Amerikanische Gesellschaft für Hirudotherapie

Intelligente Bibliothek

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Curated knowledge libraryReference collection

Conditions

12

Raynaud's Syndrome (Primary)

Tier C

Investigational use for primary Raynaud's phenomenon; mechanism via local vasodilation and rheologic improvement. No RCT evidence.

InvestigationalMechanistic

Livedo Reticularis

Tier C

Investigational use for primary livedo reticularis; very limited evidence. Secondary causes (lupus, APLAS) require rheumatology referral.

InvestigationalMechanistic

Insulin Injection Lipohypertrophy

Tier C

Investigational use to soften and remodel insulin injection-related lipohypertrophy nodules; very limited evidence.

InvestigationalMechanistic

Peyronie's Disease (Stable Phase)

Tier C

Investigational use for stable-phase Peyronie's disease; case-report-level evidence only. Standard treatments (verapamil, collagenase, surgery) remain first-line.

InvestigationalMechanistic

Ménière's Disease (Adjunctive)

Tier C

Investigational adjunctive use for Ménière's disease; very limited evidence. Standard management (diet, betahistine, intratympanic therapy) remains primary.

InvestigationalMechanistic

Peripheral Vertigo (BPPV-Refractory / Vestibular Neuritis Recovery)

Tier C

Investigational adjunct for peripheral vertigo persisting after Epley maneuvers or during prolonged vestibular neuritis recovery; anecdotal.

InvestigationalMechanistic

Tarsal Tunnel Syndrome

Tier C

Investigational use for posterior tibial nerve entrapment at the medial ankle; very limited case-report evidence.

InvestigationalMechanistic

Pubic Symphysis Dysfunction (Non-Pregnancy)

Tier C

Investigational use for non-pregnancy-related pubic symphysis dysfunction including athletic osteitis pubis; anecdotal evidence.

InvestigationalMechanistic

Cluster Headache (Episodic)

Tier C

Highly investigational use for episodic cluster headache between attack cycles; very limited anecdotal data, not for active attacks.

InvestigationalMechanistic

Severe Inflammatory Acne Vulgaris

Tier C

Highly investigational use for severe nodulocystic acne refractory to isotretinoin; very limited anecdotal evidence and significant scarring risk concerns.

InvestigationalMechanistic

Cutaneous Lichen Planus (Localized)

Tier C

Investigational use for localized cutaneous lichen planus refractory to topical corticosteroid; very limited case-report evidence.

InvestigationalMechanistic

Chronic Anal Fissure (>8 Weeks)

Tier C

Investigational adjunct for chronic anal fissure refractory to medical therapy; very limited case-report evidence; surgical sphincterotomy remains gold standard.

InvestigationalMechanistic

Compounds

52

Hyaluronidase

Enzyme that degrades hyaluronic acid in extracellular matrix — 'spreading factor' enhancing diffusion of other SGS compounds.

Preclinical / mechanisticMechanistic

Ixodegrin (leech homolog)

Platelet GP IIb/IIIa antagonist family member — RGD-motif containing.

Preclinical / mechanisticMechanistic

Leech Kallikrein Inhibitor

Plasma kallikrein-kinin system modulator — anti-inflammatory pathway distinct from cyclooxygenase.

Preclinical / mechanisticMechanistic

Leech Nitric Oxide Synthase Modulator

Modulates host NOS activity at bite site — contributes to vasodilation phase of feeding.

Preclinical / mechanisticMechanistic

Leech Histamine-like Vasodilator

Histamine-receptor-acting compound — contributes to local vasodilation at feeding site.

Preclinical / mechanisticMechanistic

Leech Acetylcholine

Cholinergic vasodilator contributing to feeding-site vascular dilation.

Preclinical / mechanisticMechanistic

Leech Collagenase

ECM-degrading enzyme — facilitates spread of salivary compounds at the bite site.

Preclinical / mechanisticMechanistic

Leech Apyrase

ADP-degrading enzyme — prevents platelet aggregation by hydrolyzing ADP at bite site.

Preclinical / mechanisticMechanistic

Leech Tissue Factor Pathway Inhibitor

Inhibitor of tissue factor / Factor VIIa complex — blocks extrinsic coagulation pathway.

Preclinical / mechanisticMechanistic

Leech Thrombomodulin-binding factor

Modulates the thrombin-thrombomodulin axis — implications for protein C pathway.

