1
|
Coombes J, Gammon J, Nigam Y. Maggot therapy for resistant infections: the disconnect between scientific evidence, clinical acceptance and practice. J Wound Care 2024; 33:495-507. [PMID: 38967338 DOI: 10.12968/jowc.2021.0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
OBJECTIVE Practitioners and scientists are re-examining marginalised wound care therapies to find strategies that combat the growing problem of antimicrobial resistance (AMR) without compromising patient outcomes. Maggot therapy (MT) makes up just an estimated 0.02% of UK's National Health Service spending on wound care. This study aims to uncover why MT is not used more often, despite its affordability and high level of efficacy for both debridement and disinfection, particularly in the context of AMR infections, and to determine what can be done to ensure MT is more effectively used in the future to improve patient outcomes and manage the growing problem of AMR. METHOD For this investigation, a qualitative review of case studies using MT against AMR infections and a quantitative analysis of randomised control trials (RCTs) were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. RESULTS Analysis showed that MT is highly effective against a range of infections and wound types, and compares well against conventional therapies. The low use of MT may be due in part to the documented 'yuck factor', often associated with maggots as well as misconceptions around the cost, efficacy and accessibility of MT. To overcome these factors, more RCTs on the spectrum and efficacy of MT across various clinical manifestations are needed, as well as professional and public engagement campaigns. CONCLUSION MT is an underused therapy, particularly regarding AMR infections, and expanding its use in these circumstances appears warranted. MT could play a vital role in conserving the efficacy of the existing pool of antimicrobials available and should be considered in the development of antimicrobial stewardship programmes. DECLARATION OF INTEREST This work was supported by the Swansea Employability Academy, Swansea University (internal funding). The authors have no conflicts of interest to declare.
Collapse
Affiliation(s)
- Joseph Coombes
- School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, Wales
| | - John Gammon
- School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, Wales
| | - Yamni Nigam
- School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, Wales
| |
Collapse
|
2
|
Romeyke T. Use of biosurgery for the treatment of foot ulcers infected with therapy-resistant bacteria: a case report. J Wound Care 2024; 33:lxxxv-xc. [PMID: 38588057 DOI: 10.12968/jowc.2024.33.sup4a.lxxxv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Biosurgery (larval therapy) has been used for centuries. However, in recent times, this treatment has been replaced with the use of antibiotics for the treatment of wounds. Due to increasing antibiotic resistance, larval therapy is once again coming to the fore as an effective and efficient treatment. Due to the increasing ageing population, along with an increase in patients with arterial occlusive disease, diabetes and immobility, the number of patients with hard-to-heal wounds will increase. The stressors associated with wounds, such as pain, limited physical functionality, depression and social withdrawal, have a negative impact on patient quality of life. This case report documents the performance of biosurgery in a patient with multimorbidities.
Collapse
Affiliation(s)
- Tobias Romeyke
- 1 University of Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Health Care, Austria
- 2 Waldhausklinik, Acute Hospital for Internal Medicine, Pain Therapy, Complementary and Individualized Patient Centred Medicine, Deuringen, Germany
| |
Collapse
|
3
|
Bauer IL. The oral repellent - science fiction or common sense? Insects, vector-borne diseases, failing strategies, and a bold proposition. Trop Dis Travel Med Vaccines 2023; 9:7. [PMID: 37381000 DOI: 10.1186/s40794-023-00195-9] [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: 12/21/2022] [Accepted: 06/09/2023] [Indexed: 06/30/2023] Open
Abstract
Over the last decades, unimaginable amounts of money have gone into research and development of vector control measures, repellents, treatment, and vaccines for vector borne diseases. Technological progress and scientific breakthroughs allowed for ever more sophisticated and futuristic strategies. Yet, each year, millions of people still die or suffer from potentially serious consequences of malaria or dengue to more recent infections, such as zika or chikungunya, or of debilitating consequences of neglected tropical diseases. This does not seem value for money. In addition, all current vector control strategies and personal protection methods have shortcomings, some serious, that are either destructive to non-target species or unsatisfactory in their effectiveness. On the other hand, the rapid decline in insect populations and their predators reflects decades-long aggressive and indiscriminate vector control. This major disruption of biodiversity has an impact on human life not anticipated by the well-meaning killing of invertebrates. The objective of this paper is to re-examine current control methods, their effectiveness, their impact on biodiversity, human and animal health, and to call for scientific courage in the pursuit of fresh ideas. This paper brings together topics that are usually presented in isolation, thereby missing important links that offer potential solutions to long-standing problems in global health. First, it serves as a reminder of the importance of insects to human life and discusses the few that play a role in transmitting disease. Next, it examines critically the many currently employed vector control strategies and personal protection methods. Finally, based on new insights into insect chemo-sensation and attractants, this perspective makes a case for revisiting a previously abandoned idea, the oral repellent, and its use via currently successful methods of mass-application. The call is out for focused research to provide a powerful tool for public health, tropical medicine, and travel medicine.
Collapse
Affiliation(s)
- Irmgard L Bauer
- College of Healthcare Sciences, Academy - Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia.
| |
Collapse
|
4
|
Morris D, Flores M, Harris L, Gammon J, Nigam Y. Larval Therapy and Larval Excretions/Secretions: A Potential Treatment for Biofilm in Chronic Wounds? A Systematic Review. Microorganisms 2023; 11:microorganisms11020457. [PMID: 36838422 PMCID: PMC9965881 DOI: 10.3390/microorganisms11020457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
Chronic wounds present a global healthcare challenge and are increasing in prevalence, with bacterial biofilms being the primary roadblock to healing in most cases. A systematic review of the to-date knowledge on larval therapy's interaction with chronic-wound biofilm is presented here. The findings detail how larval therapy-the controlled application of necrophagous blowfly larvae-acts on biofilms produced by chronic-wound-relevant bacteria through their principle pharmacological mode of action: the secretion and excretion of biologically active substances into the wound bed. A total of 12 inclusion-criteria-meeting publications were identified following the application of a PRISMA-guided methodology for a systematic review. The findings of these publications were qualitatively analyzed to provide a summary of the prevailing understanding of larval therapy's effects on bacterial biofilm. A further review assessed the quality of the existing evidence to identify knowledge gaps and suggest ways these may be bridged. In summary, larval therapy has a seemingly unarguable ability to inhibit and degrade bacterial biofilms associated with impaired wound healing. However, further research is needed to clarify and standardize the methodological approach in this area of investigation. Such research may lead to the clinical application of larval therapy or derivative treatments for the management of chronic-wound biofilms and improve patient healing outcomes at a time when alternative therapies are desperately needed.
