Leech Saliva Research Articles

A Conceptual Review of Jalauka and Jalaukaavcharana(Leech-Therapy)in Ayurveda

Jalaukaavcharana(Leech therapy) is one of the form of Raktmokshana. Jalauka(Leeches) are used for impure blood letting The two types of treatment that are advised in Ayurveda are:-1). Shaman chikitsa and 2). Shodhana chikitsa. Shamana chikitsameans Internal medicine and Shodhana chikitsameans Elimination therapy. In Ayurveda, Panchkarmais one of the tools to treat many disorders. Acharya Sushruta included Raktmokshanain Panchakarma. The first description about the Jalauka (Leech) is mentioned in Sushruta Samita.The term"Jalauka"(Leech) means, a creature whose life depends on water. Jalaukais having various names which are -Jalita, Jalauka , Jalatani. Jalaukais the only Shodhanatreatment that can be done on Children ,Ladies , weak , old , rich and fearful person . It is mainly indicated for Vitiated Pittaja and Raktajadoshas.Modern Scientists and Physicians also describe Leech and Leech saliva having Anti -Septic, Anti-Biotic and Anti-Coagulant properties.

Semi-Solid Product of Medicinal Leech Enhances Wound Healing in Rats

Background: Wound causes a series of cascading reactions such as cellular damage, inflammatory reactions, and infection. Objectives: The present study aimed to prepare pharmaceutical skin product from lyophilized Hirudo orientalis leech source with active enzyme and proteins, having wound healing and anti-coagulation activities. Methods: The present study focused on the bioactive protein of Hirudo orientalis with anti-trypsin and anti-coagulation activity. First, biological active substance was prepared from lyophilized leech conducted on resultant 5% leech cream. Skin absorption of 5% leech cream was evaluated by Franz cell test, and in vivo wound healing capability of the leech cream was compared with phenytoin cream. In addition, the microbial control of final product was summed-up. Further, the quality control analysis and protein purification in final product were conducted using elution procedure on Hirudin protein-related region. Finally, the anticoagulant activity of the resultant protein was observed. Results: Using the result of the experiments investigating the successful effect containment function of the trypsin, we established the decreased rate of UV absorption in the area of 410 nm in question based on increases in the amount of cream. With 0, 100, 200 and 300 mg of 5% leech cream, absorbance (A) rate was: A (1.9, 1.47, 0.753 and 0.00) (P < 0.05; √2 = 21.6). In anticoagulation activity increased rate of partial thromboplastin time (PTT) (sec) (mean ± SEM), (26 ± 0.00, 34.22 ± 0.61 and 42 ± 0.71) with the 0, 100, and 200 mg final product was established. No bacterial colony growth was observed in the microbial culture analysis. In vivo results demonstrated that leech cream and phenytoin could promote wound regeneration by accelerating the re-epithelialization process and initial angiogenesis among all treatment groups. Conclusions: In the wound healing, we usually seek to reduce pain and inflammation, beside epitelialization and angiogenesis. Leech saliva contains biological substances that we have proven in this study. Our expectations for wound healing will be met with this pharmaceutical product citing the result of this study. The leech product proved to be the best selection for cosmetic with the added capabilities of renovation of the hair glands and regular skin form and typical depth of outer layer of skin. Thus, the leech cream can be considered as a better substitute for the conventional wound healing products.

Nanoencapsulation of Hirudo medicinalis proteins in liposomes as a nanocarrier for inhibiting angiogenesis through targeting VEGFA in the Breast cancer cell line (MCF-7).

