Pharmacological Properties of the Medical Maggot: A Novel Therapy Overview

Published on May 3, 2018in Evidence-based Complementary and Alternative Medicine1.813
· DOI :10.1155/2018/4934890
Litao Yan3
Estimated H-index: 3
(Dalian Medical University),
Jin Chu3
Estimated H-index: 3
(Dalian Medical University)
+ 5 AuthorsShouyu Wang15
Estimated H-index: 15
(Dalian Medical University)
Sources
Abstract
In the last decade, maggot has been hailed as the miraculous “medicinal maggot” for its diverse properties, including antimicrobial, antibiofilm, anti-inflammatory, and wound healing activities. The fact that maggots show so many beneficial properties has increased the interest in these tiny larvae dramatically. Whilst there is relatively abundant clinical evidence to demonstrate the success of maggots as debridement agents, not so much emphasis has been placed on the basic science evidence, which was a combination of physical and biochemical actions. This review differs from those earlier works in that it is undertaken to provide an update of the latest scientific basis published on maggot, particularly active ingredients within maggot excretions/secretions (ES). Further investigations should focus on the isolation, identification, recombination, transgenosis, and mass production of the beneficial molecules within maggots.
References69
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#2Rosalynn M. Nazarian (Harvard University)H-Index: 26
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#1Tetsuro Tamura (Kyushu University)H-Index: 3
#1Tetsuro Tamura (Kyushu University)H-Index: 1
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: Larvae of the blowfly Lucilia sericata facilitate wound healing by removing dead tissue and biofilms from non-healing and necrotic wounds. Another beneficial action of larvae and their excretions/secretions (ES) is down-regulation of excessive inflammation. As prolonged complement activation is key to excessive inflammation, the aim of this study was to elucidate the mechanisms underlying the anti-complement activities of ES. Results revealed that heat sensitive serine proteases in ES degrade ...
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#2Heiko Vogel (MPG: Max Planck Society)H-Index: 61
Last. Andreas Vilcinskas (Fraunhofer Society)H-Index: 65
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#1Rebecca J. Linger (NCSU: North Carolina State University)H-Index: 5
#2Esther J. Belikoff (NCSU: North Carolina State University)H-Index: 9
Last. Maxwell J. Scott (NCSU: North Carolina State University)H-Index: 29
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#2Mareike Kahl (University of Giessen)H-Index: 2
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