Collapse
Affiliation(s)
- Daniel Morris
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea SA2 8PP, UK
- BioMonde, Bridgend CF31 3BG, UK
| | | | - Llinos Harris
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea SA2 8PP, UK
| | - John Gammon
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea SA2 8PP, UK
| | - Yamni Nigam
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea SA2 8PP, UK
- Correspondence:
| |
Collapse
|
5
|
Yang L, Rong GC, Wu QN. Diabetic foot ulcer: Challenges and future. World J Diabetes 2022; 13:1014-1034. [PMID: 36578870 PMCID: PMC9791573 DOI: 10.4239/wjd.v13.i12.1014] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetic foot ulcers (DFUs) have become one of the important causes of mortality and morbidity in patients with diabetes, and they are also a common cause of hospitalization, which places a heavy burden on patients and society. The prevention and treatment of DFUs requires multidisciplinary management. By controlling various risk factors, such as blood glucose levels, blood pressure, lipid levels and smoking cessation, local management of DFUs should be strengthened, such as debridement, dressing, revascularization, stem cell decompression and oxygen therapy. If necessary, systemic anti-infection treatment should be administered. We reviewed the progress in the clinical practice of treating DFUs in recent years, such as revascularization, wound repair, offloading, stem cell transplantation, and anti-infection treatment. We also summarized and prospectively analyzed some new technologies and measurements used in the treatment of DFUs and noted the future challenges and directions for the development of DFU treatments.
Collapse
Affiliation(s)
- Li Yang
- Department of Endocrinology, Dazu Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| | - Gui-Chuan Rong
- Department of Gynaecology, Dazu Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| | - Qi-Nan Wu
- Department of Endocrinology, Dazu Hospital of Chongqing Medical University, The People's Hospital of Dazu, Chongqing 402360, China
| |
Collapse
|
6
|
Hopkins RC, Williams S, Brown A, Humphreys I, Clifford R, Nigam Y. Evaluating nursing opinion and perception of maggot therapy for hard-to-heal wound management. J Wound Care 2022; 31:846-863. [PMID: 36240799 DOI: 10.12968/jowc.2022.31.10.846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Maggot therapy (MT) or larval debridement therapy is a recognised, effective but underutilised treatment for the management of hard-to-heal wounds and infected ulcers. It is available on NHS prescription in the UK, where wound management is predominantly nurse-led. Anecdotal reports and published literature suggest that nurses may be reluctant to utilise the therapy. The aim of this study was to evaluate the feelings and opinions of nurses regarding the use of MT. METHOD The first stage of this mixed-methods study was a focus group held to discuss MT and opinions of specialist nurse clinicians. Next, an anonymised web-based online survey was launched through the Nursing Times journal and distributed through social media targeting all nurses. Finally, in-depth interviews were held with specialist and generalist nurses. RESULTS Awareness of MT among all nurses was extremely high. A breakdown of results showed that MT was much more highly regarded by wound specialist nurses than non-wound specialist nurses. The latter exhibited a greater level of reluctance to administer the therapy, with almost one-third of these nurses surveyed saying they found maggots disgusting and that the idea of MT made their skin crawl. In-depth interviews revealed that a lack of knowledge about MT was a prime concern. CONCLUSION Wound specialist nurses are more likely to embrace MT than non-wound nurse specialists, who report a varying degree of wariness to MT. Our study highlights a need for better education and training in MT for all nurses, to address issues with acceptance and willingness to treat or help treat patients with hard-to-heal wounds which are suitable for MT.
Collapse
Affiliation(s)
- Ruth Cn Hopkins
- Public Health and Health Promotion, Faculty of Medicine, Health and Life Sciences, Swansea University, UK
| | - Sharon Williams
- School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, UK
| | - Amy Brown
- Public Health, Policy and Social Sciences, Faculty of Medicine, Health and Life Sciences, Swansea University, UK
| | - Ioan Humphreys
- Health and Wellbeing Academy, School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, UK
| | - Rebecca Clifford
- History Department, Faculty of Arts and Humanities, Durham University, UK
| | - Yamni Nigam
- School of Health and Social Care, Faculty of Medicine, Health and Life Sciences, Swansea University, UK
| |
Collapse
|
7
|
Song M, Bai X, Wang D, Wang Q, Pan L, He P, Gong Y, Sun X, Xu X, Che J, Wang S. Combined application of moist exposed burn ointment and maggot therapy in wound healing. J Wound Care 2022; 31:S41-S52. [DOI: 10.12968/jowc.2022.31.sup10.s41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Hard-to-heal wounds are a global health challenge, and effective treatments are still lacking. Moist exposed burn ointment (MEBO) and maggots are traditional treatments for promoting wound healing. This study was a preliminary exploration of combined maggot therapy and MEBO in the treatment of hard-to-heal wounds. Method: A coexistence experiment was conducted to determine the survival rates of maggots in MEBO. The maggots were placed in two different existence conditions: one set in MEBO (MEBO group), and another set as the control group (no MEBO) to compare survival rates. Case reports describe the use of the combined application of MEBO and maggots in the treatment of patients with hard-to-heal wounds. Results: The coexistence experiment indicated that maggots in the MEBO group had a higher survival rate. From the therapeutic effect of the clinical cases (n=7), the combined application was safe and effective, with all the reported wounds eventually healing. Conclusion: Based on the findings of this study, we believe the combined application of MEBO and maggots is a promising way of promoting wound healing. Further studies and clinical trials are needed to elucidate the mechanism of the combined application in promoting wound healing and to more persuasively clarify the therapeutic effect.