Introduction: Breast cancer is the most serious cause of women’s death throughout the world. Using nanocarrier vehicles to the exact site of cancer upgrades the therapeutic efficiency of the drugs. Capsulation of active proteins in the vesicular liposomes’ hydrophilic core is essential to develop a therapeutic protein carrier system. We aimed to encapsulate the medicinal leech saliva extract (LSE) and assess the inhibition of angiogenesis of breast cancer cells by targeting vascular endothelial growth factor A (VEGFA). Methods: In this research, enhanced formulation of liposomal protein was determined by zeta potential analysis, droplet size, drug release assay, and transmission electron microscopy (TEM). Furthermore, a cytotoxicity assay of liposomal LSE was performed to determine the cytotoxic activity of components. For assessing the expression of VEGFA, P53, and hypoxia-inducible factor subunit alpha (HIF1a) genes, Real-Time PCR was applied. Results: Nano liposome was chosen as an enhanced formulation due to its much smaller size (46.23 nm). Liposomal LSE had more practical actions on the MCF-7 cells. As noticed by DAPI staining, apoptosis was extensively greater in treated MCF-7 cells. Wound healing assay demonstrated that MCF-7 cells could not sustain growth at the presence of liposomal LSE and expression of the VEGFA gene was declined in treated cells. Downregulation of VEGFA was evaluated with western blotting technique. Conclusion: It can be concluded that our investigation of the tests confirmed the fact that nano liposomal LSE is a novel promising formulation for anticancer drugs and can significantly improve the penetration of protein drugs to cancer cells.

Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model

BackgroundTesticular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis. The saliva of leeches is full of anti-inflammatory, anticoagulants, antioxidants, and antimicrobial agents. Therefore, this study aimed to assess the protective mechanism of leech therapy on testicular ischemia/reperfusion damage.Methods18 adult male rats were randomly divided into three groups: 1-Sham-operated group (SO). 2-Torsion/detorsion (T.D) group: two hours of testicular torsion with two hours of testicular detorsion was performed. 3-Torsion/detorsion + Leech therapy (TDL) group. Sperm parameters (motility, vitality, morphology, and concentration), oxidative stress biomarkers (MDA, CAT, GPx, and TAC), histopathological factors (Mean seminiferous tubular diameter, Germinal epithelial cell thickness, Testicular capsule thickness, Johnson’s score, and Cosentino’s score), and immunohistochemical markers for apoptosis detection (Bax, Bcl-2, and Caspase-3) were measured.ResultsThere was a significant difference for all sperm parameters in the T. D group compared to the sham group. Leech therapy significantly increased progressive motility and normal morphology and reduced non-progressive motility. In the TDL group, MDA concentration significantly reduced, and levels of GPx, TAC, and CAT remarkably increased. All evaluated histopathological parameters in the TDL group significantly increased compared to the T. D group except for the testicular capsule thickness. T. D notably increased the expression of Bax and Caspase-3, while the treatment group slowed the rate of apoptosis compared to the control group. Bcl-2 expression in the T. D group was significantly lower than that in the sham group. Leech therapy increased the Bcl-2 expression.ConclusionLeech therapy attenuates damages to testicular tissue following torsion/detorsion due to its antioxidant, anti-inflammatory, and anti-apoptotic effects. Hence, it can be considered as an effective remedy for testicular ischemia/reperfusion.Graphical abstract

Prolonged Bleeding due to Hirudotherapy (Medicinal Leech Therapy)

Medicinal leech therapy is a form of complementary medicine that has long been practised and is gaining popularity in recent years for various illnesses and surgical applications. However, leech saliva contains proteins with anticoagulant properties that can lead to prolonged bleeding from the bite area. We report a case of a 35-year-old male who presented to the Emergency Department due to prolonged bleeding from a leech-bite wound. He did not have any significant past medical history or medication history. He had undergone medicinal leech therapy for chronic back pain. After the therapy, he noted that the bleeding did not stop after 7 hours (which normally stops within 30 minutes) and decided to seek treatment. There were wounds over his lower back and both feet, which were all clean. The wound over the lower back had persistent oozing. We applied topical adrenaline and manual compression on the wound, and eventually the bleeding reduced and stopped. There are many suggested methods to stop bleeding from leech-bite wounds but there is scarcity of evidence regarding the superiority of any method. This is the first case report regarding bleeding complications in medicinal leech therapy in Malaysia. This report aims to raise awareness regarding the complications arising from a leech bite among the practitioners of medicinal leech therapy, the public and healthcare providers in emergency facilities. We also suggest using topical adrenaline as an alternative to help stop bleeding from leech-bite wounds.

