Ring 26-32, 35392, Giessen, Germany
| | - Zdeněk Franta
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Winchesterstrasse 2, 35394, Giessen, Germany.
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28
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Sun X, Chen J, Zhang J, Wang W, Sun J, Wang A. Maggot debridement therapy promotes diabetic foot wound healing by up-regulating endothelial cell activity. J Diabetes Complications 2016; 30:318-22. [PMID: 26782021 DOI: 10.1016/j.jdiacomp.2015.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 11/07/2015] [Accepted: 11/09/2015] [Indexed: 01/10/2023]
Abstract
To determine the role of maggot debridement therapy (MDT) on diabetic foot wound healing, we compared growth related factors in wounds before and after treatment. Furthermore, we utilized human umbilical vein endothelial cells (HUVECs) to explore responses to maggot excretions/secretions on markers of angiogenesis and proliferation. The results showed that there was neo-granulation and angiogenesis in diabetic foot wounds after MDT. Moreover, significant elevation in CD34 and CD68 levels was also observed in treated wounds. In vitro, ES increased HUVEC proliferation, improved tube formation, and increased expression of vascular endothelial growth factor receptor 2 in a dose dependent manner. These results demonstrate that MDT and maggot ES can promote diabetic foot wound healing by up-regulating endothelial cell activity.
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Affiliation(s)
- Xinjuan Sun
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China
| | - Jin'an Chen
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China
| | - Jie Zhang
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China
| | - Wei Wang
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China
| | - Jinshan Sun
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China
| | - Aiping Wang
- Department of Endocrinology, The 454th Hospital of PLA, Nanjing, 210002, PR China.
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Nigam Y, Morgan C. Does maggot therapy promote wound healing? The clinical and cellular evidence. J Eur Acad Dermatol Venereol 2015; 30:776-82. [DOI: 10.1111/jdv.13534] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/30/2015] [Indexed: 01/27/2023]
Affiliation(s)
- Y. Nigam
- College of Human and Health Sciences; Swansea University; Swansea UK
| | - C. Morgan
- College of Medicine; Swansea University; Swansea UK
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Baumann A, Lehmann R, Beckert A, Vilcinskas A, Franta Z. Selection and Evaluation of Tissue Specific Reference Genes in Lucilia sericata during an Immune Challenge. PLoS One 2015; 10:e0135093. [PMID: 26252388 PMCID: PMC4529112 DOI: 10.1371/journal.pone.0135093] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022] Open
Abstract
The larvae of the common green bottle fly Lucilia sericata (Diptera: Calliphoridae) have been used for centuries to promote wound healing, but the molecular basis of their antimicrobial, debridement and healing functions remains largely unknown. The analysis of differential gene expression in specific larval tissues before and after immune challenge could be used to identify key molecular factors, but the most sensitive and reproducible method qRT-PCR requires validated reference genes. We therefore selected 10 candidate reference genes encoding products from different functional classes (18S rRNA, 28S rRNA, actin, β-tubulin, RPS3, RPLP0, EF1α, PKA, GAPDH and GST1). Two widely applied algorithms (GeNorm and Normfinder) were used to analyze reference gene candidates in different larval tissues associated with secretion, digestion, and antimicrobial activity (midgut, hindgut, salivary glands, crop and fat body). The Gram-negative bacterium Pseudomonas aeruginosa was then used to boost the larval immune system and the stability of reference gene expression was tested in comparison to three immune genes (lucimycin, defensin-1 and attacin-2), which target different pathogen classes. We observed no differential expression of the antifungal peptide lucimycin, whereas the representative targeting Gram-positive bacteria (defensin-1) was upregulated in salivary glands, crop, nerve ganglion and reached its maximum in fat body (up to 300-fold). The strongest upregulation in all immune challenged tissues (over 50,000-fold induction in the fat body) was monitored for attacin-2, the representative targeting Gram-negative bacteria. Here we identified and validated a set of reference genes that allows the accurate normalization of gene expression in specific tissues of L. sericata after immune challenge.
