Itt írjon a(z) Hirudotherapy-ról/ről
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=HIRUDOTHERAPY IN VET MED=
==1 - Introduction & history== The symbiosis between leeches and their host has been established a very long time ago. According to many reports, it is intuitive for animals with sick hooves to naturally go into leech water. Due to their thermoreceptors, the leeches are led to the hottest areas of the host, which have a high blood supply and/or are inflamed. Some therapists use this behaviour in their procedure. Medicinal leeches have been used for medical purposes since the beginning of civilisation The most prominent specie has been named Hirudo medicinalis by Carl Linne, in the year 1758. Hirudo medicinalis, during 1825 and 1850, reached a point where supplies were exhausted because people used a lot hirudotherapy, but near the end of the 19th century the use of medicinal leeches declined. During the last 15 years, they have been used in medicine, in reconstructive microsurgery, and now more and more in veterinary medicine.
In latin : Hirudo medicinalis, the european medicinal leech. There is several species of medicinal leeches, a mexican, a american.
==2 -General aspects of leeches==
===a.Anatomy & related physiology=== (Alex schema samedi aprem) The leeches are worms that belong to the phyluum Annelida and the subclass Hirudinea. Their body is cylindrical, flattened and divided into 33 or 34 segments. Members of the Hirudo family measure about 20 cm in length, they have 5 pairs of eyes on the head and look for their host by the help of their olfactory system. They have two suckers, one at each end of the body, a posterior and an anterior. The anterior sucker consists of 3 jaw and teeth, it's where the feeding happens. There is also some glands cells and small pores, in the jaws, through which saliva and bioactive substances are released in the wound of the host. They are covered by skin which allows them to breath oxygen water and in the atmosphere. Leeches share a clitellum, it's an enlarged glandular and non-segmented part of the body wall. It's situated near the head and it secretes a viscid sac in which the eggs are layed. Leeches are hermaphrodites. Leeches can take up an amount of blood that is 10 times their body weight and they can also live a year with no food between two meals. This is helped by their poikilothermic characteristic (their internal temperature varies constantly, the energy “saved” is used when movement is needed, like for feeding or reproduction).
===b.Saliva components===
The saliva of the leeches decreases the host’s humoral and immune response, which includes inflammation, swelling and pain.
The leeches secrete from the salivary gland a large variety of bioactive factors. They are released in the wound of the host while they are feeding themselves. Hirudin is the component of the saliva that scientist have studied the most “In 1950, Fritz Marquardt of Germany isolated a protein from H. medicinalis that he termed hirudin, and demonstrated its thrombin inhibitor properties. Hirudin is still regarded as the most potent natural inhibitor of thrombin, thanks to its high affinity for the protein” (Sobczak N. , Kantyka M. , Hirudotherapy in veterinary medicine)
Recently the scientist found a new class of leech-derived factors, the hirudin-like factors, also called HLFs. An other important component of the saliva is the lipid distribution. In these are the phospholipases and the lipases, that are present to prevent healing of the wound in the attacked host.
===c.Habitat===
Medicinal leeches habitat extends from Western, Southern Europe and Ural mountains to the countries close to the Mediterranean. The leeches are amphibious animals, they need to be close to water and land. They live only in fresh water. For example; the perfect habitat for Hirudo Medicinalis is a small pond with mud on the edges. A country where leeches are present a lot is Turkey. The highest number of leeches are present on the Black sea coast. The Leeches bred by humans are kept in aquaculture.The 2 countries that are the major exporters of medicinal leeches are the Russia and Turkey.
==3 - Medical use==
The medicinal leech is used in human medicine for a variety of diseases, mostly for venous congestion that follow reconstructive surgeries, treatments for osteoarthritis, and other therapy less known. In animals, mostly cats, horses and dogs, the primary indication for leech therapy is the need to salvage tissues whose viability is threatened by venous congestion after surgery, or in case of non efficiency of a traditional treatement. The action of leeches for venous congestion is a reduction of the capillary pressure and an increase of arterial reperfusion of capillary beds.
There is one published report that explains how a cat ,suffering from polycythemia vera, was treated with medicinal leeches, the article is linked at the end of the page and as well as 2 experiments on rats https://www.ncbi.nlm.nih.gov/pubmed/11721985
http://www.sciencedirect.com/science/article/pii/S2005290114000028 http://www.sciencedirect.com/science/article/pii/S0022480408000176
===a.Obtention & storage===
The medicinal leeches used in the treatments of animals must come from special leech breeding farms. It is forbidden to take the leeches from the nature, because they could be contaminated by bacteria, parasites or viruses*. To assure quality on the production site**, imported batches must undergo a 32 week quarantine, be traceable by documentation, have had microbial and virological examinations of their water and feeding-blood. Only healthy leeches are selected; they should be responsive to the touch, motile and flexible. Leeches should be delivered one or two days prior to the treatment, and should look healthy. They are stored in a suitable sterile glass, with water that is changed a of couple times per week and they are not fed. Although the glass is lockable, they do not suffocate as their oxygen need is minimal. No more than 5 to 10 leeches should be stored in 1Liter as their excretion of metabolic products could contaminate the group.