Collapse
Affiliation(s)
- Mingzhi Song
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 2 Department of Orthopaedics, the Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaodong Bai
- 3 Department of Plastic Surgery, Southern University of Science and Technology Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Deyu Wang
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Qingxin Wang
- 5 The Second Department of General Surgery, the Fifth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Liwen Pan
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ping He
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ying Gong
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaohong Sun
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaoguang Xu
- 8 Research Center of High Altitude Medicine, Naqu, Tibet, People's Republic of China
- 9 People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, Tibet, People's Republic of China
| | - Jianzhong Che
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Shouyu Wang
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 10 Dalian Runxi Technology Development Co. Ltd, Dalian, Liaoning, People's Republic of China
| |
Collapse
|
8
|
Yoon KA, Kim WJ, Cho H, Yoon H, Ahn NH, Lee BH, Lee SH. Characterization of anti-microbial peptides and proteins from maggots of Calliphoridae and Sarcophagidae fly species (Diptera). Comp Biochem Physiol C Toxicol Pharmacol 2022; 259:109390. [PMID: 35661821 DOI: 10.1016/j.cbpc.2022.109390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
Removal of infected wounds using maggots has been known for centuries. Early research has shown that the maggot exosecretion, whole body, and fecal waste products of Calliphoridae and Sarcophagidae species contain a variety of alkaline peptides capable of inhibiting bacterial growth. Since the wide application of antibiotics such as penicillin, a number of bacterial infections have become insensitive to antibiotic treatment. In many of these instances, maggot therapy has been successfully applied for the treatment of chronic wounds. To identify and compare the expression patterns of anti-microbial peptides (AMPs) from some dipteran species, transcriptome analyses were conducted for the maggots of 11 Calliphoridae and Sarcophagidae species. Species of the subfamily Calliphorinae showed relatively higher expression levels of AMPs and anti-microbial proteins compared with those of Luciliinae and Sarcophagidae species. Furthermore, among all of the dipteran species examined, Lucilia illustris exhibited the highest transcription levels of AMPs. Cecropin A2 and defensin, whose expression levels were the highest among the anti-microbial peptides, were synthesized to test their biological activity. The synthesized peptides showed anti-microbial activities without hemolytic activities. In particular, cecropin A2 of L. illustris exhibited the highest anti-microbial activity against all of the bacteria and fungi examined, thereby possessing the potential to be developed as a new alternative to antibiotics. This comparative transcriptomic study may provide new insights into anti-microbial compositions of some dipteran species.
Collapse
Affiliation(s)
- Kyungjae Andrew Yoon
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Republic of Korea.
| | - Woo-Jin Kim
- EntoCode Co., Seoul 06028, Republic of Korea
| | - Hanna Cho
- Biological and Genetic Resources Assessment Division, National Institute of Biological Resources, Incheon 22689, Republic of Korea
| | - Hyeokjun Yoon
- Biological and Genetic Resources Assessment Division, National Institute of Biological Resources, Incheon 22689, Republic of Korea
| | - Neung-Ho Ahn
- Biological and Genetic Resources Assessment Division, National Institute of Biological Resources, Incheon 22689, Republic of Korea
| | - Byoung-Hee Lee
- Biological and Genetic Resources Assessment Division, National Institute of Biological Resources, Incheon 22689, Republic of Korea
| | - Si Hyeock Lee
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Republic of Korea; Department of Agricultural Biology, Seoul National University, Seoul 08826, Republic of Korea.
| |
Collapse
|
9
|
Aisa J, Parlier M. Local wound management: A review of modern techniques and products. Vet Dermatol 2022; 33:463-478. [PMID: 35876262 DOI: 10.1111/vde.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 02/01/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
Abstract
Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.
Collapse
Affiliation(s)
- Josep Aisa
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Mark Parlier
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| |
Collapse
|
10
|
Yan L, Pape T, Meusemann K, Kutty SN, Meier R, Bayless KM, Zhang D. Monophyletic blowflies revealed by phylogenomics. BMC Biol 2021; 19:230. [PMID: 34706743 PMCID: PMC8555136 DOI: 10.1186/s12915-021-01156-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Blowflies are ubiquitous insects, often shiny and metallic, and the larvae of many species provide important ecosystem services (e.g., recycling carrion) and are used in forensics and debridement therapy. Yet, the taxon has repeatedly been recovered to be para- or polyphyletic, and the lack of a well-corroborated phylogeny has prevented a robust classification. RESULTS We here resolve the relationships between the different blowfly subclades by including all recognized subfamilies in a phylogenomic analysis using 2221 single-copy nuclear protein-coding genes of Diptera. Maximum likelihood (ML), maximum parsimony (MP), and coalescent-based phylogeny reconstructions all support the same relationships for the full data set. Based on this backbone phylogeny, blowflies are redefined as the most inclusive monophylum within the superfamily Oestroidea not containing Mesembrinellidae, Mystacinobiidae, Oestridae, Polleniidae, Sarcophagidae, Tachinidae, and Ulurumyiidae. The constituent subfamilies are re-classified as Ameniinae (including the Helicoboscinae, syn. nov.), Bengaliinae, Calliphorinae (including Aphyssurinae, syn. nov., Melanomyinae, syn. nov., and Toxotarsinae, syn. nov.), Chrysomyinae, Luciliinae, Phumosiinae, Rhiniinae stat. rev., and Rhinophorinae stat. rev. Metallic coloration in the adult is shown to be widespread but does not emerge as the most likely ground plan feature. CONCLUSIONS Our study provides the first phylogeny of oestroid calyptrates including all blowfly subfamilies. This allows settling a long-lasting controversy in Diptera by redefining blowflies as a well-supported monophylum, and blowfly classification is adjusted accordingly. The archetypical blowfly trait of carrion-feeding maggots most likely evolved twice, and the metallic color may not belong to the blowfly ground plan.
Collapse
Affiliation(s)
- Liping Yan
- School of Ecology and Nature Conservation, Beijing Forestry University, Beijing, China
| | - Thomas Pape
- Natural History Museum of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Karen Meusemann
- Evolutionary Biology & Ecology, University of Freiburg, Freiburg, Germany
- Zoologisches Forschungsmuseum Alexander Koenig (ZFMK)/Zentrum für Molekulare Biodiversitätsforschung (ZMB), Bonn, Germany
- Australian National Insect Collection, CSIRO National Research Collections Australia (NRCA), Canberra, Australia
| | - Sujatha Narayanan Kutty
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
- Tropical Marine Science Institute, National University of Singapore, Singapore, Singapore
| | - Rudolf Meier
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
- Museum für Naturkunde, Leibniz Institute for Evolution and Biodiversity Science, Center for Integrative Biodiversity Discovery, Berlin, Germany
| | - Keith M Bayless
- Australian National Insect Collection, CSIRO National Research Collections Australia (NRCA), Canberra, Australia
- Department of Entomology, California Academy of Sciences, San Francisco, USA
| | - Dong Zhang
- School of Ecology and Nature Conservation, Beijing Forestry University, Beijing, China.
