May
11
2005

Prescription Insects

Biotherapy is the use of animals to diagnose or treat diseases or to assist the ill or impaired.

A leech: it does a body good?
A leech: it does a body good?Courtesy Michael Jefferies

One biotherapy that many of us are familiar with is seeing eye dogs. A less common biotherapy is the use of household pets, such as dogs or cats, in long term care facilities to improve the mood of and provide companionship for the people living there.

But other, less familiar animals have been put to medicinal purposes, too. Leeches have been used for thousands of years for various "medical" uses, and have recently been approved as a medical device by the U.S. Food and Drug Administration (FDA). Doctors use leeches to restore blood circulation after cosmetic or reconstructive surgery.

Maggot therapy has also staged a comeback. Doctors use maggots to treat and clean problematic wounds.

Honey bee therapy (or apitherapy), is the use of honey bee venom—which contains anti-inflammatory substances—to relieve pain in patients suffering from rheumatoid arthritis. Apitherapy can also help treat some neurological syndromes, such as multiple sclerosis.

What do you think of biotherapy? How would you react if a doctor told you that they were going to treat you with leeches or maggots?

Want to learn more about biotherapy? The BTER Foundation is an organization dedicated to supporting patient care, education, and research in biotherapy and symbiotic medicine. The International Biotherapy Society is another organization devoted to supporting the use and understanding of living organisms in the treatment of human illnesses.

Your Comments, Thoughts, Questions, Ideas

Anonymous's picture
Anonymous says:

Good job Joe.........I would not feel so good about the leeches, but what do I know. That's why I'm here..to learn! From your mother in law

posted on Wed, 05/11/2005 - 3:36pm
Anonymous's picture
Anonymous says:

disgustin mate get a life

posted on Thu, 02/23/2006 - 4:21am
Anonymous's picture
Anonymous says:

How do you get the maggots out once you have them on someone?

posted on Wed, 05/11/2005 - 3:44pm
Joe's picture
Joe says:

Maggots are the larval stage of flies, and go through several stages of growth. The maggots usually placed on wounds are in their first stage of growth. Doctors will rinse out the maggots from the wound before they turn into their second growth size. Or, when applying the maggots to the wound they are placed in a cage-like dressing over the wound. The maggots can move around within that cage with the wound acting as the bottom of the cage. Flies (and therefore maggots) have extremely predictable life cycles, so the doctors know when to remove them. (These predictable life cycles are what also makes flies so useful in forensic entomology.)

And, even if the doctor misses a maggot or two, which is very unlikely, the maggots will only stay in the wound as long as there is something there for them to eat - the dead tissue of the wound. They don't feed on live tissue, so once all the dead stuff is gone, the maggots will move on to try to find another food source.

posted on Wed, 05/11/2005 - 4:29pm
Liza's picture
Liza says:

Certain species of maggots actually prefer to eat dead and dying tissue. (They leave healthy flesh alone.) And in the process, they excrete an anti-microbial chemical which also helps clean the wound.

How do doctors use the maggots? First they mix live fly larvae into a wound's dressing and cover the area with gauze. And then they wait. They cut the dressing away two or three days later. The well-fed maggots--now up to ten times their original size!--can be easily picked off.

Maggots are sometimes better than doctors at cleaning wounds. When humans have to cut out the dead tissue, they often make the wound bigger and remove some healthy tissue besides. But maggots, finicky eaters that they are, are extremely precise. Also, it's hard to keep wounds free of infection, but the chemical that the maggots excrete actually promotes the growth of new tissue. Plus, with maggot therapy there's no risk of anti-biotic resistance.

Sounds gross, huh? But people who have undergone maggot therapy say it's no worse than conventional treatment, and certainly better than the possibility of losing a limb. Their biggest complaints? The maggots are squirmy and cause itching while they do their work. Growing maggots crawling over nerves or squeezing into tight spaces can cause discomfort or even pain for the patient. And the wound oozes while it heals, and can sometimes be smelly. Unpleasant, to be sure, but the treatment only lasts 72 hours...

posted on Wed, 05/11/2005 - 4:45pm
Val Cervenka's picture

Great job, Joe and Liza. I would seriously like to foster an interest in maggot debridement therapy here in Minnesota, or at least in the Twin Cities, because of all the reasons you listed above. No kidding! Like a lot of things involving insects, most people can't get past the ick factor. Maybe you should take this show on the road. I'll bet Ron Sherman would fly out and give a talk to the medical community about the treatment and how to implement it. Gotta run, almost time for me to be where you are...

posted on Tue, 10/14/2008 - 5:28pm
bryan kennedy's picture

As gross as this sounds--and would probably feel--I would far prefer it to loosing a limb to gangrene. I am sure that smells worse.

