Smart Library

Investigational use for cervical radiculopathy; no verifiable published trial specific to this indication.

Investigational use; the only clinical evidence is a 7-patient case series and a 26-patient non-randomized pilot, and the proposed mechanism is hypothetical.

Investigational use for stable-phase Peyronie's disease; evidence limited to one uncontrolled Russian series of 29 patients. Standard treatments (verapamil, collagenase, surgery) remain first-line.

Investigational adjunct for peripheral vertigo persisting after Epley maneuvers or during prolonged vestibular neuritis recovery; no study specific to these conditions was identified.

Investigational use for posterior tibial nerve entrapment at the medial ankle; no clinical study of leech therapy for it was identified.

Investigational use for non-pregnancy pubic symphysis dysfunction, including osteitis pubis; no clinical study of leech therapy was identified.

Investigational adjunct for chronic tension-type headache (≥15 days/month) with persistent pericranial muscle tenderness; no study in patients diagnosed with this condition was identified.

Investigational adjunct for cervicogenic headache referred from upper cervical (C1-C3) joints; no clinical study in diagnosed cases was identified.

Investigational idea for chronic anal fissure refractory to medical therapy; no clinical study identified; sphincterotomy remains the gold standard.

Investigational adjunct for MS-related fatigue; no clinical study was identified; disease-modifying therapy and modafinil/amantadine remain primary.

Investigational adjunct for convalescent-phase Ramsay Hunt syndrome residual facial weakness; antiviral plus corticosteroid started within 72 hours of onset remains evidence-based.

Investigational adjunct for Buerger's disease; absolute tobacco cessation is the only disease-modifying intervention; iloprost and surgical sympathectomy for selected cases.

Investigational adjunct for refractory ischial (ischiogluteal) bursitis; activity modification, hamstring loading, and selective injection remain primary.

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

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

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

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

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

Anticoagulant peptide described in the terrestrial Asian leech Haemadipsa zeylanica.

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

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

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

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

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

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

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

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

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

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

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