Immunomodulatory Effects of Lucilia sericata in Wound Healing: A Summary of Current Evidence

<font color="#2d2d2d" face="Helvetica"><span style="font-size: 10px;"><div style=""><p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">The use of Lucilia sericata larvae, commonly referred to as medicinal maggots, has garnered <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">increasing attention in wound care due to their multifaceted therapeutic properties. Beyond their wellestablished <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">debridement capabilities, recent studies have highlighted their immunomodulatory effects, <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">which play a crucial role in enhancing wound healing. These larvae secrete a complex mixture of bioactive <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">compounds, including proteolytic enzymes, antimicrobial peptides, and growth<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>promoting factors that <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">influence the local immune response. One of the key mechanisms involves modulating inflammatory <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">cytokines. Research indicates that larval secretions can downregulate pro<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>inflammatory mediators such as <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">tumor necrosis factor<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>alpha (TNF<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>α) and interleukin<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>6 (IL<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>6), while upregulating anti<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>inflammatory <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">cytokines like interleukin<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>10 (IL<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">-</span>10), thereby promoting a balanced immune environment conducive to <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">tissue regeneration. Additionally, L. sericata excretions have been shown to stimulate fibroblast <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">proliferation and angiogenesis, both essential for granulation tissue formation and epithelialization. <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">Moreover, the antimicrobial properties of larval secretions contribute to reduced bacterial load in chronic <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">wounds, indirectly supporting immune function by alleviating persistent infection<span class="s1" style="font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal; font-family: Times;">—</span>a major barrier to <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">healing. Studies also suggest that these secretions can inhibit biofilm formation by pathogenic bacteria <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">such as Staphylococcus aureus and Pseudomonas aeruginosa, further enhancing the wound <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">microenvironment. Importantly, the immunomodulatory effects of L. sericata are not limited to local wound <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical-sizing: auto; font-feature-settings: normal; font-variation-settings: normal; font-stretch: normal; line-height: normal;">sites. Emerging evidence points to systemic immune benefits, including improved leukocyte function and <p class="p1" style="margin-bottom: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-variant-alternates: normal; font-kerning: auto; font-optical