Effectiveness of Leech Therapy

Effectiveness of Leech TherapyIt has been estimated that there atomic number 18 about 60,000 miles or more race vessels within a human body where blood, gases and nutrients atomic number 18 being circulated. Any obstructer of these vessels will cause blood congestion at the site and thus give rise to respective(a) vascular diseases. For instance, a close up coronary artery will cause heart attacks, and a impede carotid artery will cause strokes. Other common examples are inflammatory reactions, haematomas, deep vein thrombosis, and so on. Hidurotherapy, also known as the leech therapy, is an ancient remedy now being bring round and evaluated scientifically, hoping that it could be a one cure for all these diseases and provide a overmuch more in cause(p) yet safer dole outment.So, how a leech can cure and is it really more effective over shortly used drugs in treating vascular congestion and related diseases?The mechanism behind hidurotherapy can be modify as such when a leech bites a target, the patient will not feel much painfulness because its spittle contains finical anaesthetics. It then starts its lively feeding by sucking the blood. At the corresponding time, the saliva which also contains various components that prevent the formation of blood clot at the wound and allow in it to flow continuously for hours even after the leech has been removed. This situation is known as liquid bleeding.I have classified the leech treatment into 3 common types based on these effects of saliva contents and their applications.Type 1 Hirudin as an anticoagulantIt has been recognised that the acute coronary syndromes involving the atherosclerotic plaques or thrombus has direct connection to the thrombin in the blood. Thrombin triggers thrombocyte aggregation and gives rise to fibrin clot formation. Intravenous heparin, aspirin, and anti-ischemic medications are the type treatments provided by hospitals. Hirudin appears to have more advantages when com pared to heparin. It can act indep discontinueently while heparin works indirectly with anti-thrombin III as its cofactor. As a result of this, heparin is not effective when it comes to the fibrin clot that already has thrombin bounded to it.In addition, platelet factor 4 or plasma proteins force neutralise the effect of heparin. Some patients might even develop thrombocytopenia, which affects 5 to 15 percent of the patient population. In such cases, hirudin is highly selective for thrombin and is not affected by peptides and enzymes in the blood. It binds with thrombin to form an inactive hirudin-thrombin complex and halts the variety of fibrinogen into insoluble fibrin. Another highlight of hirudin would be its stability as its form can run unchanged when it is removed from the body through urination.Overdosage of hirudin is very rare, if such cases really happen, there is no counterpoison because no antagonists for it have been found. This would be the disadvantage of hirudin but its usage remains safe as retentive as the doctors prescribe living leeches according to standard recommendations.In a research, patients with acute coronary syndromes were every which way given either intravenous heparin and hirudin placebo or hidurin and heparin placebo on a double blind basis. This led to the possibility of comparing the effect of hirudin and heparin in treating coronary syndromes and preventing deaths.The outcome results showed that hirudin had significantly fall the risk of death or myocardial infarction or reinfarction over hours of study compared to heparin.In dogged term, hirudin still displays significant advantage over heparin in reducing the risk of death or myocardial infarction or reinfarction.Type 2 Removal of blood via active feeding and peaceful bleedingDetached body interweaves or limbs can be reattached, transferred or transplanted through modern rehabilitative surgeries. Microsurgical techniques are being used to restore the blood vesse ls supplying blood and oxygen to the connecting tissues or limbs to alter their survival. However, often we see that after a complicated reconstructive surgery, venous congestion occurs at the connecting tissues collectible to the formation of blood clot after a venous outflow. Thus, the blood cannot be circulated and the tissue flourish will eventually die off and is lost if the congestion prolonged.It is then vital to remove dissipation blood accumulated at the site so that risk of cell death can be minimised. Moreover, it provides time for the ingrowth of new venous outflow from the surrounding normal tissues. Surgical revision is rarely workable or successful to fix the problem.When venous congestion threatens a tissue flap, live medicinal leeches (Hirudo medicinalis) are placed on the congested tissue to remove excess blood. The application of medicinal leeches to a congested tissue flap reportedly increases blood flow within congested tissue directly via active feeding an d indirectly by passive bleeding from the bite after the leech detaches. The continued passive procession of blood following leech detachment assists in the decongestion process. It is facilitated by the actions and interactions among different salivary secretions of the leech, and platelet aggregation inhibitors.Type 3 Effects of other substances in the leech salivaAs the leech saliva also contains anti-inflammatory and anaesthetics substances, the patient will feel