| |
Collapse
|
11
|
Ostróżka-Cieślik A, Maciążek-Jurczyk M, Pożycka J, Dolińska B. Pre-Formulation Studies: Physicochemical Characteristics and In Vitro Release Kinetics of Insulin from Selected Hydrogels. Pharmaceutics 2021; 13:pharmaceutics13081215. [PMID: 34452176 PMCID: PMC8398322 DOI: 10.3390/pharmaceutics13081215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/25/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022] Open
Abstract
Insulin loaded to the polymer network of hydrogels may affect the speed and the quality of wound healing in diabetic patients. The aim of our research was to develop a formulation of insulin that could be applied to the skin. We chose hydrogels commonly used for pharmaceutical compounding, which can provide a form of therapy available to every patient. We prepared different gel formulations using Carbopol® UltrezTM 10, Carbopol® UltrezTM 30, methyl cellulose, and glycerin ointment. The hormone concentration was 1 mg/g of the hydrogel. We assessed the influence of model hydrogels on the pharmaceutical availability of insulin in vitro, and we examined the rheological and the texture parameters of the prepared formulations. Based on spectroscopic methods, we evaluated the influence of model hydrogels on secondary and tertiary structures of insulin. The analysis of rheograms showed that hydrogels are typical of shear-thinning non-Newtonian thixotropic fluids. Insulin release from the formulations occurs in a prolonged manner, providing a longer duration of action of the hormone. The stability of insulin in hydrogels was confirmed. The presence of model hydrogel carriers affects the secondary and the tertiary structures of insulin. The obtained results indicate that hydrogels are promising carriers in the treatment of diabetic foot ulcers. The most effective treatment can be achieved with a methyl cellulose-based insulin preparation.
Collapse
Affiliation(s)
- Aneta Ostróżka-Cieślik
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-200 Sosnowiec, Poland;
- Correspondence:
| | - Małgorzata Maciążek-Jurczyk
- Department of Physical Pharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.M.-J.); (J.P.)
| | - Jadwiga Pożycka
- Department of Physical Pharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jagiellońska 4, 41-200 Sosnowiec, Poland; (M.M.-J.); (J.P.)
| | - Barbara Dolińska
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-200 Sosnowiec, Poland;
- “Biochefa” Pharmaceutical Research and Production Plant, Kasztanowa 3, 41-200 Sosnowiec, Poland
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Harman RM, Theoret CL, Van de Walle GR. The Horse as a Model for the Study of Cutaneous Wound Healing. Adv Wound Care (New Rochelle) 2021; 10:381-399. [PMID: 34042536 DOI: 10.1089/wound.2018.0883] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Significance: Cutaneous wounds are a major problem in both human and equine medicine. The economic cost of treating skin wounds and related complications in humans and horses is high, and in both species, particular types of chronic wounds do not respond well to current therapies, leading to suffering and morbidity. Recent Advances: Conventional methods for the treatment of cutaneous wounds are generic and have not changed significantly in decades. However, as more is learned about the mechanisms involved in normal skin wound healing, and how failure of these processes leads to chronic nonhealing wounds, novel therapies targeting the specific pathologies of hard-to-heal wounds are being developed and evaluated. Critical Issues: Physiologically relevant animal models are needed to (1) study the mechanisms involved in normal and impaired skin wound healing and (2) test newly developed therapies. Future Directions: Similarities in normal wound healing in humans and horses, and the natural development of distinct types of hard-to-heal chronic wounds in both species, make the horse a physiologically relevant model for the study of mechanisms involved in wound repair. Horses are also well-suited models to test novel therapies. In addition, studies in horses have the potential to benefit veterinary, as well as human medicine.
Collapse
Affiliation(s)
- Rebecca M. Harman
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | | | - Gerlinde R. Van de Walle
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, New York
| |
Collapse
|
14
|
Maggot Therapy as a Part of a Holistic Approach in the Treatment of Multimorbid Patients with Chronic Ulcer. Clin Pract 2021; 11:347-357. [PMID: 34199361 PMCID: PMC8293264 DOI: 10.3390/clinpract11020049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Patients with chronic wounds (leg ulcers, decubitus, and diabetic foot ulcers) suffer from marked restrictions in their quality of life and can often no longer adequately carry out their everyday tasks. The need for nursing and medical care increases when other illnesses and complaints are present at the same time. Qualified wound care and the treatment of comorbidities are therefore of particular importance. The treatment of this disease, which is increasing in number, requires a holistic, multimodal treatment approach which, in addition to professional wound care, also includes comorbidities in the treatment. This case study describes an old treatment method for refractory wounds, the so-called "maggot therapy", and shows how this is integrated into a holistic, multimodal therapeutic approach.
Collapse
|
15
|
Zn(II)-alloferon complexes - Similar sequence, different coordination modes, no antibacterial activity. J Inorg Biochem 2020; 213:111275. [PMID: 33091731 DOI: 10.1016/j.jinorgbio.2020.111275] [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: 07/06/2020] [Revised: 09/27/2020] [Accepted: 10/03/2020] [Indexed: 11/23/2022]
Abstract
Often, in the search for a highly defined scientific phenomenon, a different one becomes apparent. This was also the case of this work, in the scope of which we planned to search for metal-enhanced, novel antibacterial/antifungal compounds. Instead, we denied the existence of such and revealed the details of the bioinorganic chemistry of Zn(II)-alloferon complexes. Zinc(II) complexes of alloferon 1 and 2, ligands with a sequential difference of one amino acid only, show a substantially different coordination pattern at physiological pH. In the case of Zn(II)-alloferon 1 species, a histamine-like binding mode is observed (N-terminal amine and imidazole of His-1) and the coordination sphere is completed with the imidazole nitrogens of His-6 and His-9; His-12 is not involved in binding. In the case of Zn(II)-alloferon 2, the N-terminal amine and all the three imidazoles present in the sequence participate in the coordination, however, with the chemical shift of His-5 being less affected than those of other imidazoles. The histamine-like binding in Zn(II)-alloferon 1 complex strongly enhances its thermodynamic stability in comparison to the His-1 lacking alloferon 2 analogue. Despite previous reports on the antibacterial and antifungal activity of alloferon 1, no such activity was detected, neither for alloferon 1 and 2 nor for their Zn(II) complexes.
Collapse
|
16
|
Alipour H, Shahriari-Namadi M, Ebrahimi S, Moemenbellah-Fard MD. Wound healing potential: evaluation of molecular profiling and amplification of Lucilia sericata angiopoietin-1 mRNA mid-part. BMC Res Notes 2020; 13:308. [PMID: 32611449 PMCID: PMC7329540 DOI: 10.1186/s13104-020-05141-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 06/16/2020] [Indexed: 12/28/2022] Open
Abstract
Objective High prevalence of chronic ulcers and the burden of disease necessitate the increasingly significant production of new recombinant proteins in the world. The angiopoietin-1 enzyme is a part of the growth factors group which is secreted by Lucilia sericata (Diptera: Calliphoridae) larvae when they meet lesions to ensure maggot therapy. It is one of the most potent proteins in wound healing. Given its essential role, the angiopoietin-1 gene of L. sericata was characterized, which provided some necessary information on its identity. Results The mid-part of the angiopoietin-1 mRNA sequence was thus characterized based on the design of different primers such as exon-exon junction, conserved regions, and specific region primers via conventional polymerase chain reaction (PCR). Its structural features were configured by in silico method. The sequence of mid-part (390 bp) of angiopoietin-1 was determined empirically, and BLAST analysis unraveled its high identity (85%) with the sequence of angiopoietin-1 mRNA of the larval housefly, Musca domestica. The homology of this enzyme also exhibited that its nucleic acid sequence was very similar to the domains of angiopoietin-1 in Lucilia cuprina. The current data are instructive and critical to evaluate the action of this enzyme in recombinant protein production in future molecular studies on wound healing.