posted on Wed, 10/29/2008 - 2:33pm
Anonymous's picture
Anonymous says:

I have seen a TV show about a calm dog that one day started nipping at and finaly bit his owner's breast. She went to the doctor to examine the bite, and they found a cancer tumor exactly where the bite was. Thanks to the dog, she was cured soon enough.

posted on Thu, 05/12/2005 - 4:03pm
bryan kennedy's picture

This might not be as crazy as it seems. In a report from Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D., doctors reported being able to train a group of 6 dogs to sniff out the smell of urine from a person with bladder cancer. I haven't been able to find any evidence of this same ability transferring to breast cancer. However, one thing is for sure; we don't know much about a dog's remarkable sense of smell. It is very hard to breed dogs to be good sniffers and there is no one breed where every dog is a good sniffer.

This is all a good reminder that if you observe something in our world and it looks strange and implausible, that doesn't mean that it isn't true. You might just need to study it more.
-----------------------------
bryan kennedy
Science Buzz Site Admin

posted on Thu, 05/12/2005 - 4:23pm
Joe's picture
Joe says:

The use of dogs to detect cancer is being closely examined. The BTER Foundation sites several articles about the use of dogs to detect cancer. There is even some anecdotal evidence that dogs may even be able to detect seizures.

posted on Fri, 05/13/2005 - 9:56am
bryan kennedy's picture

Wow, that's cool Joe. Now we just need to train more humans to understand what dogs mean when they are freaking out about something important.
-----------------------------
bryan kennedy
Science Buzz Site Admin

posted on Fri, 05/13/2005 - 10:23am
Liz's picture
Liz says:

I heard on the radio that there used to be a job, or maybe still is, to collect the leeches used for medicinal purposes. The claim was that people were hired to wade in leech infested water, come onto shore, scrape the bloodsuckers off, and go back in agian. Is this true? It certainly makes my job sound much more appealing!

posted on Fri, 05/13/2005 - 7:07am
Joe's picture
Joe says:

The leeches that are used in hospitals usually come from "farms", primarily Biopharm. I would imagine wading through ponds or lakes was a method of collecting leeches in the past, but hospitals and doctors are a bit fussier about their leeches these days. Although, you are right, it does help you look at your own job in a different light.

posted on Fri, 05/13/2005 - 10:41am
Joe's picture
Joe says:

The FDA is now taking an even closer look at the use of maggots and leeches. Currently the FDA considers both "unclassified" medical devices, but there is consideration now that both be classified as class II medical devices, subject to some safety requirements.

Given that demand for medical grade maggots has grown significantly over the past few years it is likely that more businesses will get into the business of growing and distributing them, so the FDA has good reason to formalize things.

The FDA's device division will conduct the review, as the FDA sees the process these creatures use (chewing dead flesh, eating blood) as mechanical processes.

After panel meeting this past Thursday, both maggots and leeches were recommended both be classified as Class II medical devices with special controls. In each case the special controls would be a detailed guidance document.

posted on Wed, 09/07/2005 - 8:25am
Anonymous's picture
Anonymous says:

Could maggots be used for the treamnet of glioma or other brain tumors? Is anyone currently studying this?

posted on Thu, 12/01/2005 - 12:17am
Joe's picture
Joe says:

I'd suggest you contact the BTER Foundation with this question. A quick search of the internet didn't reveal any connections, and my guess is that since maggots only eat dead tissue, and tumors, such as Arterio-Venous Malformations that occur in the brain, are not dead tissue, so the maggots wouldn't eat them. Also, the maggots need air to breathe, and it may be difficult to leave the part of the brain needing to be cleared open to air for the many days that maggots need to work.

posted on Thu, 12/01/2005 - 11:21am
Keisha Diaz's picture
Keisha Diaz says:

Hello..can you please tell me how I can get into owning my own leech and maggot farm, my friends think I'm crazy but they know that I've always been the kind of person to do the unordinary thing....thanks Keisha Diaz

posted on Fri, 01/27/2006 - 1:00pm
Liza's picture
Liza says:

It's a surprisingly complicated business, actually, and not very many companies supply maggots and leeches.

Here, for example, is information about Biopharm Leeches, one of the first and biggest companies to get into the leech business. (Look especially at "Leech Information.")