Assessment of Trace Heavy Metals Contamination in the Tissues and Saliva of the Medicinal Leech Hirudinaria manillensis

Concentrations of heavy metals (HMs) in the tissues and saliva extracts of leeches (Hirudinaria manillensis) collected from Cheneh Lake, Terengganu, Malaysia were investigated. Concentrations of HMs like Cadmium (Cd), Chromium (Cr), Iron (Fe), Manganese (Mn), Nickel (Ni), Lead (Pb), Selenium (Se) and Zinc (Zn) were revealed by utilising Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). Nearly all the examined HMs concentrations in the lake water were noted to be higher compared to the Maximum Permissible Limits (MPL) as per Interim National Water Quality Standards for Malaysia (INWQS). Moreover, traces of HMs were discovered in tissues and saliva extracts of leeches. Such quantities may pose a health hazard to the patients upon an instant application of leeches on their skin. In this work, a novel technique was presented to decrease the level of metals in leech saliva by espousing a frequent washing process involving deionized or non-chlorinated water for three weeks. This process was extremely effectual in considerably decreasing HMs concentrations (P<0.05), particularly Cd level (up to 99.7%) in saliva and Pb level (up to 92.38%) in tissues. Thus, a constant washing process might aid in harmless utilization of leeches for different conventional biomedical practices.

NMR-Based Structural Characterization of a Two-Disulfide-Bonded Analogue of the FXIIIa Inhibitor Tridegin: New Insights into Structure-Activity Relationships.

The saliva of blood-sucking leeches contains a plethora of anticoagulant substances. One of these compounds derived from Haementeria ghilianii, the 66mer three-disulfide-bonded peptide tridegin, specifically inhibits the blood coagulation factor FXIIIa. Tridegin represents a potential tool for antithrombotic and thrombolytic therapy. We recently synthesized two-disulfide-bonded tridegin variants, which retained their inhibitory potential. For further lead optimization, however, structure information is required. We thus analyzed the structure of a two-disulfide-bonded tridegin isomer by solution 2D NMR spectroscopy in a combinatory approach with subsequent MD simulations. The isomer was studied using two fragments, i.e., the disulfide-bonded N-terminal (Lys1–Cys37) and the flexible C-terminal part (Arg38–Glu66), which allowed for a simplified, label-free NMR-structure elucidation of the 66mer peptide. The structural information was subsequently used in molecular modeling and docking studies to provide insights into the structure–activity relationships. The present study will prospectively support the development of anticoagulant-therapy-relevant compounds targeting FXIIIa.

A Case Study: Effect of Jalaukavcharan in Adhimantha With Special Reference to Chronic Simple Glaucoma

In Ayurveda Raktamokshana is the procedure of Panchakarma. Jalaukavcharana is the type of Raktamokshana. A detail description on Jalaukavcharan is available in Ayurveda. It is used in the management of various diseases in all the systems of the body including ears, nose, throat, eyes and head. Now a day’s Leeches are also used by ophthalmologists to treat inflammatory, traumatic processes and various diseases of eyes. There are various bioactive substances are present in saliva of leech. Along with that, it also exerts a therapeutic effect in several diseases. Jalaukavcharana is very effective ancient method of Panchakarma neglected by physician. There are many side effects of modern medicine. So it is the need to spread awareness about Jalaukavcharana and its efficacy. Thus Jalaukavcharana is the alternative therapy promising more effective and safer outcome for the society.

Prostaglandin E1 Is an Efficient Molecular Tool for Forest Leech Blood Sucking.