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Affiliation(s)
- Andre Baumann
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
| | - Rüdiger Lehmann
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
| | - Annika Beckert
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
| | - Andreas Vilcinskas
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
- Institute of Phytopathology and Applied Zoology, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Zdeněk Franta
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Giessen, Germany
- * E-mail:
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Chirino MG, Rossi LF, Bressa MJ, Luaces JP, Merani MS. Comparative study of mitotic chromosomes in two blowflies, Luciliasericata and L.cluvia (Diptera, Calliphoridae), by C- and G-like banding patterns and rRNA loci, and implications for karyotype evolution. COMPARATIVE CYTOGENETICS 2015; 9:103-18. [PMID: 25893078 PMCID: PMC4387384 DOI: 10.3897/compcytogen.v9i1.8671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 12/22/2014] [Indexed: 05/27/2023]
Abstract
The karyotypes of Luciliacluvia (Walker, 1849) and Luciliasericata (Meigen, 1826) from Argentina were characterized using conventional staining and the C- and G-like banding techniques. Besides, nucleolus organizer regions (NORs) were detected by fluorescent in situ hybridization (FISH) and silver staining technique. The chromosome complement of these species comprises five pairs of autosomes and a pair of sex chromosomes (XX/XY, female/male). The autosomes of both species have the same size and morphology, as well as C- and G-like banding patterns. The X and Y chromosomes of Luciliacluvia are subtelocentric and easily identified due to their very small size. In Luciliasericata, the X chromosome is metacentric and the largest of the complement, showing a secondary constriction in its short arm, whereas the Y is submetacentric and smaller than the X. The C-banding patterns reflect differences in chromatin structure and composition between the subtelocentric X and Y chromosomes of Luciliacluvia and the biarmed sex chromosomes of Luciliasericata. These differences in the sex chromosomes may be due to distinct amounts of constitutive heterochromatin. In Luciliacluvia, the NORs are placed at one end of the long-X and of the long-Y chromosome arms, whereas one of the NORs is disposed in the secondary constriction of the short-X chromosome arm and the other on the long-Y chromosome arm in Luciliasericata. Although the G-like banding technique does not yield G-bands like those in mammalian chromosomes, it shows a high degree chromosomal homology in both species because each pair of autosomes was correctly paired. This chromosome similarity suggests the absence of autosomal rearrangements during karyotype evolution in the two species studied.
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Affiliation(s)
- Mónica G. Chirino
- Instituto de Ecología, Genética y Evolución de Buenos Aires, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, C1428EHA Ciudad Autónoma de Buenos Aires, Argentina
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - Luis F. Rossi
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - María J. Bressa
- Instituto de Ecología, Genética y Evolución de Buenos Aires, Departamento de Ecología, Genética y Evolución, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, C1428EHA Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan P. Luaces
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
| | - María S. Merani
- Laboratorio de Biología Cromosómica, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
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Blenkiron C, Tsai P, Brown LA, Tintinger V, Askelund KJ, Windsor JA, Phillips AR. Characterisation of the small RNAs in the biomedically important green-bottle blowfly Lucilia sericata. PLoS One 2015; 10:e0122203. [PMID: 25803701 PMCID: PMC4372549 DOI: 10.1371/journal.pone.0122203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 02/08/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The green bottle fly maggot, Lucilia sericata, is a species with importance in medicine, agriculture and forensics. Improved understanding of this species' biology is of great potential benefit to many research communities. MicroRNAs (miRNA) are a short non-protein coding regulatory RNA, which directly regulate a host of protein coding genes at the translational level. They have been shown to have developmental and tissue specific distributions where they impact directly on gene regulation. In order to improve understanding of the biology of L. sericata maggots we have performed small RNA-sequencing of their secretions and tissue at different developmental stages. RESULTS We have successfully isolated RNA from the secretions of L. sericata maggots. Illumina small RNA-sequencing of these secretions and the three tissues (crop, salivary gland, gut) revealed that the most common small RNA fragments were derived from ribosomal RNA and transfer RNAs of both insect and bacterial origins. These RNA fragments were highly specific, with the most common tRNAs, such as GlyGCC, predominantly represented by reads derived from the 5' end of the mature maggot tRNA. Each library also had a unique profile of miRNAs with a high abundance of miR-10-5p in the maggot secretions and gut and miR-8 in the food storage organ the crop and salivary glands. The pattern of small RNAs in the bioactive maggot secretions suggests they originate from a combination of saliva, foregut and hindgut tissues. Droplet digital RT-PCR validation of the RNA-sequencing data shows that not only are there differences in the tissue profiles for miRNAs and small RNA fragments but that these are also modulated through developmental stages of the insect. CONCLUSIONS We have identified the small-RNAome of the medicinal maggots L. sericata and shown that there are distinct subsets of miRNAs expressed in specific tissues that also alter during the development of the insect. Furthermore there are very specific RNA fragments derived from other non-coding RNAs present in tissues and in the secretions. This new knowledge has applicability in diverse research fields including wound healing, agriculture and forensics.