Preclinical / mechanisticMechanistic

Leech VEGF Modulator

Vascular endothelial growth factor pathway modulator — angiogenic and wound-healing implications.

Preclinical / mechanisticMechanistic

Leech PDGF Modulator

Platelet-derived growth factor pathway modulator — implications for wound-healing.

Preclinical / mechanisticMechanistic

Leech Eicosanoid Modulator

Modulates prostaglandin and leukotriene cascades — anti-inflammatory pathway.

Preclinical / mechanisticMechanistic

Bufrudin

Direct thrombin inhibitor from the Asian buffalo leech — hirudin homolog described in Hirudinaria manillensis secretome.

Preclinical / mechanisticMechanistic

Haemadipsin

Anticoagulant peptide described in the terrestrial Asian leech Haemadipsa zeylanica.

Preclinical / mechanisticMechanistic

Whitmanin

Direct thrombin inhibitor homolog cataloged in the Chinese medicinal leech Whitmania pigra secretome.

Preclinical / mechanisticMechanistic

Piscicolin

Small direct thrombin inhibitor described in the fish leech Piscicola geometra secretome.

Preclinical / mechanisticMechanistic

Macrobdellin

Anticoagulant peptide described in the North American medicinal leech Macrobdella decora.

Preclinical / mechanisticMechanistic

Destabilase-2

Second isoform of destabilase — lysozyme / isopeptidase activity targeting cross-linked fibrin.

Preclinical / mechanisticMechanistic

Hirudinase

Alternate fibrin-cleaving enzyme reported in Hirudo medicinalis salivary secretions.

Preclinical / mechanisticMechanistic

Collagenolytic Fibrinolysin

Dual-function protease degrading both fibrin clot scaffolds and collagen extracellular matrix.

Preclinical / mechanisticMechanistic

Leech Bradykinin Modulator

Salivary factor reported to modulate the bradykinin / kinin-kallikrein vasoactive cascade.

Preclinical / mechanisticMechanistic

Leech Substance P Modulator

Salivary factor reported to modulate the substance P / neurokinin-1 nociceptive pathway.

Preclinical / mechanisticMechanistic

Leech Granulin-A

Granulin-family peptide identified in Hirudo medicinalis — putative growth-factor / wound-healing analog (mechanistic only).

Preclinical / mechanisticMechanistic

Buccalin-Like Peptide

Putative neuroactive signaling peptide identified in leech salivary tissue — named by analogy to mollusc buccalin; function speculative.

Preclinical / mechanisticMechanistic

Leech Thrombin-Cleavable Peptide

Substrate-mimetic peptide segment identified in leech salivary transcriptome — putative thrombin substrate / competitive inhibitor variant.

Preclinical / mechanisticMechanistic

Leech Hirudo Lectin

Carbohydrate-binding lectin reported in Hirudo medicinalis salivary glands — putative agglutinin / immune modulator.

Preclinical / mechanisticMechanistic

Leech Saposin-Like Peptide

Saposin-like lipid-binding peptide identified in leech salivary transcriptome — putative membrane-active component.

Preclinical / mechanisticMechanistic

Leech Thrombospondin-Like Protein

Thrombospondin-type repeat (TSR)-domain protein identified in leech salivary transcriptome — putative platelet / matrix interactor.

Preclinical / mechanisticMechanistic

Leech Phospholipase A2 Inhibitor

Putative PLA2 inhibitor identified in leech salivary transcriptome — candidate eicosanoid-cascade modulator.

Preclinical / mechanisticMechanistic

Leech C-Type Lectin

C-type lectin domain protein identified in Hirudo medicinalis salivary transcriptome — putative carbohydrate / glycoprotein binder.

Preclinical / mechanisticMechanistic

WP-Anticoagulant Genes (7-Transcript Family)

Whitmania pigra salivary anticoagulant gene family (Huang 2026 transcriptome) — seven coagulation-related transcripts including fibrinolytic enzymes, neutrophil-elastase inhibitors, factor Xa inhibitors.

Preclinical / mechanisticMechanistic

Hirudin-Like Factors (HLFs)

Hirudin-paralog family lacking some structural hirudin features — Müller 2016 phylogenetic characterization across Hirudo and Hirudinaria genera.

Preclinical / mechanisticMechanistic

Haemadipsa yanyuanensis Progranulin (Hy-PGRN)

Putative progranulin gene with 122 cysteine residues and nine tandem repeats — distinctive structural organization (Lin 2025 chromosome-level genome).