From a survival perspective, it is hypothesized that leech saliva exhibits certain physiological effects to ensure fast blood-feeding, including analgesia, anesthesia, and anti-inflammation to stay undetected by the host and vasodilatation and anti-hemostasis to ensure a steady, rapid, and sustained blood flow to the feeding site. Many anti-hemostatic compounds have been identified in leech saliva, such as hirudin, calin, and bdellin A. However, no specific substance with direct vasodilatory and anti-inflammatory function has been reported from forest leech saliva. Herein, using activity-guided analysis, prostaglandin E1 (PGE1) was identified for the first time as an efficient molecular tool for forest leech blood sucking. The structure of PGE1 was analyzed by nuclear magnetic resonance spectroscopy and high-resolution electrospray ionization mass spectroscopy. PGE1 was found to be primarily distributed in the leech salivary gland (1228.36 ng/g body weight). We also analyzed how forest leech PGE1 affects platelet aggregation, skin vascular permeability, bleeding time, and pain. Results indicated that PGE1 efficiently inhibited platelet aggregation induced by adenosine diphosphate (ADP) (5 μM) with an IC50 of 21.81 ± 2.24 nM. At doses of 10, 100 nM, and 1 μM, PGE1 increased vascular permeability by 1.18, 5.8, and 9.2 times. It also prolonged bleeding time in a concentration-independent manner. In the formalin-induced mouse paw pain model, PGE1 suppressed acute pain. To the best of our knowledge, this is the first report on PGE1 in invertebrates. The functions of PGE1, such as vasodilation, platelet aggregation inhibition, anti-inflammation, and pain alleviation, may facilitate the ingestion of host blood by leeches.

An Analytical Study to Evaluate the Safety of Reusing of the Vomited Leech in Leech Therapy

Background: Leech therapy is a point of attraction in the medical as well as in the scientific world due to its various outstanding properties, while studying the Ayurveda and scientific literature one can find difference, i.e., discarding after single use as per modern literature, but in Ayurveda, it can be reused after 7 days of leech therapy. Studies of such kind were not carried or published in any scientific journals, so ethical approval and developing scientific methods for validating the study were necessary, so a pilot study began with ethical clearance. Objective: The objective of the study was to evaluate the bacterial and fungal count of leech saliva and blood emesis before and after leech therapy using disc diffusion method. Materials and Methods: Leeches were collected from the normal habitat from Mangalore region possessing the same weight and morphological characteristics as that of the Nirvisha Jalouka as mentioned in classics (Shanku-mukhi). The selected leeches were stored in well water having nonchlorinated with minimum bacterial load. The well water was selected from three geographical regions of Belagavi city, and among them, one sample was selected having minimal bacterial load. Ten patients with infectious skin diseases who were indicated for Jalaukavacharana (Vidradhi, Dushta-vrana) were selected. The experimental leech saliva was tested for total bacterial count (TBC) and total fungal count (TFC) before and on 8th day of application, along with venous blood of the patient and blood vomitus of leech after application was tested for TBC and TFC. Statistical analysis was done based on TFC and TBC before and after application. Results: TBC and TFC of leech saliva at 8th day and before application were similar which indicates the leech gut has destroyed the bacteria or inhibited the growth of bacteria. Conclusion: TBC and TFC help to produce evidence that after application of leech and proper vomiting will not allow the growth of bacteria. Hence, safely, it can be reused after 7 days.

Justification of the effectiveness of hirudotherapy in dentistry

This article provides a systematic review of studies on the composition of leech saliva secretions, the method of hirudotherapy, and the results of hirudotherapy in complex treatment. The following databases were used to search for the study: Scopus, Web of Science, MedLine, and Global Health. When using known methods of treatment, there is often no stability of results, this is explained by the search for new drugs and methods for treating periodontitis. It is known that the secret of the salivary glands of the medical leech contains more than 100 biologically active substances. The therapeutic effect of hirudotherapy is associated with the mechanical discharge of blood flow and the action of a complex salivary gland secretion of a medical leech. The molecules that exist in leech saliva and are the most studied to date include active substances such as hyaluronidase, hirudin, Kalin, destabilase, bdellins, histamine-like substances, hirustazine, factor XA inhibitor, and collagenase. It is scientifically proven that hirudotherapy leads to a significant improvement in the clinical condition of periodontal tissues, is simple, accessible, and can be recommended for use in the practice of periodontists.