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Affiliation(s)
- Cherie Blenkiron
- Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Biodiscovery, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Peter Tsai
- Bioinformatics Institute, University of Auckland, Auckland, New Zealand
| | - Lisa A. Brown
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Vernon Tintinger
- Department of Anthropology, University of Auckland, Auckland, New Zealand
| | - Kathryn J. Askelund
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - John A. Windsor
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Biodiscovery, University of Auckland, Auckland, New Zealand
| | - Anthony R. Phillips
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Biodiscovery, University of Auckland, Auckland, New Zealand
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Li PN, Li H, Zhong LX, Sun Y, Yu LJ, Wu ML, Zhang LL, Kong QY, Wang SY, Lv DC. Molecular events underlying maggot extract promoted rat in vivo and human in vitro skin wound healing. Wound Repair Regen 2015; 23:65-73. [DOI: 10.1111/wrr.12243] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 11/24/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Pei-Nan Li
- Department of Orthopedic Surgery; First Clinical College; Dalian Medical University; Dalian China
| | - Hong Li
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Li-Xia Zhong
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Yuan Sun
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Li-Jun Yu
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Mo-Li Wu
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Lin-Lin Zhang
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Qing-You Kong
- Department of Cell Biology; College of Basic Medical Sciences; Dalian Medical University; Dalian China
| | - Shou-Yu Wang
- Department of Orthopedic Surgery; First Clinical College; Dalian Medical University; Dalian China
| | - De-Cheng Lv
- Department of Orthopedic Surgery; First Clinical College; Dalian Medical University; Dalian China
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Pinilla YT, Patarroyo MA, Velandia ML, Segura NA, Bello FJ. The effects of Sarconesiopsis magellanica larvae (Diptera: Calliphoridae) excretions and secretions on fibroblasts. Acta Trop 2015; 142:26-33. [PMID: 25445745 DOI: 10.1016/j.actatropica.2014.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 10/30/2014] [Accepted: 11/01/2014] [Indexed: 10/24/2022]
Abstract
Sarconesiopsis magellanica is a necrophagous blowfly which is relevant in both forensic and medical sciences. Previous studies regarding this species have led to understanding life-cycle, population and reproduction parameters, as well as identifying and characterising proteolytic enzymes derived from larval excretions and secretions (ES). As other studies have shown that ES proteolytic activity plays a significant role in wound healing and fibroblasts play a relevant role in granulation tissue formation during such healing, the present study was aimed at analysing the biological effect of S. magellanica larval ES on fibroblasts. ES were obtained from third-instar larvae and added to fibroblast cells at three concentrations (10, 5 and 1 μg/mL) to evaluate their behaviour. MTT assays were used for analysing cell proliferation and viability, whilst cell adhesion was measured by optical density with 10% SDS. Fibroblast migration and morphology was recorded by microscopic observation. ES did not affect fibroblast viability and induced an increase in cell proliferation; cell adhesion became reduced, whilst cell migration through extracellular matrix increased. ES also induced a decreased cell surface and morphological alterations. Changes in all the above-mentioned parameters were reduced when ES were incubated at 60 °C, probably due to protease denaturation. These results suggested that the proteases contained in S. magellanica larval ES contributed towards granulation tissue formation, increased cell migration and promoted cell proliferation. All these data support carrying out further experiments aimed at validating S. magellanica usefulness in larval therapy.