Collapse
Affiliation(s)
- Hamzeh Alipour
- Department of Medical Entomology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marziae Shahriari-Namadi
- Department of Medical Entomology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Saeedeh Ebrahimi
- Department of Medical Entomology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad D Moemenbellah-Fard
- Department of Medical Entomology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran. .,Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Vazeille S, Hawker L, Chandrasekar R, Srinivas-Shankar U. Recalcitrant Foot Ulceration in a Patient With Type 1 Diabetes Mellitus. Cureus 2020; 12:e8898. [PMID: 32742865 PMCID: PMC7389212 DOI: 10.7759/cureus.8898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We describe the case of a middle-aged woman with type 1 diabetes mellitus who presented to the emergency department with diabetic ketoacidosis. An intravenous cannula was inserted into the veins of the dorsum of the right foot due to difficulty in obtaining intravenous access in the upper limb for managing diabetic ketoacidosis. Our patient developed edema and bullae on the dorsum of the right foot and received intravenous antibiotics for bullous cellulitis. Our patient developed ulceration on the dorsum of the right foot and over the next few months was admitted to hospital on several occasions with infected foot ulceration, which required several courses of intravenous antibiotics, larval therapy and surgical debridement of the necrotic eschar and slough. With regular review in the multidisciplinary diabetic foot clinic, the foot ulceration finally healed in eight months. This case highlights the importance of avoiding trauma in any form to the feet of people with diabetes even if aseptic techniques are taken.
Collapse
Affiliation(s)
- Stephan Vazeille
- Diabetes and Endocrinology, Wirral University Teaching Hospital, Birkenhead, GBR
| | - Lydia Hawker
- Diabetes and Endocrinology, Wirral University Teaching Hospital, Birkenhead, GBR
| | | | | |
Collapse
|
19
|
Asotibe JC, Achebe I, Mbachi C, Igwilo R, Paintsil I. Wound Myiasis in Severe Venous Stasis Ulcer. Cureus 2020; 12:e8585. [PMID: 32670720 PMCID: PMC7358903 DOI: 10.7759/cureus.8585] [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] [Indexed: 11/05/2022] Open
Abstract
Although myiasis infestation of wounds presents with significant psychological discomfort to patients, studies have shown that it can be beneficial in the management of recalcitrant ulcers resistant to standard management. Here we report a patient with persistent ulcers unresponsive to standard management who was lost to follow-up for five months and presented with ''maggots in his wound''. This however proved beneficial to the patient as the ulcer showed healthy granulation tissue on presentation and improved healing on follow-up. Our case presents the beneficial effect of myiasis infestation in the 21st century and helps to highlight a time-tested therapy with further encouragement of the use of biotherapy (sterile maggots) for the management of recalcitrant ulcers.
Collapse
|
20
|
Tahmasebi M, Soleimanifard S, Sanei A, Karimy A, Abtahi SM. A Survey on Inhibitory Effect of Whole-Body Extraction and Secretions of Lucilia sericata's Larvae on Leishmania major In vitro. Adv Biomed Res 2020; 9:12. [PMID: 32318361 PMCID: PMC7147512 DOI: 10.4103/abr.abr_56_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/26/2019] [Accepted: 11/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Leishmaniasis is a skin disease caused by Leishmania parasite. Despite being self-limiting, must be treated. Available drugs have side effects and drug resistance has also been seen. Materials and Methods: Maggot debridement therapy (MDT) is using sterile fly larvae (maggots) of blow flies (Lucilia sericata) for the treatment of different types of tissue wounds. Larvae have excreted and secreted substances that have been proved to have antimicrobial effects, in addition to the some other specifications. Results: In this study, the anti-leishmanial effects of extracts and secretions of sterile second- and third-instar larvae of L. sericata on the growth of Leishmania major promastigotes and amastigotes in the J774 macrophages have been evaluated in vitro. Conclusion: The results showed that extracts and secretions had almost the same leishmaniocidal effect on promastigotes and intracellular amastigotes without cytotoxic effect on macrophages.
Collapse
Affiliation(s)
- Maryam Tahmasebi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Simindokht Soleimanifard
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sanei
- Department of Medical Entomology, School of Health, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Azadeh Karimy
- Department of Entomology, Zist Eltiam Sepanta Company, Azad University of Khorasgan, Technology Incubator, Center of Medicinal Plant and Traditional Medicine, Isfahan, Iran
| | - Seyed Mohammad Abtahi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
21
|
Stadler F. The maggot therapy supply chain: a review of the literature and practice. MEDICAL AND VETERINARY ENTOMOLOGY 2020; 34:1-9. [PMID: 31350920 DOI: 10.1111/mve.12397] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/13/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
Maggot therapy (MT) is the clinical application of living fly larvae for the treatment of non-healing wounds and wounds that require debridement. This systematized and expanded literature review is the first study to investigate MT through the conceptual and disciplinary framework of supply chain management. The review of 491 selected academic papers was expanded to include the grey literature and online information resources to construct a first-pass theory of the medicinal maggot supply chain. It shows that the literature to date has focused on isolated discussions of echelon-specific issues such as diet improvement and sterilization protocols in the production echelon, and the relative effectiveness of medicinal maggot application methods in the treatment echelon. There is little knowledge in the public domain regarding the transport and distribution of medicinal maggots, but existing supply chains for vaccines, blood and pathology specimens may provide learning and supply chain integration opportunities. Maggot therapy knowledge across the treatment echelon is generally substantive but there is still insufficient knowledge regarding patients' and health care providers' attitudes toward the therapy, and their experiences of receiving and administering MT. Moreover, there is no research concerned with the humane disposal of medicinal flies during production and after treatment.