Leech therapy in skin conditions from the viewpoints of Avicenna and modern medicine: Historical review, current applications, and future recommendations

Background: Skin conditions are among the most common health problems worldwide and are associated with immense psychological, social, and financial burdens. Atopic dermatitis, alopecia, eczema, diabetic ulcers, and abscesses are common acute or chronic conditions, which are increasing dramatically in prevalence due to industrialization and unhealthy lifestyle habits. The use of complementary and alternative medicine to treat skin diseases has been increasing in recent years. Methods: This review focuses on proposed skin conditions for leech therapy as mentioned by Avicenna, a great Iranian philosopher and physician (980-1037 AD)in the Canon of Medicine. Electronic databases including PubMed, Scopus, and Google Scholar were searched for clinical studies on treatment protocols in this book to compare them with recent clinical trials involving leech therapy. Results: Investigation of traditional Iranian medicine literature can lead to the identification of natural medicines for the management of skin problems. Leech saliva contains anti-coagulative, antiaggregative, and vasodilatory components. Conclusions: In addition to the annelid’s mechanical ability to extract blood, leeches can contribute to patients’ health while posing minimal risks.

ROLE OF JALAUKAVCHARAN IN ADHIMANTHA WITH SPECIAL REFERENCE TO GLAUCOMA

Raktamokshana is the procedure of Panchakarma. Jalaukavcharana is the type of Raktamokshana. A de-tail description on Jalaukavcharan is available in Ayurveda. It is used in the management of various dis-eases in all the systems of the body including ears, nose, throat, eyes and head. Now a day Leeches are al-so used by ophthalmologists to treat inflammatory, traumatic processes and various diseases of eyes. There are various bioactive substances are present in saliva of leech. Along with that, it also exerts a therapeutic effect in several diseases. Jalaukavcharana is very effective ancient method of Panchakarma neglected by physician. There are many side effects of modern medicine. So, it is the need to spread awareness about Jalaukavcharana and its efficacy. Thus, Jalaukavcharana is the alternative therapy promising more effec-tive and safer outcome for the society.

Leech therapy (Jalaukavacharana) - A gift of ayurveda for treatment of medico-surgical diseases

The first description of Jalaukavacharana (leech therapy) is available in Sushruta Samhita written in 800 B.C. Recently, many pieces of research have proved that leech saliva has a variety of bioactive compounds including anti-thrombin (Hirudin, bufrudin), antiplatelet (calin), factor Xa inhibitors, antibacterial and other property. The main objective of the present article is to explore the procedures of leech therapy and research works done over a few decades on the application of leech therapy in different medico-surgical diseases. The procedure of leech therapy is documented from authors' observations and information, and its application in different diseases is gathered from various published works of the last ten years. Many clinical pieces of research show that leech therapy is beneficial in various medico-surgical diseases. A total of eight publications were included in the final selection after systematic analysis. Leech therapy or Jalaukavacharan is an ancient Ayurvedic bloodletting technique that has the great potential to manage many inflammatory, ischemic, and infectious diseases. Leech’s saliva contains many biologically and pharmacologically active compounds that exert anticoagulant, antiplatelet, anti-inflammatory, and anti-edema effects in the host's body. Arthritis, venous congestion, vascular diseases, abscess, ischemic heart disease, etc. can be successfully managed by leech therapy.

Time to Change Theory; Medical Leech from a Molecular Medicine Perspective Leech Salivary Proteins Playing a Potential Role in Medicine.

Followed by developing modern medicine, leeches did not have extensive use as before; however, in the late 19th century, they were still used in most countries all over the world. Thus far, leeches were utilized in treating various diseases like skin disorders, arthritis, and cancer. In Egypt, using leeches for treatment dates back to early 1500 BC. A medical leech’s salivary glands involve over 100 bioactive proteins and the salivary gland secretion contains bacteriostatic, analgesic, and anticoagulation influences; with resolving activity, it causes microcirculation disorders elimination, restoring the hurt vascular permeability of organs and tissues, removing hypoxia, decreasing blood pressure and detoxifying the organism by antioxidant paths. The current work reviews the innovative treatment with medical leech, especially proteins in leech saliva extraction (LSE) with high potential in medicine. The virtue of salivary gland secretions which are proteinaceous enzymes, leech acts on various diseases such as venous congestion in reconstructive and plastic surgery, osteoarthritis, cardiovascular diseases caused by blood coagulation disorders, pain management, priapism, macroglossia, cancer complications, wounds and many other. To confirm the potential therapeutic impacts of leech treatment, more studies are required in more extensive areas with more exact methodologies.