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36
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El-Tantawy NL. Helminthes and insects: maladies or therapies. Parasitol Res 2014; 114:359-77. [PMID: 25547076 DOI: 10.1007/s00436-014-4260-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 12/15/2014] [Indexed: 11/24/2022]
Abstract
By definition, parasites cause harm to their hosts. But, considerable evidence from ancient traditional medicine has supported the theory of using parasites and their products in treating many diseases. Maggots have been used successfully to treat chronic, long-standing, infected wounds which failed to respond to conventional treatment by many beneficial effects on the wound including debridement, disinfection, and healing enhancement. Maggots are also applied in forensic medicine to estimate time between the death and discovery of a corpse and in entomotoxicology involving the potential use of insects as alternative samples for detecting drugs and toxins in death investigations. Leeches are segmented invertebrates, famous by their blood-feeding habits and used in phlebotomy to treat various ailments since ancient times. Leech therapy is experiencing resurgence nowadays in health care principally in plastic and reconstructive surgery. Earthworms provide a source of medicinally useful products with potential antimicrobial, antiviral, and anticancer properties. Lumbrokinases are a group of fibrinolytic enzymes isolated and purified from earthworms capable of degrading plasminogen-rich and plasminogen-free fibrin and so can be used to treat various conditions associated with thrombotic diseases. Helminth infection has been proved to have therapeutic effects in both animal and human clinical trials with promising evidence in treating many allergic diseases and can block the induction of or reduce the severity of some autoimmune disorders as Crohn's disease or ulcerative colitis. What is more, venomous arthropods such as scorpions, bees, wasps, spiders, ants, centipedes, snail, beetles, and caterpillars. The venoms and toxins from these arthropods provide a promising source of natural bioactive compounds which can be employed in the development of new drugs to treat diseases as cancer. The possibility of using these active molecules in biotechnological processes can make these venoms and toxins a valuable and promising source of natural bioactive compounds. The therapeutic use of helminthes and insects will be of great value in biomedicine and further studies on insect toxins will contribute extensively to the development of Biomedical Sciences.
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Affiliation(s)
- Nora L El-Tantawy
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt,
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Abstract
Maggot debridement therapy is used extensively in the UK in both community and hospital situations, but remains a potentially under-used modality in many wound care markets. It promotes wound healing by performing three key processes: debridement, disinfection and growth-promoting activity. It can be used for the debridement of non-healing necrotic skin and soft tissue wounds, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers and non-healing traumatic of post-surgical wounds. With the increase in chronic diabetic foot wounds, maggot debridement therapy is a promising tool for health professionals dealing with difficult wounds. This article presents an overview of the research evidence surrounding maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future.
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Affiliation(s)
- Eric Shi
- Podiatric Medical Student, Western University of Health Sciences College of Podiatric Medicine, Pomona, CA, USA
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van der Plas MJA, Andersen AS, Nazir S, van Tilburg NH, Oestergaard PR, Krogfelt KA, van Dissel JT, Hensbergen PJ, Bertina RM, Nibbering PH. A novel serine protease secreted by medicinal maggots enhances plasminogen activator-induced fibrinolysis. PLoS One 2014; 9:e92096. [PMID: 24647546 PMCID: PMC3960166 DOI: 10.1371/journal.pone.0092096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 02/19/2014] [Indexed: 11/23/2022] Open
Abstract
Maggots of the blowfly Lucilia sericata are used for the treatment of chronic wounds. As haemostatic processes play an important role in wound healing, this study focused on the effects of maggot secretions on coagulation and fibrinolysis. The results showed that maggot secretions enhance plasminogen activator-induced formation of plasmin and fibrinolysis in a dose- and time-dependent manner. By contrast, coagulation was not affected by secretions. Biochemical studies indicated that a novel serine protease within secretions, designated Sericase, cleaved plasminogen to several fragments. Recombinant Sericase degraded plasminogen leading amongst others to the formation of the mini-plasminogen like fragment Val454-plasminogen. In addition, the presence of a non-proteolytic cofactor in secretions was discovered, which plays a role in the enhancement of plasminogen activator-induced fibrinolysis by Sericase. We conclude from our in vitro studies that the novel serine protease Sericase, with the aid of a non-proteolytic cofactor, enhances plasminogen activator-induced fibrinolysis.