Collapse
Affiliation(s)
- F Stadler
- School of Medicine, Faculty of Health, Griffith University, Gold Coast, Qld, 4222, Australia
| |
Collapse
|
22
|
Kaplun O, Pupiales M, Psevdos G. Adjuvant Maggot Debridement Therapy for Deep Wound Infection due to Methicillin-resistant Staphylococcus aureus. J Glob Infect Dis 2019; 11:165-167. [PMID: 31849439 PMCID: PMC6906895 DOI: 10.4103/jgid.jgid_30_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 09/04/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Olga Kaplun
- Department of Infectious Diseases, Stony Brook University Hospital, NY, New York, USA
| | - Magdalena Pupiales
- Department of Surgery, Veterans Affairs Medical Center, NY, New York, USA
| | - George Psevdos
- Veterans Affairs Medical Center, Stony Brook University School of Medicine, NY, New York, USA.,Department of Infectious Diseases, Stony Brook University School of Medicine, NY, New York, USA
| |
Collapse
|
23
|
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.
Collapse
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.
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
|
26
|
Laverde-Paz MJ, Echeverry MC, Patarroyo MA, Bello FJ. Evaluating the anti-leishmania activity of Lucilia sericata and Sarconesiopsis magellanica blowfly larval excretions/secretions in an in vitro model. Acta Trop 2018; 177:44-50. [PMID: 28982577 DOI: 10.1016/j.actatropica.2017.09.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/29/2017] [Accepted: 09/30/2017] [Indexed: 11/29/2022]
Abstract
Leishmaniasis is a vector-borne disease caused by infection by parasites from the genus Leishmania. Clinical manifestations can be visceral or cutaneous, the latter mainly being chronic ulcers. This work was aimed at evaluating Calliphoridae Lucilia sericata- and Sarconesiopsis magellanica-derived larval excretions and secretions' (ES) in vitro anti-leishmanial activity against Leishmania panamensis. Different larval-ES concentrations from both blowfly species were tested against either L. panamensis promastigotes or intracellular amastigotes using U937-macrophages as host cells. The Alamar Blue method was used for assessing parasite half maximal inhibitory concentration (IC50) and macrophage cytotoxicity (LC50). The effect of larval-ES on L. panamensis intracellular parasite forms was evaluated by calculating the percentage of infected macrophages, parasite load and toxicity. L. sericata-derived larval-ES L. panamensis macrophage LC50 was 72.57μg/mL (65.35-80.58μg/mL) and promastigote IC50 was 41.44μg/mL (38.57-44.52μg/mL), compared to 34.93μg/mL (31.65-38.55μg/mL) LC50 and 23.42μg/mL (22.48-24.39μg/mL) IC50 for S. magellanica. Microscope evaluation of intracellular parasite forms showed that treatment with 10μg/mL L. sericata ES and 5μg/mL S. magellanica ES led to a decrease in the percentage of infected macrophages and the amount of intracellular amastigotes. This study produced in vitro evidence of the antileishmanial activity of larval ES from both blowfly species on different parasitic stages and showed that the parasite was more susceptible to the ES than it's host cells. The antileishmanial effect on L. panamensis was more evident from S. magellanica ES.
Collapse
Affiliation(s)
- Mayra Juliana Laverde-Paz
- Medical and Forensic Entomology Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia; Public Health Department, Medicine Faculty, Universidad Nacional de Colombia, Bogotá DC, Colombia.
| | - María Clara Echeverry
- Public Health Department, Medicine Faculty, Universidad Nacional de Colombia, Bogotá DC, Colombia.
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá DC, Colombia; Basic Sciences Department, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia.
| | - Felio Jesús Bello
- Medical and Forensic Entomology Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia; Medicine Faculty, Universidad Antonio Nariño, Bogotá DC, Colombia; Faculty of Agricultural and Livestock Sciences, Universidad de La Salle, Bogotá DC, Colombia.
| |
Collapse
|
27
|
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
|
28
|
Debridement Techniques and Non–Negative Pressure Wound Therapy Wound Management. Vet Clin North Am Small Anim Pract 2017; 47:1181-1202. [DOI: 10.1016/j.cvsm.2017.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
29
|
Flying maggots: a smart logistic solution to an enduring medical challenge. JOURNAL OF HUMANITARIAN LOGISTICS AND SUPPLY CHAIN MANAGEMENT 2017. [DOI: 10.1108/jhlscm-02-2017-0003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Whilst there is a growing body of research which discusses the use of remotely piloted aircraft systems (RPAS) (otherwise known as “drones”) to transport medical supplies, almost all reported cases employ short range aircraft. The purpose of this paper is to consider the advantages and challenges inherent in the use of long endurance remotely piloted aircraft systems (LE-RPAS) aircraft to support the provision of medical supplies to remote locations – specifically “medical maggots” used in maggot debridement therapy (MDT) wound care.
Design/methodology/approach
After introducing both MDT and the LE-RPAS technology, the paper first reports on the outcomes of a case study involving 11 semi-structured interviews with individuals who either have experience and expertise in the use of LE-RPAS or in the provision of healthcare to remote communities in Western Australia. The insights gained from this case study are then synthesised to assess the feasibility of LE-RPAS assisted delivery of medical maggots to those living in such geographically challenging locations.
Findings
No insuperable challenges to the concept of using LE-RPAS to transport medical maggots were uncovered during this research – rather, those who contributed to the investigations from across the spectrum from operators to users, were highly supportive of the overall concept.
Practical implications
The paper offers an assessment of the feasibility of the use of LE-RPAS to transport medical maggots. In doing so, it highlights a number of infrastructure and organisational challenges that would need to be overcome to operationalise this concept. Whilst the particular context of the paper relates to the provision of medical support to a remote location of a developed country, the core benefits and challenges that are exposed relate equally to the use of LE-RPAS in a post-disaster response. To this end, the paper offers a high-level route map to support the implementation of the concept.
Social implications
The paper proposes a novel approach to the efficient and effective provision of medical care to remote Australian communities which, in particular, reduces the need to travel significant distances to obtain treatment. In doing so, it emphasises the importance in gaining acceptance of both the use of MDT and also the operation of RPAS noting that these have previously been employed in a military, as distinct from humanitarian, context.
Originality/value
The paper demonstrates how the use of LE-RPAS to support remote communities offers the potential to deliver healthcare at reduced cost compared to conventional approaches. The paper also underlines the potential benefits of the use of MDT to address the growing wound burdens in remote communities. Finally, the paper expands on the existing discussion of the use of RPAS to include its capability to act as the delivery mechanism for medical maggots.
Collapse
|
30
|
|
31
|
Choudhary V, Choudhary M, Pandey S, Chauhan VD, Hasnani JJ. Maggot debridement therapy as primary tool to treat chronic wound of animals. Vet World 2016; 9:403-9. [PMID: 27182137 PMCID: PMC4864483 DOI: 10.14202/vetworld.2016.403-409] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/12/2016] [Indexed: 11/10/2022] Open
Abstract
Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.
