About this Journal Submit a Manuscript Table of Contents
Evidence-Based Complementary and Alternative Medicine

Volume 2014 (2014), Article ID 904958, 21 pages

http://dx.doi.org/10.1155/2014/904958
Review Article

Recent Advances in Developing Insect Natural Products as Potential Modern Day Medicines

1Laboratório de Biologia de Insetos, Departamento de Biologia Geral, Universidade Federal Fluminense, Niterói, RJ, Brazil

2Department of Biosciences, College of Science, Swansea University, Singleton Park, Swansea SA2 8PP, UK

3Laboratório de Bioquímica e Fisiologia de Insetos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Avenida Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brazil

Received 1 December 2013; Accepted 28 January 2014; Published 6 May 2014

Academic Editor: Ronald Sherman

Copyright © 2014 Norman Ratcliffe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Except for honey as food, and silk for clothing and pollination of plants, people give little thought to the benefits of insects in their lives. This overview briefly describes significant recent advances in developing insect natural products as potential new medicinal drugs. This is an exciting and rapidly expanding new field since insects are hugely variable and have utilised an enormous range of natural products to survive environmental perturbations for 100s of millions of years. There is thus a treasure chest of untapped resources waiting to be discovered. Insects products, such as silk and honey, have already been utilised for thousands of years, and extracts of insects have been produced for use in Folk Medicine around the world, but only with the development of modern molecular and biochemical techniques has it become feasible to manipulate and bioengineer insect natural products into modern medicines. Utilising knowledge gleaned from Insect Folk Medicines, this review describes modern research into bioengineering honey and venom from bees, silk, cantharidin, antimicrobial peptides, and maggot secretions and anticoagulants from blood-sucking insects into medicines. Problems and solutions encountered in these endeavours are described and indicate that the future is bright for new insect derived pharmaceuticals treatments and medicines.

1. Introduction

Previously, a number of overviews on insect natural products and their potential for development into drugs to treat human diseases have been published [13]. Recently, however, there have been additional advances in this field. The present review therefore focuses on these as well as their implication for studying mammalian physiology and the immune reactions to human pathogens.

Surprisingly, despite the success of insects in terms of numbers and diversity, the most successful drugs derived from natural products, including artemisinin, quinine, aspirin, cocodamol, simvastatin, and cyclosporine, have been isolated from plants, marine organisms, and microbes [3, 4]. Altogether, 939 nature-derived approved drugs were developed between 1961 and 2010 [4] but none of these were from insects and only a few originated from invertebrates such as leeches, sponges, and cone snails. Difficulties in species identification, drug toxicity, development costs, and large scale production [3] partially explain the reason for the slow progress in developing insect products as potential modern medicines. However, since modern genomics, in silico drug design and high throughput screening have failed to yield new generations of novel drugs; there is now renewed interest in more traditional methods of screening using the huge diversity of animals, plants, and microbes available [5]. Furthermore, more traditional biochemical screening techniques have now resulted in notable progress in developing therapeutics from arthropods, including melittin from bees [6], alloferon from blowflies [7], and anticoagulants from ticks [8].

2. Use of Insects in Folk Medicine

Despite the fact that insects have not been a rich source of modern drugs, they have, for thousands of years, provided many invaluable natural substances, including silk and honey products (royal jelly, beeswax, pollen, and propolis). Insect secretions and ground-up bodies have commonly been used in Folklore Medicine not only in China and Bahia but also in India, Asia, Africa, and Mexico (e.g., [2, 9, 10]). Unfortunately, two of the most fascinating accounts of the use of insects in Folk Medicine have not been published in mainline scientific journals but are well worth reading [11, 12]. One of these includes an unpublished book by Lockhart [11], while the other is a blog describing the experiences of the author with the use of ants in the Bolivian Amazon [12]. A more recent published review on insects as medicines deserves mentioning too as it presents alluring accounts of Insect Folk Medicine in India and Zaire as well as the use of insects as food [13].

Insects and insect extracts have been used in Folk Medicine for a huge range of conditions including arthritis treatment with Pseudomyrmex ant venom which resulted in US patent number 4, 247, 540 in 1981 [11, 12]. Amazonian Indians also diagnosed diabetes by watching to see whether ants swarmed over urine which in diabetics contains high levels of sugar to attract the ants [11]. Particularly thought provoking is the account of ants being used to cure lethargy [11]. Altogether in China, 1,700 medicines have been produced from ca. 300 insect species while 42 species have been used as Folk Medicines in Bahia [14].