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Affiliation(s)
- Mariena J. A. van der Plas
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Anders S. Andersen
- Department of Microbiology and Infection Control, Statens Serum Institute, Copenhagen, Denmark
- Novozymes A/S, Bagsvaerd, Denmark
- Copenhagen Wound Healing Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - Sheresma Nazir
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands
| | - Nico H. van Tilburg
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Karen A. Krogfelt
- Department of Microbiology and Infection Control, Statens Serum Institute, Copenhagen, Denmark
| | - Jaap T. van Dissel
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul J. Hensbergen
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Rogier M. Bertina
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter H. Nibbering
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands
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Sherman RA. Mechanisms of maggot-induced wound healing: what do we know, and where do we go from here? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:592419. [PMID: 24744812 PMCID: PMC3976885 DOI: 10.1155/2014/592419] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/15/2014] [Indexed: 12/18/2022]
Abstract
MEDICINAL MAGGOTS ARE BELIEVED TO HAVE THREE MAJOR MECHANISMS OF ACTION ON WOUNDS, BROUGHT ABOUT CHEMICALLY AND THROUGH PHYSICAL CONTACT: debridement (cleaning of debris), disinfection, and hastened wound healing. Until recently, most of the evidence for these claims was anecdotal; but the past 25 years have seen an increase in the use and study of maggot therapy. Controlled clinical studies are now available, along with laboratory investigations that examine the interaction of maggot and host on a cellular and molecular level. This review was undertaken to extract the salient data, make sense, where possible, of seemingly conflicting evidence, and reexamine our paradigm for maggot-induced wound healing. Clinical and laboratory data strongly support claims of effective and efficient debridement. Clinical evidence for hastened wound healing is meager, but laboratory studies and some small, replicated clinical studies strongly suggest that maggots do promote tissue growth and wound healing, though it is likely only during and shortly after the period when they are present on the wound. The best way to evaluate-and indeed realize-maggot-induced wound healing may be to use medicinal maggots as a "maintenance debridement" modality, applying them beyond the point of gross debridement.
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Affiliation(s)
- Ronald A. Sherman
- BioTherapeutics, Education & Research (BTER) Foundation, 36 Urey Court, Irvine, CA 92617, USA
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Mudge E, Price P, Walkley N, Neal W, Harding KG. A randomized controlled trial of larval therapy for the debridement of leg ulcers: results of a multicenter, randomized, controlled, open, observer blind, parallel group study. Wound Repair Regen 2013; 22:43-51. [PMID: 24299513 DOI: 10.1111/wrr.12127] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 09/09/2013] [Indexed: 12/01/2022]
Abstract
It has been known for centuries that the application of larvae is useful to heal certain wounds by facilitating debridement of necrotic tissue,(1) yet the efficacy of larval therapy continues to be debatable. This study compared the clinical effectiveness of a larval therapy dressing (BioFOAM) with a standard debridement technique (Purilon gel; hydrogel) in terms of time to debridement of venous (VLU) or mixed arterial/venous (MLU) leg ulcers. Data analyses were conducted on 88 subjects. Sixty-four subjects completed the full study. Of these, 31 of the 32 (96.9%) patients who completed treatment in the larvae arm debrided fully, compared with 11 of the 32 (34.4%) patients who completed the hydrogel arm. In addition, 42 (48%) ulcers fully debrided within the 21-day intervention phase, 31 (67.4%) from the larvae arm (n = 46), and 11 (26.2%) from the hydrogel arm (n = 42), which was statistically significant (p = 0.001) in support of larvae. A statistically significant difference was also observed between treatment arms with regard to numbers of dressing changes during the intervention phase of the study (p < 0.001) in that subjects in the larvae arm required significantly fewer dressing changes(mean = 2.83) than those in the hydrogel arm (mean = 5.40). There were no statistically significant differences in the clinical condition of the wound bed and surrounding skin by intervention. Subjects in the larvae arm experienced more ulcer-related pain or discomfort than subjects in the hydrogel arm (p < 0.001). This study provided good evidence to show that larval therapy, in the form of a BioFOAM dressing, debrided VLU and MLU considerably more quickly than a hydrogel, although the possibility of resloughing should be closely monitored.