Collapse
Affiliation(s)
- Vijayata Choudhary
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Mukesh Choudhary
- Department of Veterinary Pathology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Sunanda Pandey
- Department of Veterinary Pathology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - Vandip D. Chauhan
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| | - J. J. Hasnani
- Department of Veterinary Parasitology, Veterinary College, Anand Agricultural University, Anand, Gujarat, India
| |
Collapse
|
32
|
Abstract
BACKGROUND When disaster strikes, the number of patients requiring treatment can be overwhelming. In low-income countries, resources to assist the injured in a timely fashion may be limited. As a consequence, necrosis and wound infection in disaster patients is common and frequently leads to adverse health outcomes such as amputations, chronic wounds, and loss of life. In such compromised health care environments, low-tech and cheap wound care options are required that are in ready supply, easy to use, and have multiple therapeutic benefits. Maggot debridement therapy (MDT) is one such wound care option and may prove to be an invaluable tool in the treatment of wounds post-disaster. DISCUSSION This report provides an overview of the wound burden experienced in various types of disaster, followed by a discussion of current treatment approaches, and the role MDT may play in the treatment of complex wounds in challenging health care conditions. Maggot debridement therapy removes necrotic and devitalized tissue, controls wound infection, and stimulates wound healing. These properties suggest that medicinal maggots could assist health care professionals in the debridement of disaster wounds, to control or prevent infection, and to prepare the wound bed for reconstructive surgery. Maggot debridement therapy-assisted wound care would be led by health care workers rather than physicians, which would allow the latter to focus on reconstructive and other surgical interventions. Moreover, MDT could provide a larger window for time-critical interventions, such as fasciotomies to treat compartment syndrome and amputations in case of life-threatening wound infection. RECOMMENDATIONS There are social, medical, and logistic hurdles to overcome before MDT can become widely available in disaster medical aid. Thus, research is needed to further demonstrate the utility of MDT in Disaster Medicine. There is also a need for reliable MDT logistics and supply chain networks. Integration with other disaster management activities will also be essential. CONCLUSIONS In the aftermath of disasters, MDT could play an important role facilitating timely and efficient medical treatment and improving patient outcomes. Existing social, medical, and logistic barriers will need to be overcome for MDT to be mainstreamed in Disaster Medicine.
Collapse
|
33
|
Evans R, Dudley E, Nigam Y. Detection and partial characterization of antifungal bioactivity from the secretions of the medicinal maggot,Lucilia sericata. Wound Repair Regen 2015; 23:361-8. [DOI: 10.1111/wrr.12287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 03/19/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Rhys Evans
- College of Human and Health Sciences; Swansea University; Swansea Wales United Kingdom
| | - Ed Dudley
- College of Medicine, Swansea University; Swansea Wales United Kingdom
| | - Yamni Nigam
- Lead, Swansea Maggot Research Group, College of Human and Health Sciences; Swansea University; Swansea Wales United Kingdom
| |
Collapse
|
34
|
Kahl M, Gökçen A, Fischer S, Bäumer M, Wiesner J, Lochnit G, Wygrecka M, Vilcinskas A, Preissner KT. Maggot excretion products from the blowfly Lucilia sericata contain contact phase/intrinsic pathway-like proteases with procoagulant functions. Thromb Haemost 2015; 114:277-88. [PMID: 25948398 DOI: 10.1160/th14-06-0499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 03/15/2015] [Indexed: 01/09/2023]
Abstract
For centuries, maggots have been used for the treatment of wounds by a variety of ancient cultures, as part of their traditional medicine. With increasing appearance of antimicrobial resistance and in association with diabetic ulcers, maggot therapy was revisited in the 1980s. Three mechanisms by which sterile maggots of the green bottle fly Lucilia sericata may improve healing of chronic wounds have been proposed: Biosurgical debridement, disinfecting properties, and stimulation of the wound healing process. However, the influence of maggot excretion products (MEP) on blood coagulation as part of the wound healing process has not been studied in detail. Here, we demonstrate that specific MEP-derived serine proteases from Lucilia sericata induce clotting of human plasma and whole blood, particularly by activating contact phase proteins factor XII and kininogen as well as factor IX, thereby providing kallikrein-bypassing and factor XIa-like activities, both in plasma and in isolated systems. In plasma samples deficient in contact phase proteins, MEP restored full clotting activity, whereas in plasma deficient in either factor VII, IX, X or II no effect was seen. The observed procoagulant/intrinsic pathway-like activity was mediated by (chymo-) trypsin-like proteases in total MEP, which were significantly blocked by C1-esterase inhibitor or other contact phase-specific protease inhibitors. No significant influence of MEP on platelet activation or fibrinolysis was noted. Together, MEP provides contact phase bypassing procoagulant activity and thereby induces blood clotting in the context of wound healing. Further characterisation of the active serine protease(s) may offer new perspectives for biosurgical treatment of chronic wounds.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - K T Preissner
- Klaus T. Preissner, PhD, Department of Biochemistry, Medical School, Justus-Liebig-University, Friedrichstrasse 24, 35392 Giessen, Germany, Tel.: +49 641 994 7500, Fax: +49 641 994 7509, E-mail:
| |
Collapse
|
35
|
The Effect of Salivary Gland Extract of Lucilia sericata Maggots on Human Dermal Fibroblast Proliferation within Collagen/Hyaluronan Membrane In Vitro. Adv Skin Wound Care 2015; 28:221-6. [DOI: 10.1097/01.asw.0000461260.03630.a0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Identification and characterisation of different proteases in Lucilia sericata medicinal maggots involved in maggot debridement therapy. J Appl Biomed 2014. [DOI: 10.1016/j.jab.2014.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
38
|
Teh CH, Nazni WA, Lee HL, Fairuz A, Tan SB, Sofian-Azirun M. In vitro antibacterial activity and physicochemical properties of a crude methanol extract of the larvae of the blow fly Lucilia cuprina. MEDICAL AND VETERINARY ENTOMOLOGY 2013; 27:414-420. [PMID: 23650928 DOI: 10.1111/mve.12012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 09/27/2012] [Accepted: 10/12/2012] [Indexed: 06/02/2023]
Abstract
The emergence of multidrug-resistant bacterial strains has prompted the reintroduction of maggot therapy in the treatment of chronic, infected wounds. Many previous studies have demonstrated the potent antibacterial activity of larval excretions/secretions of the blowfly Lucilia sericata (Meigen) (Diptera:Calliphoridae) against bacteria. However, the antibacterial activity of its sibling species, Lucilia cuprina (Wiedemann) (Diptera:Calliphoridae) against a wide range of pathogenic bacteria has never been determined. The aim of this study was to develop a new procedure to produce whole body extract of larvae of L. cuprina via methanol extraction as well as to demonstrate the in vitro antibacterial activity of this extract against seven selected wound pathogens (Staphylococcus aureus, methicillin-resistant S. aureus, S. epidermidis, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli). The turbidimetric assay demonstrated that L. cuprina larval extract was significantly potent against all bacteria tested (P < 0.001). Additionally, colony-forming unit (CFU), agar well diffusion and minimum inhibitory concentration assays have confirmed the apparent potency of larval extract against P. aeruginosa. The reconstituted larval extract was highly robust and thermally stable. These observations substantiated the feasibility of the methanol extraction method in the production of larval extract.
