Phimosis Treatment with steroids and foreskin Anatomy
Rhys Evans EWMA conference presentation
1. Rhys Evans a
Claire Morgan b
Yamni Nigam c
a College of Human and
Health Sciences, Swansea
University
b College of Medicine,
Swansea University
c Lead Swansea University
Maggot Research Group
Correspondence:
685449@swansea.ac.uk
+44 1792 518565
Figure 1. Clinical used of larval debridement therapy. (A and B) Maggot
infested wound (B) [1, 2] and (C) the adult stage of the common green bottle fly
[3].
A B C
2. Chronic wounds can develop in a number of pathologies.
Characterised by altered growth characteristics including an inability to heal, chronic
inflammation and infection unresponsive to antibiotics
Larval debridement therapy (LDT) has been show to effectively treat chronic wounds
Previous studies have show that the healing properties of maggot native excretions/secretions
(nES) may be due to the presence of digestive proteases [3,4].
Our Hypothesis:
Additional factors are present in the maggot secretions which contribute to wound healing.
Our Research:
Maggot secretions with and without protease inhibitors (PI) were added to human skin
fibroblasts and their effects measure using A) growth and B) migration assays.
Maggot secretions were analysed for human protein homologues by Western Blot technique.
A B
Figure 2. The benefits of larval debridement therapy (LDT) in the treatment of chronic wounds such as Buerger's
disease (A) and diabetic gangrene (B) [2].
3. Vehicle control nES with added
PI
nES without PI
t0
t12
t14
t16
Figure 3. Fibroblast migration following treatment of nES with and without added protease inhibitors. Following treatment
with maggot nES with added protease inhibitors, fibroblasts were found to migrate at a significantly faster rate across an
artificially created wound compared to the vehicle control (P <0.05).
4. Figure 4. A – E are representative western blots demonstrating the presence or absence of proteins homologous to
the human growth factors TGF-β (A), VEGF (B), EGF (C), FGF (D), PDGF (E) and HGF (F) detected in maggot secretions.
Lane 1, MW ladder. Figures 1A, C-F: lane 2, positive control; Lane 3-6 nES (1 - 0.125 concentrated). Figures 1B: lane 2-
4, positive cell control lysates (PC-3, PNT-2, LnCAP); Lane 5-8 nES.
1 2 3 4 5 6
1 2 3 4 5 6
1 2 3 4 5 6 7 8
1 2 3 4 5 6 1 2 3 4 5 6
1 2 3 4 5 6
Human
TGF-β
Maggot
secretions
Human
EGF
Maggot
secretions
Human
PDGF-BB
Maggot
secretions
Human
VEGF
Maggot
secretions
Human
FGF
Maggot
secretions
Human
HGF
A B
C
D
E F
5. Chronic wounds are a significant health issue and result in a
massive financial burden on the NHS.
Maggot nES are able to significantly increase fibroblast
migration but did not affect fibroblast migration.
Maggot secretions appear to possess human growth factor
homologues which may contribute to the increased rate of
wound healing see during LDT.
References
1. http://missipipure.blogspot.co.uk/2010/07/lalat-dalam-kesehatan.html(accessed on 22/04/2015).
2. http://imgarcade.com/1/maggot-therapy-for-wounds/ (accessed on 21/04/2015).
3. http://www.agenciadenoticias.unal.edu.co/ndetalle/article/larvae-feed-on-dead-tissue-and-help-to-avoid-amputations.html
(accessed on 21/04/2015).
4. http://www.btmcl.com/eng/ (accessed on 21/04/2015).
5. Horobin A et al. Maggots and wound healing: an investigation of the effects of secretions from Lucilia sericata larvae upon
interactions between human dermal fibroblasts and extracellular matrix components. British Journal of Dermatology.
2003;148(5):923-33.
6. Horobin A et al. Maggots and wound healing: an investigation of the effects of secretions from Lucilia sericata larvae upon the
migration of human dermal fibroblasts over a fibronectin-coated surface. Wound Repair Regeneration. 2005;13(4):422-33.