**: Guidline by the German health authority (Bundesintiture fur Arzneimittel & medizinprodukte BfArM, www.bfarm.de)
===b.Procedure===
The patients, most commonly: cats, dogs or horses, receive one to seven sessions depending on the severity of the disease or wound treated. The number of leeches used in the session varies on the patient specie, its characteristics and its size: One Hirudo medicinalis is used for a small animal weighing 10 kg, whereas therapists use five to fifteen leeches when healing a horse. (mettre image). The medicinal leech is placed on the wound, where it pierces the skin with its 3 jaws. The saliva components of the leech prevent the animal from feeling pain due to the bite. The leeches stay on the affected sites until they reach satiety, which can take from 30-60 minutes in small animals to 120 minutes in horses. When the Hirudo medicinalis is done sucking blood, it falls off. The bleeding continues from the the site of the bite and it shouldn’t be stopped as it is part of the therapy. The therapist treats biting-site with bandages after the blood cesses to flow. To ensure quality of treatments, leeches should not be used repetitively, even on a same patient.
===c.Biochemical healing & Physio===
The active effect of hirudin is based on synergies with other components of leech saliva, such as antistasin and ghilanten, which are potent specific inhibitors of the blood coagulation Factor Xa [11]. Bdellin is a substance which exerts an anti- inflammatory influence by inhibiting the protease involved in the spread of inflammation. Hyaluronidase, an enzyme with antibiotic properties that degrades hyaluronic acid, facilitates the penetration and diffusion of pharmacologically- active substances into tissues. Other important substances produced by leeches may include substances that reduce blood viscosity and have anti-cancer properties. In addition, leeches produce a number of important neurotransmitters such as dopamine, serotonin, acetylcholine and enkephalin, which reduce the perception of pain by the patient and have a relaxation effect on the whole organism
ALEX REWRITE/CONTINUE WITH 1rst EMAIL DOC Mode of action: Anticoagulant effect: Antialgesic effect: Anti-infla Stimulation of blood circulation Antibiosis
===d.Conditions leading to treatement failure===
First of all, the transport of leeches must be done correctly. They musn’t be used if they show any disease indication, such as show any injuries, leave a blood-trail, smell, have a pale skin colour or are covered in slime. The water in which the leeches are stored must be analysed. Some substances even at low doses, such as Chlorine (often found in tap water), may lead to their death. Some drugs or ointements used on the patient may also lead the the treatement inefficiency as leeches won’t bite the host. Although leeches can survive in temperature varying from 0 to over 30°C, they can undergo lethal stress in case of thermic choc. This is in hot summers and cold winters (when treating an animal outside), loss rate of leeches is quite high.
4 - Benefits
5 - Risks & contreindications Side effects:
1rst email Aeromonad spp. infection: https://link.springer.com/article/10.1007%2Fs10096-016-2629-5
===6.Conditions that are already treated with leech therapy===
“According to the estimates of Bierbertaler Blutegelzucht GmbH , aout 20.000 to 25.000 annual leech treatments are performed on animals” www.blutegel.de/egel/export/sites/default/en/downloads_en/pdf/VET_Aurich_Henne_The_Use_of_Leeches_in_Veterinary_Medicine.pdf Most common: hip and elbow dysplasia, acute and chronic arthritis, diseases associated with inflammation of tendons, ligaments, and fascia, diseases of the vertebrae and the treatment of scars https://www.ncbi.nlm.nih.gov/pubmed/27427444: LT in flap salvage: systematic review & practical recommendations. Article entier sur DirectScience: https://linkinghub.elsevier.com/retrieve/pii/S0294-1260(16)30091-7
https://vcot.schattauer.de/en/contents/archivestandard/issue/1868/manuscript/21092.html
tableau/specie
===7.Futur projects=== Importance of alternative medicine is growing, which plays a major role here.