no pain being bitten. This special effect attributes towards the treatment of diseases such as arthritis of the joint.Although arthritis belongs to immunological disorder, the inflammation around the joints causes pain to the patients. Therefore, leech therapy might be useful in soothing the pain suffered with the anti-inflammatory and anaesthetics substances. A study designed by researchers from Germanys Academic Teaching Hospital showed that one application of leeches to the area can reduce pain 60% for more than 60 days. Besides that, the results also showed that it is even more effective than Diclofenac. Diclofenac is a group of drugs that is unremarkably used to treat pain or inflammation caused by arthritis or ankylosing spondylitis by reducing the hormones create such symptoms.2There was also a previous leech therapy for knee degenerative arthritis that gave significant pain relief for over a week differences for function, stiffness, and total symptoms remained significant in favour of leech therapy until the end of study and for quality of life until day 28.Ann Intern Med. 2003 Nov 4139(9)724-30.Effectiveness of leech therapy in osteoarthritis of the knee a randomized,controlled trial.Michalsen A, Klotz S, Ldtke R, Moebus S, Spahn G, Dobos GJ.AlternativesRecombinant HirudinA leechs saliva contains limited amount of natural hirudin, so the stem of mass hirudin extraction for treatments is almost im practicable as this will multiply the cost. One possible stem to this is to synthesise a similar substance. Scientists have previously cloned the cDNA for hirudin and it is expressed in yeast. However, the resulting recombinant protein was found to be produced in the unsulfated form, which is known to have an at least 10 times lower affinity for thrombin than the of course occurring tyrosine-sulfated hirudin.Recombinant hirudin has been approved by United States FDA to be produced and applied commercially. It can be an alternative when living leeches are not available and the patient seems to develop intolerance against heparin. The dosage must be calculated aright in order to reduce the risk of side effects.HirudinHeparinRecombinant HirudinAdvantagesLed to a very accordant anticoagulant effect over time, independently of the use of thrombolytic therapy, a feature that represents a practical advantageInexpensive, performed well as an antithrombin agent in the current trial and should still be regarded as the standard therapyDemonstrable and consistant effect, espec ially on the rate of reinfarction, in the group of patients with acute coronary syndromes as a wholeDisadvantagesExcessive usage will increase bleeding riskNot infrequently engenders an immune thrombocytopenia, which can result in serious thrombotic complicationsSmall clinical effectTable 1 Comparison between hirudin, heparin, and recombinant hirudin by means of advantages and disadvantagesHementinHementin is a unique secretion in the saliva of virago Giant Leech (Haementeria ghilianii). As shown in Figure 2, it inhibits the coagulation of blood differently with hirudin by jailbreak down the fibrinogen. Because Haementeria ghilianii does not belong to the order of Arhynchobdellida but Rhynchobdellida, therefore it was not recognised as medicinal leech. However, Maurice Moloney, professor of plant biotechnology at the University of Calgary in Alberta, Canada discovered that while hirudin prevents clot formation, hementin dissolves a finicky kind of platelet-rich clot that can cause stroke and heart attack and against which clot busters like streptokinase and plasminogen activator are ineffective.3Mechanical LeechA leech-induced skin wound on a congested fasciocutaneous tissue flap will bleed passively for a number of hours with 90 percent of blood emission within 5 hours after leech detachment. However, after 3 hours, passive blood loss averages yet 2.9 ml. Furthermore, increases of maximum surface perfusion only extend 8 mm from the leech bite during passive bleeding. As suggested by these prior results, passive blood loss from a single leech bite should not be relied on to sufficiently decongest an impaired tissue flap, even after a relatively hulky active blood meal. There is the potential, however, of augmenting passive blood loss volumes with the use of a mechanical wind that facilitates the antithrombogenic environment of a congested tissue flap. Such a mechanical device may advance increased tissue viability. Increases in blood loss volumes may tra nslate into improved postoperative blood perfusion in congested tissue flaps, resulting in improved tissue flap viability and survival.ImplicationsEnvironmental, Economic disposal, release to the wild, pollution, disrupts aliment chain, expensive for medical purposes, but lucrative for pharmaceutical industriesEthical, Social reject the chance giving disclose treatment for patients, risk of side effects (bleeding), fear, can be overcome by mechanical leeches evaluationConclusionIt can be seen that leech therapy is somehow more effective than modern drugs. However, it raises a hardly a(prenominal) more questions like why we do not just extract the leech contents to treat the patients directly with it? I think it is because even though numerous studies and researches have been carried out, there are still some uncertain areas need to be recognised and solved. Besides that, the current situation allows us to rid of overdose of leech contentetc.