Effect of leech therapy on biomarkers of angiogenesis in chronic non-healing ulcers: A pilot randomized study

Abstract BACKGROUND: Chronic wounds, persisting for more than 6 weeks, present a global medical challenge with limited effective treatments. Conventional therapies often fail, leading to prolonged suffering and complications. Leech therapy (~Jalaukavacharana) , rooted in Ayurveda, has shown promise in managing non-healing ulcers, prompting this study. OBJECTIVE: To assess the effect of leech therapy on biomarkers of angiogenesis in chronic non-healing ulcers, focusing on vascular endothelial growth factor (VEGF) expression. MATERIALS AND METHODS: A pilot randomized clinical trial was conducted involving 30 patients diagnosed with chronic non-healing ulcers. Participants were allocated into two groups of 15 each using the block randomization method. Group A received daily wound cleaning with normal saline followed by dressing with Jatyadi Ghrita , while Group B underwent leech therapy on days 0, 7, 14, 21, and 28 in addition to wound cleansing and dressing. All participants were also administered oral Ayurvedic medicines, including Triphala Guggulu (500 mg TDS) and Amalaki Churna (5 g BD) with lukewarm water. VEGF levels were quantified using sandwich-enzyme-linked immunosorbent assay on days 0 and 28. Statistical analysis was performed using paired and unpaired t- tests. RESULTS: Both groups showed significant changes in VEGF levels with ( P = 0.001) within groups, as well as between groups on day 28 ( P = 0.001). Group B demonstrated a more substantial improvement in VEGF levels, indicating a potential enhancement of angiogenesis and tissue repair processes. CONCLUSION: Leech therapy, when added to the Ayurveda wound care regimen, significantly increased VEGF expression in chronic non-healing ulcers. The study contributes to understanding the multifaceted role of leech therapy in effective wound healing. Further research and clinical trials are warranted to delve deeper into specific mechanisms and validate leech therapy’s therapeutic potential in chronic non-healing ulcers, aiming to improve patient’s quality of life.