Preclinical / mechanisticMechanistic

Haemadipsa yanyuanensis Bdellin Expansion

Lineage-specific 8.7-25-fold expansion of bdellin protease-inhibitor gene family in H. yanyuanensis genome (Lin 2025) — candidate driver of terrestrial-blood-feeding adaptation.

Preclinical / mechanisticMechanistic

Haemadipsa yanyuanensis LDTI Expansion

Lineage-specific expansion of LDTI (leech-derived tryptase inhibitor) gene family in H. yanyuanensis (Lin 2025) — candidate mast-cell modulator repertoire.

Preclinical / mechanisticMechanistic

Hirudinaria manillensis Macins (Hman1/Hman2/Hman3)

Three macin antimicrobial peptide paralogs from Asian buffalo leech — Yu 2025 documents Hman1 functional, Hman2 / Hman3 partly pseudogenized.

Preclinical / mechanisticMechanistic

Hirudinaria bpling Anticoagulant Family

Chromosome-level genome of H. bpling (Khan 2025) annotates 20+ anticoagulant gene families including 'Bplins' — a novel species-specific factor family.

Preclinical / mechanisticMechanistic

Hni-Antistasin

Novel anticoagulant factor identified in the Hirudo nipponia salivary-gland transcriptome — Kim 2024 de novo assembly + in situ hybridisation.

Preclinical / mechanisticMechanistic

Hni-Ghilanten

Novel ghilanten family anticoagulant in the Hirudo nipponia salivary-gland transcriptome — Kim 2024 spatial expression mapping.

Preclinical / mechanisticMechanistic

Hni-Bdellin

Novel bdellin family Kazal-domain trypsin / plasmin inhibitor identified in the Hirudo nipponia salivary-gland transcriptome — Kim 2024.

Preclinical / mechanisticMechanistic

Hni-GLIPR1

Previously unrecognized immune-related glioma-pathogenesis-related protein 1 homolog in the Hirudo nipponia salivary gland — Kim 2024.

Preclinical / mechanisticMechanistic

H. nipponia Starvation-Induced Salivary Proteome

181 differentially expressed proteins (72 up / 109 down) in starved Hirudo nipponia salivary glands — Cai 2024 proteomic + transcriptomic profiling.

Preclinical / mechanisticMechanistic

H. yanyuanensis Bdellin Family Expansion (2025)

8.7–25× lineage-specific expansion of the bdellin gene family in the terrestrial blood-feeding leech Haemadipsa yanyuanensis — Lin 2025 chromosome-level genome.

Preclinical / mechanisticMechanistic

H. yanyuanensis LCI Family Expansion (2025)

Lineage-specific expansion of the leech carboxypeptidase inhibitor (LCI) family in the terrestrial blood-feeding leech Haemadipsa yanyuanensis — Lin 2025.

Preclinical / mechanisticMechanistic

H. yanyuanensis Progranulin (122-Cys Variant)

Distinctive progranulin paralog with 122 cysteine residues + nine tandem repeats in the terrestrial blood-feeding leech Haemadipsa yanyuanensis — Lin 2025.

Preclinical / mechanisticMechanistic

H. verbana ERGA Chromosome-Level Anticoagulant Repertoire

First chromosome-level Hirudo verbana genome (14 pseudomolecules, 0.18 Gb, ERGA-BGE 2026) framing the southern medicinal leech as a primary genomic reference.

Preclinical / mechanisticMechanistic

W. pigra Chromosome-Level Genome (79 Antithrombotic Genes)

Chromosome-level W. pigra genome unexpectedly carries 79 antithrombotic genes — more than the 72 in blood-sucking H. manillensis (Liu 2024).

Preclinical / mechanisticMechanistic

Bloodsucking Leech FBN1 / GLB3 Expansion (Comparative)

Expanded FBN1 (fibrillin-1) + GLB3 (globin-3) gene families across H. nipponia / H. manillensis vs W. pigra — Zheng 2023 functional-genomic comparison.

Preclinical / mechanisticMechanistic

Eglin C CTRL-Resistance Determinants

Structural determinants (Gln192, Lys218) explaining why eglin C, a classical broad-spectrum chymotrypsin / elastase inhibitor, poorly inhibits human chymotrypsin-like protease — Németh 2024.

Preclinical / mechanisticMechanistic

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