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Affiliation(s)
- Elizabeth Mudge
- Wound Healing Research Unit, Cardiff University School of Medicine, Cardiff, United Kingdom
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Pinilla YT, Moreno-Pérez DA, Patarroyo MA, Bello FJ. Proteolytic activity regarding Sarconesiopsis magellanica (Diptera: Calliphoridae) larval excretions and secretions. Acta Trop 2013; 128:686-91. [PMID: 24076089 DOI: 10.1016/j.actatropica.2013.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 09/06/2013] [Accepted: 09/18/2013] [Indexed: 11/16/2022]
Abstract
Sarconesiopsis magellanica (Diptera: Calliphoridae) is a medically important necrophagous fly which is used for establishing the post-mortem interval. Diptera maggots release proteolytic enzymes contained in larval excretion and secretion (ES) products playing a key role in digestion. Special interest in proteolytic enzymes has also been aroused regarding understanding their role in wound healing since they degrade necrotic tissue during larval therapy. This study was thus aimed at identifying and characterising S. magellanica proteolytic enzyme ES products for the first time. These products were obtained from first-, second- and third-instar larvae taken from a previously-established colony. ES proteins were separated by SDS-PAGE and their proteolytic activity was characterised by zymograms and inhibition assays involving BAPNA (Nα-benzoyl-dl-Arg-p-nitroanilide) and SAPNA substrates, using synthetic inhibitors. The protein profile ranged from ∼69kDa to ∼23kDa; several of them coincided with the Lucilia sericata ES protein profile. Serine-protease hydrolysis activity (measured by zymogram) was confirmed when a ∼25kDa band disappeared upon ES incubation with PMSF inhibitor at pH 7.8. Analysis of larval ES proteolytic activity on BAPNA and SAPNA substrates (determined by using TLCK and TPCK specific inhibitors) suggested a greater amount of trypsin-like protease. These results support the need for further experiments aimed at validating S. magellanica use in larval therapy.
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Affiliation(s)
- Yudi T Pinilla
- Medical and Forensic Entomology Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
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Pritchard D, Nigam Y. Maximising the secondary beneficial effects of larval debridement therapy. J Wound Care 2013; 22:610-11, 614-6. [DOI: 10.12968/jowc.2013.22.11.610] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Y. Nigam
- College of Human and Health Sciences, Swansea University, Swansea, UK
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Cazander G, Pritchard DI, Nigam Y, Jung W, Nibbering PH. Multiple actions ofLucilia sericatalarvae in hard-to-heal wounds. Bioessays 2013; 35:1083-92. [DOI: 10.1002/bies.201300071] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Gwendolyn Cazander
- Department of Surgery; Bronovo Hospital; The Hague The Netherlands
- Department of Surgery; Leiden University Medical Center; Leiden The Netherlands
| | | | - Yamni Nigam
- College of Human and Health Sciences; Swansea University; Swansea UK
| | | | - Peter H. Nibbering
- Department of Infectious Diseases; Leiden University Medical Center; Leiden The Netherlands
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Rafter L. Larval therapy applied to a large arterial ulcer: an effective outcome. ACTA ACUST UNITED AC 2013; 22:S24, S26-30. [PMID: 23587971 DOI: 10.12968/bjon.2013.22.sup4.s24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article is a review of larval therapy and includes a case study that uses larval therapy in the treatment of complex leg ulcer wounds. Complex wounds require careful management from the multidisciplinary team and present clinicians with intricate challenges to save the limb. Wound-bed preparation and debridement needs to be as effective and non-traumatic as possible for the patient. Larval therapy removes the devitalised tissue effectively with minimal tissue trauma. This case study reports on a patient with a non-progressing, full-thickness wound with exposed tendon following reconstructive surgery at a local vascular unit. The patient was left with very limited treatment options, as traditional dressings for the arterial ulcer nearly resulted in amputation due to the deterioration in the wound. As part of the patient's management, she was treated with larval therapy in an attempt to salvage her limb. This article follows the progress of complex leg ulcer wounds employing BioFoam® dressing (BioMonde, Bridgend) for larvae debridement therapy over a 4-week period and incorporating five applications of three BioFoam dressing bags. This care pathway ensured the patient's safety by promoting effective wound healing with the larval therapy leading to excellent clinical patient outcomes.
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Abstract
Supported by the NHS Lymphoedema Service Administrator, this article reports on a project undertaken by a clinical nurse specialist in Lymphoedema (CNS) and in part fulfilment of an MSc in Skin integrity skills and treatment, achieved from the University of Hertfordshire, September 2011. The need for the project was generated by the 5-day delay experienced by terminally ill patients in a hospice while waiting to receive treatment for lymphorrhoea from the community-based CNS. The training and assessment of healthcare assistants in a cost-effective treatment enabled the instigation of care within 3 hours of the development of lymphorrhoea in a patient and an evaluation of its competent delivery.