References : Sobczak N. , Kantyka M. ,2014, Hirudotherapy in veterinary medicine, Annals of Parasitology 60(2): 89-92
http://ac.els-cdn.com/S2225411016302875/1-s2.0-S2225411016302875-main.pdf?_tid=8e14b404-2028-11e7-9c68-00000aab0f6c&acdnat=1492074601_f79573b230284c71f57534ef3521b7fe Global: file:///C:/Users/Alexia/Downloads/2014-60-2_89%20a.pdf = https:// www.ncbi.nlm.nih.gov/pubmed/ 25115059 http://www.sciencedirect.com/science/article/pii/S0266435603002420
Edit conflict - your version:
=HIRUDOTHERAPY IN VET MED=
==1 - Introduction & history== The symbiosis between leeches and their host has been established a very long time ago. According to many reports, it is intuitive for animals with sick hooves to naturally go into leech water. Due to their thermoreceptors, the leeches are led to the hottest areas of the host, which have a high blood supply and/or are inflamed. Some therapists use this behaviour in their procedure. Medicinal leeches have been used for medical purposes since the beginning of civilisation The most prominent specie has been named Hirudo medicinalis by Carl Linne, in the year 1758. Hirudo medicinalis, during 1825 and 1850, reached a point where supplies were exhausted because people used a lot hirudotherapy, but near the end of the 19th century the use of medicinal leeches declined. During the last 15 years, they have been used in medicine, in reconstructive microsurgery, and now more and more in veterinary medicine.
In latin : Hirudo medicinalis, the european medicinal leech. There is several species of medicinal leeches, a mexican, a american.
==2 -General aspects of leeches== === a.Anatomy & related physiology === (Alex schema samedi aprem) The leeches are worms that belong to the phyluum Annelida and the subclass Hirudinea. Their body is cylindrical, flattened and divided into 33 or 34 segments. Members of the Hirudo family measure about 20 cm in length, they have 5 pairs of eyes on the head and look for their host by the help of their olfactory system. They have two suckers, one at each end of the body, a posterior and an anterior. The anterior sucker consists of 3 jaw and teeth, it's where the feeding happens. There is also some glands cells and small pores, in the jaws, through which saliva and bioactive substances are released in the wound of the host. They are covered by skin which allows them to breath oxygen water and in the atmosphere. Leeches share a clitellum, it's an enlarged glandular and non-segmented part of the body wall. It's situated near the head and it secretes a viscid sac in which the eggs are layed. Leeches are hermaphrodites. Leeches can take up an amount of blood that is 10 times their body weight and they can also live a year with no food between two meals. This is helped by their poikilothermic characteristic (their internal temperature varies constantly, the energy “saved” is used when movement is needed, like for feeding or reproduction).
b.Saliva components
The saliva of the leeches decreases the host’s humoral and immune response, which includes inflammation, swelling and pain.
The leeches secrete from the salivary gland a large variety of bioactive factors. They are released in the wound of the host while they are feeding themselves. Hirudin is the component of the saliva that scientist have studied the most “In 1950, Fritz Marquardt of Germany isolated a protein from H. medicinalis that he termed hirudin, and demonstrated its thrombin inhibitor properties. Hirudin is still regarded as the most potent natural inhibitor of thrombin, thanks to its high affinity for the protein” (Sobczak N. , Kantyka M. , Hirudotherapy in veterinary medicine)
Recently the scientist found a new class of leech-derived factors, the hirudin-like factors, also called HLFs. An other important component of the saliva is the lipid distribution. In these are the phospholipases and the lipases, that are present to prevent healing of the wound in the attacked host.
c.Habitat
Medicinal leeches habitat extends from Western, Southern Europe and Ural mountains to the countries close to the Mediterranean. The leeches are amphibious animals, they need to be close to water and land. They live only in fresh water. For example; the perfect habitat for Hirudo Medicinalis is a small pond with mud on the edges. A country where leeches are present a lot is Turkey. The highest number of leeches are present on the Black sea coast. The Leeches bred by humans are kept in aquaculture.The 2 countries that are the major exporters of medicinal leeches are the Russia and Turkey.
== 3 - Medical use == The medicinal leech is used in human medicine for a variety of diseases, mostly for venous congestion that follow reconstructive surgeries, treatments for osteoarthritis, and other therapy less known. In animals, mostly cats, horses and dogs, the primary indication for leech therapy is the need to salvage tissues whose viability is threatened by venous congestion after surgery, or in case of non efficiency of a traditional treatement. The action of leeches for venous congestion is a reduction of the capillary pressure and an increase of arterial reperfusion of capillary beds.
There is one published report that explains how a cat ,suffering from polycythemia vera, was treated with medicinal leeches, the article is linked at the end of the page and as well as 2 experiments on rats https://www.ncbi.nlm.nih.gov/pubmed/11721985
http://www.sciencedirect.com/science/article/pii/S2005290114000028 http://www.sciencedirect.com/science/article/pii/S0022480408000176
a.Obtention & storage
The medicinal leeches used in the treatments of animals must come from special leech breeding farms. It is forbidden to take the leeches from the nature, because they could be contaminated by bacteria, parasites or viruses*. To assure quality on the production site**, imported batches must undergo a 32 week quarantine, be traceable by documentation, have had microbial and virological examinations of their water and feeding-blood. Only healthy leeches are selected; they should be responsive to the touch, motile and flexible. Leeches should be delivered one or two days prior to the treatment, and should look healthy. They are stored in a suitable sterile glass, with water that is changed a of couple times per week and they are not fed. Although the glass is lockable, they do not suffocate as their oxygen need is minimal. No more than 5 to 10 leeches should be stored in 1Liter as their excretion of metabolic products could contaminate the group.
