How to read the Compound Atlas

A reader’s guide to the leech-compound registry and what each entry does — and does NOT — claim.

Última actualización: June 2, 2026Revisado por: ASH Editorial Board

Educational guideMechanism reference

The Compound Atlas is a registry of bioactive molecules described in the medicinal-leech literature — hirudin, bivalirudin, destabilase, eglin, saratin, and roughly two hundred others. It exists for science education and research orientation, not for treatment guidance. Each entry summarizes what a molecule is and what is known about its biochemistry. This page explains how to read those entries, and, just as importantly, why describing a mechanism is never a treatment claim.

A biochemistry catalog, not a treatment plan

Listing a compound in the Atlas describes the state of the published science for that molecule — its structure, its molecular target, and how well that interaction has been characterized. A compound entry is not a treatment claim, a recommendation, or a statement that the molecule, or whole-leech therapy, works for any condition.

A described mechanism is a statement about chemistry, not about clinical benefit. Knowing that a molecule inhibits an enzyme tells you what it does in a test tube; it does not establish that it treats, cures, or prevents a disease in people. Read every entry as “here is what the science says about this molecule,” never as “here is what you should do.”

What every compound entry shows

Each entry in the registry is built from the same three parts, plus a standing non-clinical notice.

1. Mechanism

The molecular target and the biochemical action — for example, “direct thrombin inhibitor” or “collagen-platelet adhesion blocker.” This is a description of chemistry. A mechanism is not a clinical indication: stating how a molecule behaves at its target does not assert that it treats any condition in patients.

2. Evidence status

A GRADE-aligned badge marks how the molecule’s action has been characterized — from cell-free assays through animal models to the rare cases where a derived drug reached human trials. The badge calibrates how much weight the science carries.

In vitroPreclinical (animal)Mechanistic

3. Drug-vs-whole-leech distinction

Where a purified or synthetic drug has been developed from a leech molecule (as with hirudin and the anticoagulant bivalirudin), the entry separates the two explicitly. An FDA-regulated pharmaceutical is a different thing, under a different regulatory pathway, from the whole-leech device. Claims for one do not transfer to the other.

4. Non-clinical notice

Every entry carries a standing notice: describing a mechanism is not a treatment claim or a clinical indication, and nothing in the entry asserts a cure or a guaranteed benefit. The notice below applies to every compound in the registry.

How a few entries read in practice

Each example below carries its own mechanism, evidence-status badge, and a non-clinical notice. The notice is repeated deliberately — it is a property of every entry, not a footnote.

Hirudin

Mechanistic

Mechanism: a direct thrombin inhibitor that binds the clotting enzyme thrombin and blocks fibrin formation. This describes a biochemical interaction characterized in structural and enzyme-kinetic studies.

Non-clinical notice: describing thrombin inhibition is a statement about chemistry, not a treatment claim or a clinical indication. No cure or efficacy claim is made for hirudin or for whole-leech therapy.

Bivalirudin

Randomized controlled trial (the drug)

Mechanism: a synthetic peptide analog inspired by hirudin’s thrombin-binding chemistry. Bivalirudin is a separately developed pharmaceutical, not a leech extract — its trial evidence belongs to the drug, not to whole-leech therapy.

Non-clinical notice: the existence of a derived drug is not a treatment claim for the leech or its compounds. Evidence for the drug does not extend to whole-leech therapy, and no cure or efficacy claim is made here.

Destabilase

In vitro

Mechanism: an enzyme reported to dissolve cross-linked fibrin (isopeptidase activity), characterized mainly in cell-free and laboratory assays.

Non-clinical notice: an in-vitro enzyme activity is not a clinical indication. Describing what destabilase does in a tube makes no treatment, cure, or efficacy claim.

Eglin

Mechanistic

Mechanism: a small protein protease inhibitor with reported activity against enzymes such as elastase and cathepsin G, described in biochemical studies.

Non-clinical notice: protease inhibition is a described mechanism, not a treatment claim or clinical indication. No cure or efficacy claim is made for eglin.

Saratin

Preclinical (animal)

Mechanism: a protein reported to inhibit collagen-mediated platelet adhesion, studied in laboratory and animal-model settings.

Non-clinical notice: a preclinical mechanism is not evidence of human benefit and not a clinical indication. No cure or efficacy claim is made for saratin.

Why the drug-vs-whole-leech line matters

The clearest example is hirudin and bivalirudin. The first is a molecule the leech makes; the second is a pharmaceutical inspired by it. They live in different regulatory worlds, and the Atlas keeps them apart.

Drug-vs-leech distinction

FDA-approved drug

Bivalirudin (Angiomax)

Approval:: FDA-approved — drug
Indication:: Anticoagulation during cardiac procedures
Derived from:: Synthetic peptide analog inspired by hirudin chemistry

FDA-cleared medical device

Hirudo medicinalis

FDA status:: FDA medical device K040187
Cleared indication:: Venous congestion in surgical flaps

These are two distinct regulatory contexts. The drug above is a recombinant or synthetic pharmaceutical analog regulated under FDA NDA/BLA pathways. The whole-leech therapy is regulated as a medical device. Clinical claims for the drug do NOT extend to whole-leech therapy, and vice versa.

What a compound entry does NOT mean (summary)

A described mechanism is not a treatment claim — it describes chemistry, not clinical benefit.
A mechanism is not a clinical indication; how a molecule behaves at its target says nothing about treating a disease.
An evidence-status badge describes how a molecule was studied, not that it works in people.
No compound entry asserts a cure or a guaranteed benefit.
An FDA-approved drug derived from a leech molecule is not the same as whole-leech therapy, and its evidence does not transfer.
In-vitro or preclinical activity is hypothesis-generating, not proof of human efficacy or safety.
Listing a molecule in the registry is not a claim that it, or hirudotherapy, treats any condition.

Reading an entry in practice

Start with the evidence-status badge. It tells you whether the molecule was characterized in a test tube, an animal model, or a human trial of a derived drug, so you can calibrate how much the science establishes.
Read the mechanism as chemistry. A molecular action is what the molecule does at its target — not a statement that it treats a condition.
Watch the drug-vs-whole-leech line. Where a derived drug exists, its evidence belongs to the drug alone, never to whole-leech therapy.
Take questions to a qualified clinician. The registry informs a conversation about the science; it does not replace individualized medical advice.

Compound Registry

Browse the full catalog of leech-derived bioactive molecules and their citations.

Open the registry →

How Evidence Is Graded

The full Tier A/B/C framework and GRADE-aligned ratings behind every badge.

Read the method →