Collapse
Affiliation(s)
- C H Teh
- Method and Statistics Section, Institute for Public Health, Kuala Lumpur, Malaysia
| | | | | | | | | | | |
Collapse
|
39
|
|
40
|
El Shazely B, Veverka V, Fucík V, Voburka Z, Zdárek J, Cerovský V. Lucifensin II, a defensin of medicinal maggots of the blowfly Lucilia cuprina (Diptera: Calliphoridae). JOURNAL OF MEDICAL ENTOMOLOGY 2013; 50:571-578. [PMID: 23802451 DOI: 10.1603/me12208] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A novel homolog of insect defensin, designated lucifensin II (Lucilia cuprina Wiedemann [Diptera: Calliphoridae] defensin), was purified from hemolymph extract from larvae of the blowfly L. cuprina. The full-length primary sequence of this peptide of 40 amino acid residues and three intramolecular disulfide bridges was determined by electrospray ionization-orbitrap mass spectrometry and Edman degradation and is almost identical to the previously identified sequence of lucifensin (Lucilia sericata Meigen defensin). Lucifensin II sequence differs from that of lucifensin by only one amino acid residue, that is, by isoleucine instead of valine at position 11. The presence of lucifensin II also was detected in the extracts of other larval tissues, such as gut, salivary glands, fat body, and whole body extract.
Collapse
Affiliation(s)
- Baydaa El Shazely
- Department of Zoology, Faculty of Science, Alexandria University, Alexandria, Egypt
| | | | | | | | | | | |
Collapse
|
41
|
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.
Collapse
|
42
|
ZHANG ZHEN, WANG JIANGNING, ZHANG BO, LIU HUANRAN, SONG WEI, HE JIAO, LV DECHENG, WANG SHOUYU, XU XIAOGUANG. Activity of antibacterial protein from maggots against Staphylococcus aureus in vitro and in vivo. Int J Mol Med 2013; 31:1159-65. [DOI: 10.3892/ijmm.2013.1291] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 02/15/2013] [Indexed: 11/06/2022] Open
|
43
|
Abstract
Myiasis is caused by the larval stages of flies feeding on live or dead mammalian tissues and fluids. Human cases involving the genitourinary system are very rare and present with unusual symptoms.We report the case of a male, 25-year-old shepherd who underwent a surgical intervention on his urinary tract for renal lithiasis and was catheterized with a drain dwelling in his left kidney. A few days after the patient showed signs of dysuria, polyuria and pollakisuria. Lower urinary tract infection with ciprofloxacin susceptible E. coli was diagnosed and treated accordingly. The symptoms persisted and, a few days later, fly maggots were released repeatedly in the urine of the patient and sent for investigation. Macroscopic analysis and microscopy were performed. We detected 3-4 mm long, dorso-ventrally flattened white live fly larvae with lateral projections, typical for Fannia (Diptera: Fannidae) genus. Identification on a species level could not be performed as larva feeding facilities or specific DNA based methods were not available for us.Even if maggot urinary tract infestations are extremely rare in Europe, we should consider them in order to provide a rapid and correct diagnosis followed by an adequate treatment.
Collapse
Affiliation(s)
- Enikő Barabás-Hajdu
- 1 University of Medicine and Pharmacy Department of Microbiology and Clinical Pharmacy Tg. Mures Romania
| | | | - Ágnes Mihály
- 2 University of Medicine and Pharmacy 6th year student General Medicine Tg. Mures Romania
| |
Collapse
|
44
|
Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy. J Burn Care Res 2012; 33:e169-75. [PMID: 21983646 DOI: 10.1097/bcr.0b013e318233570d] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management.
Collapse
|
45
|
Abstract
The treatment of poorly healing wounds, although not a typical problem in the periorbital area, has been enriched by the option of biosurgery, the therapeutic application of larvae of the blow fly (Lucilia sericata).
Collapse
Affiliation(s)
- S Pitz
- Augenklinik der Universitätsmedizin, Johannes Gutenberg Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | | | | |
Collapse
|
46
|
Davydov L. Maggot therapy in wound management in modern era and a review of published literature. J Pharm Pract 2012; 24:89-93. [PMID: 21650065 DOI: 10.1177/0897190010366938] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Maggot therapy is an old remedy, which is being looked into with renewed interest. The use of medicinal maggots was approved by Food and Drug Administration (FDA) as a medical device in 2004. Maggot therapy appears to be efficacious, well tolerated, and cost-effective. Because American Medical Association (AMA) and Centers for Medicare and Medicaid (CMS) released reimbursement coding guidelines with regards to maggot therapy, there is a potential for a wider use of maggot therapy in United States in the near future. Several mechanisms of action suggested for maggots in debriding wounds are discussed. While maggot therapy demonstrated effectiveness in necrotic wounds, not all wound types respond well to maggot therapy. Future large, randomized, well-designed studies would help better delineate the place of maggot therapy among other options for wound care, and determine whether maggot therapy should be initiated earlier in the course of treatment, or continued to be used as a last resort.
Collapse
Affiliation(s)
- Liya Davydov
- Clinical Pharmacy Services, Innovatix, LLC, New York, NY 10011, USA.
| |
Collapse
|
47
|
Kruglikova AA. Antimicrobial components of haemolymph and exosecretion of larvae Lucilia sericata (Meigen) (Diptera, Calliphoridae). J EVOL BIOCHEM PHYS+ 2012. [DOI: 10.1134/s0022093011060044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
48
|
|
49
|
Kruglikova AA, Chernysh SI. Antimicrobial compounds from the excretions of surgical maggots, Lucilia sericata (Meigen) (Diptera, Calliphoridae). ACTA ACUST UNITED AC 2011. [DOI: 10.1134/s0013873811070013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
50
|
White R. Wound dressings and other topical treatment modalities in bioburden control. J Wound Care 2011; 20:431-9. [DOI: 10.12968/jowc.2011.20.9.431] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|