JALAUKAVACHARAN AND DIETARY INTERVENTION IN TWAKA VIKAR (VICHARCHIKA): A CASE STUDY

Currently observed that the sedentary lifestyle and stressed work schedule has increased the number of skin disorders (Twaka Vikara). It has been established fact that the common cause of various skin disorders (Twaka Vikara) is altered Ahara and Vihara (Dietary and Lifestyle changes), specially Viruddhaahar (in-compatible diet). Ancient Ayurveda Scholars described in detail Raktamokshana (the procedure of remov-ing the vitiated blood) for the management of the diseases caused by Rakta and Pitta. The Jalaukavacha-ran (Leech therapy) is one of the effective Raktamokshan (bloodletting) management of vitiated Rakta and Pitta caused skin disorders. In Jalaukavacharan the anti-coagulant property of hirudin, contained in leech saliva, lead to wider therapeutic application in prevention and treatment of various Twaka vikara. Twaka Vikara (Vicharchika) is one of the mostly observed skin disease, which is mainly developed on account of misconduct in all aspect including kayik, vachik, manasik variety of misconducts along with dietary and lifestyle irregularities. Dietary intervention and lifestyle modification play an important role to cure the diseases. In Present case study Patient showing symptoms of Vicharchika (Twaka Vikara) having improper dietary habits and stressed work schedule, after the Dietary Regimen and lifestyle modification along with Jalaukavacharan at local area showed improvement in skin texture. The details of the causative factors, clinical findings, improvements observed after implementation of preventive and curative management plans are presented here.

REVIEW ARTICLE ON JALAUKA AND JALAUKAAVCHARNA

The term Jalauka (leech) may be etymologically interpreted to mean creature whose life (Ayu) or whose longevity is depends upon water, whereas the derivative meaning of the term Jalauka is based upon the fact of their dwelling (“oka” – dwelling place) in water (Jalam). A creature whose life is water called Ja-lauka. Jalauka is having various names which are – Jalayuka, Jalaua, Jaluka etc. There are two types of treatment, advised in Ayurveda - 1. Shamana (internal medicine) 2. Shodhana (internal purification). Leech therapy (Jalaukavacharana) takes a pride of place in the list of Panchakarma like Shodhana Chikitsa. Ja-lauka is the only shodhana treatment that can be done on rich, weak, fearful, sophisticated, old& in case of ladies and children. Due to its sophisticated nature. The knowledge of Jalaukavacharana is as old as the Ayurveda. It is described in Rigved, kaushik sutra, VinayPitak, CharakSamhita and Sushruta Samhita. Sushruta give a detailed description of the Leech and Leech therapy. Modern medical science also de-scribes it in detail. There are two types of Leeches six poisonous (savisha)and six nonpoisonous (nirvisha). Nirvishajalauka are strong and large Ready suckers, Greedy (Mahashana), Saivalashyava (Varna), Vrutta (round), Blue colored. Acharaya Sushruta gives a detailed description of the collection method, collection time, and preservation methods. Leech therapy or Jalaukaavcharana is mainly indicated for Pittaja and Raktaajavikara as vidradhi (Abscess), gulma (Abdominal swelling) arsha (Piles), kushtha (Skin disease) etc. Sushruta describe the method of application of leech in details dividing it into three parts namely Pur-vakarama, Pradhankarama and Pachchatkarama. Modern scientists and physicians also describe Leech and leech saliva having properties of antibiotics, anesthetic, antiseptic, anticoagulant.