(For a kids' look at leaches, check out "The Yuckiest Site on the Internet.")

posted on Fri, 01/27/2006 - 2:39pm
Qq's picture
Qq says:

Hello! There have been important warnings never to re-use a leech on a second patient and never return a used leech to a pharmacy as they might spread blood related Diseases. If a leech bit someone with HIV, will it spread to another person who was accidently bitten?? *curious* How do we ensure that a leech is "Healthy"? Thank uu~

posted on Wed, 02/15/2006 - 8:50am
bryan kennedy's picture

Good question. What I have read that there is a general practice in this field to only use a leach once per treatment and patient. This would be similar to how needles are used in the medical practice. While there doesn't seem to be research on HIV transmission by leeches they have been shown to be able to carry Hepatitis-B:

There are problems associated with the use of leeches in this way. One is the possibility that, if used on more than one patient, they could transmit pathogens like the hepatitis B virus and HIV from one patient to another. Research done on A. buntonensis in Durban by Glenn Wilken suggests that if a leech is fed on hepatitis B +ve blood, the virus may persist in its bloodmeal for several months while digestion takes place. Although we know nothing about the fate of HIV under such conditions, such "mechanical" transmission will be avoided by the general policy of using a leech only once.

From An African leech for use in microsurgery in Africa! at Science in Africa.

Leeches would also not be used on someone who is known to actually have HIV.

Patients with HIV infection, or individuals taking immunosuppressive medications should not undergo leech therapy because of the risk of overwhelming bacterial sepsis.

From Aetena's (health care provider) Clinical Policy Bulletin on Leech Therapy

posted on Wed, 02/15/2006 - 11:04am
Rohit's picture
Rohit says:

Hi,
Did you find more links on the Leeches and the HIV virus etc, if yes please share them with me as I am keen to know more on the subject.

Regards

Rohit

posted on Thu, 03/16/2006 - 12:22pm
Anonymous's picture
Anonymous says:

which is more effective , honey bee's, leeches or maggots ?
and what do each of them effect ?

posted on Mon, 10/29/2007 - 12:44pm
Joe's picture
Joe says:

Your question is pretty hard to answer as they treat different ailments. I would say that if they are used in modern medical practices that would imply that they are effective. How effective I imagine varies on a case by case basis. As to what they each effect - I suggest reading the article above and following the links provided. That'll get you what you need, I think.

posted on Tue, 10/30/2007 - 5:23pm
Lottie's picture
Lottie says:

Where do you get maggots and leeches and which companies supply them?

posted on Wed, 10/31/2007 - 7:11am
Joe's picture
Joe says:

Again, follow the links in the main article for the answers.

posted on Wed, 10/31/2007 - 3:30pm
Anonymous's picture
Anonymous says:

How does a maggot just 'get' on someone - someone I know had been sick and he had maggots in his pants - how could this happen - there were no flies that anyone saw...

posted on Wed, 07/02/2008 - 1:17pm
JGordon's picture
JGordon says:

Maggots in his pants...

Well, I'm done for the day.

posted on Wed, 07/02/2008 - 1:41pm
Liza's picture
Liza says:

Here's an awesome leech link (to MAKE Magazine, one of my faves). It's a teaser for a NOVA Science Now episode about the little bloodsuckers. Also, you'll find info about buying and raising leeches, and who doesn't want that?

posted on Mon, 08/04/2008 - 11:40am
Bella's picture
Bella says:

I am searching for information regarding the use of leeches to treat adenoid cystic carcinoma. Is it possible to incise the palate and attach a leech to remove the tumour? Perhaps this is an absurd question but I would appreciate any feedback .

posted on Mon, 01/05/2009 - 3:14pm
Liza's picture
Liza says:

Hmmm, interesting thought.

I don't think a leech is the proper critter. They're bloodsuckers, and generally used to restore blood flow after microsurgery.

Blowfly maggots, on the other hand, are used for wound treatment since they feed on dead tissue. The tricky bit, though, is that tumors are anything but dead tissue. And, in fact, the maggots encourage live tissue to grow--something you'd definitely want to avoid when dealing with a tumor. A quick Google search looking for maggot therapy as a cancer treatment turned up nothing. That doesn't mean it wouldn't work, or that someone isn't looking into it, but I couldn't find any information. And my hunch is that, as remarkable as maggot therapy is for lots of other ailments, cancer treatment isn't its strong suit.

posted on Mon, 01/05/2009 - 5:02pm
Bella's picture
Bella says:

Hi Liza , thankyou for replying. I have been searching the internet and have come across several sites relating to leeches being used in medicine today. Also, mentioning leech treatment for tumours. A research paper, refers to leech treatment in many medical conditions, however the article is very brief and doesn't expand on such treatment in ENT tumours. I will keep searching and let you know if I have success.

posted on Tue, 01/06/2009 - 12:12am
Anna Kate's picture
Anna Kate says:

Very interesting but I have a project on how doctors use leeches for medical uses. Know any websites?

posted on Fri, 01/16/2009 - 9:06pm
darrie's picture
darrie says:

I don't think I could ever stand leeches on me, I can't stay anywhere near them, they are just not for me. Thank you, I'll pass.

posted on Wed, 09/23/2009 - 4:37pm

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