Traditional uses, chemical constituents, pharmacological activities and toxicology of Chinese medicinal leech (Shuizhi): A comprehensive review

ETHNOPHARMACOLOGICAL RELEVANCE: The Chinese medicinal leech (Shuizhi in Chinese) has been widely used in traditional Asian medicine, particularly in China, to treat blood stasis-related disorders, including hematological diseases, gynecological diseases, trauma, arthritis, and edema. AIM OF THE STUDY: This review systematically evaluates leech's traditional uses, chemical constituents, pharmacological activities, and toxicology, aiming to provide insights for its further development and utilization. MATERIAL AND METHODS: The relevant information of leech was obtained from several databases. Moreover, the medical books, PhD and MSc dissertations in Chinese were also used to perform this work. RESULTS: Traditional uses of leech have lasted for millennia in China. Within the past decades, approximately 100 chemical constituents, including proteins, peptides, amino acid, lipids, sterols, fatty acid esters, and trace elements, have been identified from leech. Modern pharmacological studies have confirmed numerous bioactivities of leech, such as anticoagulant activity, antithrombotic activity, antiatherosclerotic activity, anti-fibrotic activity, anti-inflammatory activity. Additionally, toxicity studies confirm its safety. CONCLUSION: Based on the summary of the research work of leech, we systematically show the traditional uses, chemical constituents, pharmacological activities and toxicology studies. Leech is a renowned traditional ethnic medicine with numerous pharmacological activities attributed to its bioactive components, and are being actively developed for uses other than traditional uses. Modern pharmacological research primarily focuses on its cardiovascular and cerebrovascular system effect. Therefore, it is important to further explore its pharmacological activities and fill the research gaps related to other traditional uses and chemical constituents. In addition, its safety studies should be expanded to prepare for clinical use.

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Comprehensive review of the Chinese medicinal leech (Shuizhi) documenting roughly 100 chemical constituents and confirming anticoagulant, antithrombotic, anti-atherosclerotic, anti-fibrotic and anti-inflammatory bioactivities, with toxicity studies supporting its safety.

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