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Morgan C, Nigam Y. Naturally derived factors and their role in the promotion of angiogenesis for the healing of chronic wounds. Angiogenesis 2013; 16:493-502. [DOI: 10.1007/s10456-013-9341-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 02/11/2013] [Indexed: 12/21/2022]
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Strohal R, Dissemond J, Jordan O’Brien J, Piaggesi A, Rimdeika R, Young T, Apelqvist J. EWMA Document: Debridement: An updated overview and clarification of the principle role of debridement. J Wound Care 2013; 22 Suppl:S1-S52. [DOI: 10.12968/jowc.2013.22.sup1.s1] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- R Strohal
- Department of Dermatology and Venerology, Federal University Teaching Hospital Feldkirch, Feldkirch, Austria
| | - J Dissemond
- Clinic of Dermatology, Venerology and Allercology, Essen University Hospital, Germany
| | - J Jordan O’Brien
- Centre of Education,Beaumont Hospital,Beaumont Road, Dublin, Ireland
| | - A Piaggesi
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
| | - R Rimdeika
- Kaunas University Hospital, Department of Plastic and Reconstructive Surgery, Lithuania; Lithuanian University of Health Sciences, Faculty of Medicine, Lithuania
| | - T Young
- Bangor University, North Wales, United Kingdom
| | - J Apelqvist
- Department of Endocrinology, University Hospital of Malmö, Sweden
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Telford G, Brown AP, Rich A, English JSC, Pritchard DI. Wound debridement potential of glycosidases of the wound-healing maggot, Lucilia sericata. MEDICAL AND VETERINARY ENTOMOLOGY 2012; 26:291-299. [PMID: 22620282 DOI: 10.1111/j.1365-2915.2011.01000.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The wound-healing maggot, Lucilia sericata Meigen (Diptera: Calliphoridae), degrades extracellular matrix components by releasing enzymes. The purpose of this study was to investigate the glycosylation profiles of wound slough/eschar from chronic venous leg ulcers and the complementary presence of glycosidase activities in first-instar excretions/secretions (ES1) and to define their specificities. The predominant carbohydrate moieties present in wound slough/eschar were determined by probing one-dimensional Western blots with conjugated lectins of known specificities. The presence of specific glycosidase activities in ES1 was determined using chromogenic and fluorogenic substrates. The removal of carbohydrate moieties from slough/eschar proteins by glycosidases in ES1 was determined by two-dimensional electrophoresis and Emerald 300 glycoprotein staining. α-D-glucosyl, α-D-mannosyl and N-acetylglucosamine residues were detected on slough/eschar-derived proteins. Furthermore, it was demonstrated that the treatment of slough/eschar with ES1 significantly reduced uptake of the carbohydrate-specific stain. Subsequently, α-D-glucosidase, α-D-mannosidase and N-acetylglucosaminidase activities were identified in ES1. Specific chromogenic and fluorogenic substrates and gel filtration chromatography showed that these activities result from distinct enzymes. These activities were mirrored in the removal of α-D-glucosyl, α-D-mannosyl and N-acetylglucosamine residues from proteins of slough/eschar from maggot-treated wounds. These data suggest that maggot glycosidases remove sugars from slough/eschar proteins. This may contribute to debridement, which is ultimately accomplished by a suite of biochemically distinct enzymes present in ES1.
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Affiliation(s)
- G Telford
- Immune Modulation Research Group, School of Pharmacy, University of Nottingham, Nottingham, UK.
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Wang SY, Wang JN, Lv DC, Diao YP, Zhang Z. Clinical research on the bio-debridement effect of maggot therapy for treatment of chronically infected lesions. Orthop Surg 2012; 2:201-6. [PMID: 22009949 DOI: 10.1111/j.1757-7861.2010.00087.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the bio-debridement effect of maggot therapy for treating chronically infected lesions. METHODS A retrospective study was conducted of 25 patients with diabetic foot ulcers and 18 patients with pressure ulcers after spinal cord injury treated by maggot therapy or traditional dressing. Changes in the lesions were observed and bacterial cultures tested. RESULTS All ulcers healed completely. The times taken to achieve bacterial negativity, granulation and healing of lesions were all significantly shorter in the maggot therapy group than in the control group, both for diabetic foot ulcers (P < 0.05) and pressure ulcers (P < 0.05). CONCLUSION Maggot therapy is a safe and effective method for treating chronically infected lesions.
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Affiliation(s)
- Shou-yu Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian, China
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