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Medicinal leeches were used for bloodletting, and have been applied to congested or inflamed parts of the human body for over 2,000 years. They were used for engorged hemorrhoids, swollen testicles, laryngitis, prolapsed rectum and inflamed vulva. Today, leeches are used in plastic surgery, for the treatment of avulsed appendages following successful arterial revascularization but limited venous repair (Wells et al., 1993; Adams et al., 1995). Leeches are also used in the treatment of such disorders as inflammation and peripheral venous and arterial diseases. Patients suffering from deep venous thrombosis in the legs could develop post-phlebitic syndrome, a complication that occurs as a consequence of venous valve destruction. Leech therapy has been successfully used for the treatment of such conditions (for review see Eldor et al., 1996).

In Russia, hirudotherapy is used for cardiovascular diseases such as arterial hypertension, angina pectoris, myocardial infarction and post-infractional cardiosclerosis. Leeches are also used by ophthalmologists, to treat inflammatory and traumatic processes such as keratitis, chorioretinitis, periorbital hematoma, subretinal hemorrhage, glaucoma and cataract. Hirudotherapy is being used by otolaryngologists, to treat inflammatory and neurological diseases of the ear, nose and throat such as acute and chronic otitis, sinusitis, and laryngitis, and by dermatologists, to treat clinical forms of dermatitis and dermatosis (eczema, psoriasis, paronychia, scleroderma). Some stomatologists in Russia use leeches to treat acute and chronic inflammatory dystrophic and neurological lesions of the oral mucosa and peridontium (Ruber lichen planus, recurrent aphthous ulceration, chilitis glandularis, glossalgia). Furthermore, urologists use leeches to treat inflammatory conditions of the urogenital tract, dysfunction and injuries of the genital organs in postoperative rehabilitation. Gynecologists use leeches to rehabilitate patients with postpartum pyo-septic complications. The multiple curative effects of leeches are due to anti-thrombotic, thrombolytic, hypotensive, anti-inflammatory, bacteriostatic and analgesic components of their saliva. Hirudotherapy was also found to be effective in healing intractable and non-granulating wound, trophic ulcers, especially in elderly and immunocompromized patients (Gilyova, 1998).

Hirudin is the principal anticoagulant in leech saliva. It is a polypeptide, which has highly potent antiprotease activity with a strict specificity for thrombin. Hirudin is now produced by recombinant DNA technology and is administered to patients undergoing coronary angioplasty, for the treatment of deep venous thrombosis and as a substitute for heparin in patients developing heparin-induced thrombocytopenia.



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Copyright 2007 Hebrew University, Jerusalem, Israel
Last modified: 01/01/07