REVIEW ARTICLE ON JALAUKA AND JALAUKAAVCHARNA

The term Jalauka (leech) may be etymologically interpreted to mean creature whose life (Ayu) or whose longevity is depends upon water, whereas the derivative meaning of the term Jalauka is based upon the fact of their dwelling (“oka” – dwelling place) in water (Jalam). A creature whose life is water called Ja-lauka. Jalauka is having various names which are – Jalayuka, Jalaua, Jaluka etc. There are two types of treatment, advised in Ayurveda - 1. Shamana (internal medicine) 2. Shodhana (internal purification). Leech therapy (Jalaukavacharana) takes a pride of place in the list of Panchakarma like Shodhana Chikitsa. Ja-lauka is the only shodhana treatment that can be done on rich, weak, fearful, sophisticated, old& in case of ladies and children. Due to its sophisticated nature. The knowledge of Jalaukavacharana is as old as the Ayurveda. It is described in Rigved, kaushik sutra, VinayPitak, CharakSamhita and Sushruta Samhita. Sushruta give a detailed description of the Leech and Leech therapy. Modern medical science also de-scribes it in detail. There are two types of Leeches six poisonous (savisha)and six nonpoisonous (nirvisha). Nirvishajalauka are strong and large Ready suckers, Greedy (Mahashana), Saivalashyava (Varna), Vrutta (round), Blue colored. Acharaya Sushruta gives a detailed description of the collection method, collection time, and preservation methods. Leech therapy or Jalaukaavcharana is mainly indicated for Pittaja and Raktaajavikara as vidradhi (Abscess), gulma (Abdominal swelling) arsha (Piles), kushtha (Skin disease) etc. Sushruta describe the method of application of leech in details dividing it into three parts namely Pur-vakarama, Pradhankarama and Pachchatkarama. Modern scientists and physicians also describe Leech and leech saliva having properties of antibiotics, anesthetic, antiseptic, anticoagulant.

Leeth Therapy (Jalaukavacharana) - A Novel Gift from Ayurveda for Treatment of Medico-Surgical Diseases

Background: The first description of Jalaukavacharana (leech therapy) was found in the text of Sushruta Samhita in 800 B.C. Recently, many researches proved that leech saliva have variety of bioactive compounds involving anti-thrombin (hirudin, bufrudin), anti-platelet (calin), factor Xa inhibitors, antibacterial and others property. Aim: Main aim of present article is to explore about procedures of leech therapy and research works done over few decades on application of leech therapy in different medico-surgical diseases. Methodology: The procedure of leech therapy is documented from authors own observations and Information of its application in different diseases was gathered from various published work of last ten years. Result:-Many clinical researches show that leech therapy is very effective in various medico-surgical diseases. Total eight publications were included in the final selection after systematic analysis. Conclusion: -Leech therapy or Jalaukavacharan is an ancient Ayurvedic bloodletting technique which having the great potential to manage many inflammatory, ischemic and infectious diseases. Leech’s saliva contains many biologically and pharmacologically active compounds which exert effects anti-coagulant, profibrinolytic, anti-platelet, anti-inflammatory and anti-edema in the host’s body. Arthritis, venous congestion, vascular diseases, abscess, ischemic heart disease etc. can be successfully manage by leech therapy/.

Co-administration of Erythromycin and Leech Salivary Extract Alleviates Osteomyelitis in Rats Induced by Methicillin-Resistant Staphylococcus aureus.

Erythromycin (Ery) and leech saliva (LS) can inhibit Staphylococcus aureus growth in in vitro conditions. This study aimed to evaluate the activities and synergy between Ery and LS on chronic osteomyelitis in male Wistar rat's tibia induced by methicillin-resistant S. aureus (MRSA). Four weeks after osteomyelitis induction, rats were divided into four groups including no treatment (control), Ery monotherapy (orally), LS monotherapy, or Ery + LS twice daily for 2 weeks. Staphylococcus aureus growth, pathological signs and inflammatory cytokine tumour necrosis factor-alpha (TNF-α) levels were assessed. Rats tolerated all therapeutic strategies well during the experiment. The Ery treatment alone significantly decreased bacterial growth, pathological signs and TNF-α levels. Leech saliva alone reduced TNF-α level significantly, but did not produce a significant reduction in bacterial growth and pathological signs. Ery + LS treatment significantly decreased bacterial growth, considerably alleviated bone pathological signs and decreased TNF-α levels compared with other groups. Statistical analysis suggested that there was a stronger efficiency and synergistic action of Ery and LS when combined against MRSA-induced osteomyelitis in rats. The present study suggests that LS may have clinical utility to treat MRSA-induced osteomyelitis when combined with Ery or other therapeutics.