**: Guidline by the German health authority (Bundesintiture fur Arzneimittel & medizinprodukte BfArM, www.bfarm.de)
b.Procedure
The patients, most commonly: cats, dogs or horses, receive one to seven sessions depending on the severity of the disease or wound treated. The number of leeches used in the session varies on the patient specie, its characteristics and its size: One Hirudo medicinalis is used for a small animal weighing 10 kg, whereas therapists use five to fifteen leeches when healing a horse. (mettre image). The medicinal leech is placed on the wound, where it pierces the skin with its 3 jaws. The saliva components of the leech prevent the animal from feeling pain due to the bite. The leeches stay on the affected sites until they reach satiety, which can take from 30-60 minutes in small animals to 120 minutes in horses. When the Hirudo medicinalis is done sucking blood, it falls off. The bleeding continues from the the site of the bite and it shouldn’t be stopped as it is part of the therapy. The therapist treats biting-site with bandages after the blood cesses to flow. To ensure quality of treatments, leeches should not be used repetitively, even on a same patient.
c.Biochemical healing & Physio
The active effect of hirudin is based on synergies with other components of leech saliva, such as antistasin and ghilanten, which are potent specific inhibitors of the blood coagulation Factor Xa [11]. Bdellin is a substance which exerts an anti- inflammatory influence by inhibiting the protease involved in the spread of inflammation. Hyaluronidase, an enzyme with antibiotic properties that degrades hyaluronic acid, facilitates the penetration and diffusion of pharmacologically- active substances into tissues. Other important substances produced by leeches may include substances that reduce blood viscosity and have anti-cancer properties. In addition, leeches produce a number of important neurotransmitters such as dopamine, serotonin, acetylcholine and enkephalin, which reduce the perception of pain by the patient and have a relaxation effect on the whole organism
ALEX REWRITE/CONTINUE WITH 1rst EMAIL DOC Mode of action: Anticoagulant effect: Antialgesic effect: Anti-infla Stimulation of blood circulation Antibiosis
d.Conditions leading to treatement failure
First of all, the transport of leeches must be done correctly. They musn’t be used if they show any disease indication, such as show any injuries, leave a blood-trail, smell, have a pale skin colour or are covered in slime. The water in which the leeches are stored must be analysed. Some substances even at low doses, such as Chlorine (often found in tap water), may lead to their death. Some drugs or ointements used on the patient may also lead the the treatement inefficiency as leeches won’t bite the host. Although leeches can survive in temperature varying from 0 to over 30°C, they can undergo lethal stress in case of thermic choc. This is in hot summers and cold winters (when treating an animal outside), loss rate of leeches is quite high.
4 - Benefits 5 - Risks & contreindications Side effects: 1rst email Aeromonad spp. infection: https://link.springer.com/article/10.1007%2Fs10096-016-2629-5
6.Conditions that are already treated with leech therapy
“According to the estimates of Bierbertaler Blutegelzucht GmbH , aout 20.000 to 25.000 annual leech treatments are performed on animals” www.blutegel.de/egel/export/sites/default/en/downloads_en/pdf/VET_Aurich_Henne_The_Use_of_Leeches_in_Veterinary_Medicine.pdf Most common: hip and elbow dysplasia, acute and chronic arthritis, diseases associated with inflammation of tendons, ligaments, and fascia, diseases of the vertebrae and the treatment of scars https://www.ncbi.nlm.nih.gov/pubmed/27427444: LT in flap salvage: systematic review & practical recommendations. Article entier sur DirectScience: https://linkinghub.elsevier.com/retrieve/pii/S0294-1260(16)30091-7
https://vcot.schattauer.de/en/contents/archivestandard/issue/1868/manuscript/21092.html
tableau/specie
7.Futur projects
Importance of alternative medicine is growing, which plays a major role here.
References : Sobczak N. , Kantyka M. ,2014, Hirudotherapy in veterinary medicine, Annals of Parasitology 60(2): 89-92
http://ac.els-cdn.com/S2225411016302875/1-s2.0-S2225411016302875-main.pdf?_tid=8e14b404-2028-11e7-9c68-00000aab0f6c&acdnat=1492074601_f79573b230284c71f57534ef3521b7fe Global: file:///C:/Users/Alexia/Downloads/2014-60-2_89%20a.pdf = https:// www.ncbi.nlm.nih.gov/pubmed/ 25115059 http://www.sciencedirect.com/science/article/pii/S0266435603002420
End of edit conflict