American Society of Hirudotherapy

Neuro-immune lessons from an annelid: The medicinal leech

Review published in Dev Comp Immunol (2016)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsTasiemski A et al. · Dev Comp Immunol, 2016

Abstract

An important question that remains unanswered is how the vertebrate neuroimmune system can be both friend and foe to the damaged nervous tissue. Some of the difficulty in obtaining responses in mammals probably lies in the conflation in the central nervous system (CNS), of the innate and adaptive immune responses, which makes the vertebrate neuroimmune response quite complex and difficult to dissect. An alternative strategy for understanding the relation between neural immunity and neural repair is to study an animal devoid of adaptive immunity and whose CNS is well described and regeneration competent. The medicinal leech offers such opportunity. If the nerve cord of this annelid is crushed or partially cut, axons grow across the lesion and conduction of signals through the damaged region is restored within a few days, even when the nerve cord is removed from the animal and maintained in culture. When the mammalian spinal cord is injured, regeneration of normal connections is more or less successful and implies multiple events that still remain difficult to resolve. Interestingly, the regenerative process of the leech lesioned nerve cord is even more successful under septic than under sterile conditions suggesting that a controlled initiation of an infectious response may be a critical event for the regeneration of normal CNS functions in the leech. Here are reviewed and discussed data explaining how the leech nerve cord sensu stricto (i.e. excluding microglia and infiltrated blood cells) recognizes and responds to microbes and mechanical damages.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReviewResearch Support, Non-U.S. Gov't
Indexed MeSH termsAnimalsAnnelidaAntimicrobial Cationic PeptidesCentral Nervous SystemHumansImmunity, InnateLeechesMammalsModels, AnimalNeuroimmunomodulationNeuronsReceptors, Pattern Recognition

Summary

Review of medicinal leech CNS regeneration and neuro-immunity; controlled infectious response may be critical event for regeneration of normal CNS functions in leech.

Why This Matters for Hirudotherapy

This review examines the medicinal leech as a model organism for understanding neuro-immune interactions, emphasizing that the leech nerve cord regenerates after crush or partial transection — even in culture — and that regeneration is enhanced under septic versus sterile conditions. The authors discuss how the leech CNS (excluding microglia and blood cells) recognizes and responds to microbes and mechanical damage, drawing parallels to the mammalian neuroimmune system and spinal cord injury. For ASH, this is directly relevant as it reviews the medicinal leech's biology and its potential to inform neuroimmune and regenerative science. CAVEAT: This is a narrative review of comparative neurobiology; it involves no hirudotherapy, no leech secretome therapeutics, and the findings are primarily of translational/model-system interest rather than direct clinical relevance.

Citation

Neuro-immune lessons from an annelid: The medicinal leech.

Tasiemski A et al. · Dev Comp Immunol, 2016

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.