Only a few Insect Folk Medicines have undergone exhaustive clinical trials to prove their efficacy. Scientists, however, are now using knowledge accrued from exponents of Folk Medicine to develop potential new medicines for treating intractable diseases such as cancer and the problems associated with newly emerging antibiotic-resistant bacteria. In the following examples of the development of insect products as potential modern medicines, there is already a long history of the use of these substances in Folk Medicine.

3. Bee, Wasp, and Ant Products

Bee, wasp, and ant products, including honey and venom, have been used in Folk Medicine for thousands of years for treating wounds, ulcers, inflammation, infections, pain, cancer, and allergies [3]. Studies of natural products from hymenopterans (Figure 1) have mainly concentrated on honey bee compounds because of the ready availability of large numbers of these insects reared under relatively constant controlled conditions.

904958.fig.001
Figure 1: Schematic showing approximate evolutionary relationship of spiders, silkworms, bees, wasps, and ants mentioned in this review. Figure from Tara D. Sutherland, Sarah Weisman, Andrew A. Walker, and Stephen T. Mudie, “The Coiled Coil Silk of Bees, Ants, and Hornets,” Biopolymers volume 97, Issue 6, pp. 446–454, 2012 (DOI 10.1002/bip.21702) published by John Wiley and Sons with permission.
3.1. Honey Products from Bees

Recently, the use of honey for wound healing has been extensively reviewed [1517]. These studies demonstrated the efficacy of honey in wound repair and sterilization of infected wounds and generally supported the use of honey in clinical practice, but only with certain types of wounds and after additional clinical trials [15]. The evidence available, for example, includes 19 randomized controlled trials with 2554 patients which suggested that honey improved healing times but only in mild-to-moderate superficial burns and not in full thickness burns [18]. In addition, more recently, an analysis of 44 Cochrane reviews also provided robust evidence that in some wound care interventions topical honey application reduced healing times of burns [19].

Honey is a complex mixture of substances and progress is being made at the molecular level in understanding the functions of the various components on cells and the effectiveness of honey in treating a range of human ailments. For example, Tonks et al. [21] isolated a 5.8 kDa honey component which stimulated the production of the TNF-alpha cytokine via TLR4 in human monocyte cultures. TNF-alpha is involved in the repair and regeneration of tissues.

The antimicrobial activity of honey is probably due to a combination of low pH, high osmolality, and hydrogen peroxide generation together with defensin-1 and methylglyoxal, with the latter an aldehyde generated from pyruvic acid [3, 22]. Interestingly, Kwakman et al. [22] recently showed that Revamil and Manuka honeys have different antibacterial components, with the former containing defensin-1, hydrogen peroxide, and methylglyoxal, while the latter only had methylglyoxal at 44 times the concentration of Revamil. In addition, Manuka honey was also shown to contain other unidentified antibacterial factors. Great variations in antimicrobial properties have also been discovered for a range of honeys, limiting those suitable for use in medicine [23].

There is great recent interest in the antimicrobial activity of honey against important antibiotic-resistant human pathogens (reviewed in [17]). These studies showed, for example, inhibition of Gram-positive MRSA (methicillin resistant Staphylococcus aureus), of vancomycin-sensitive and resistant Enterococci (VSE and VRE, e.g., [24]), and of Streptococcus species isolated from wounds [25]. Honey also impacts Gram-negative bacteria associated with wounds such as Pseudomonas aeruginosa, Stenotrophomonas species, and Acinetobacter baumannii (e.g., [17]). Manuka honey appears to inhibit cell division in MRSA [26], while, with P. aeruginosa, the cell wall is destabilised and lysis occurs [27]. Bacterial DNA degradation in pathogens has also been reported with Buckwheat honey [28]. Finally, honey can not only inhibits planktonic bacteria but also prevents the formation of biofilms [17, 29] that form, for example, on surgical implants, thus causing prosthesis failure and additional patient distress. A review has been published of recent patents resulting from all this work on antibiotics from hives [30].

The above benefits of honey in wound healing and bacterial inhibition have resulted in the development of special dressings to treat different types of wounds. Some of these are in the form of ointments or gels, while others are actual dressings made from mixes of alginate with honey [17].

Other honey products have also been shown to have antimicrobial activity so that propolis and the apalbumins in royal jelly have been reported to inhibit bacteria [3, 31]. Propolis also has a synergistic effect with antimicrobial drugs in the treatment of experimental S. aureus keratitis and diminishes the resistance of the bacterial cell walls to antibiotics (reviewed in [31]). The effect of propolis on oral Streptococcus mutans also indicates the possible development of this factor as a cariostatic agent to control caries and other infectious diseases of the mouth [31].

Regarding the anticancer properties of honey products, these have been reported previously with a fatty acid in royal jelly and the flavonoids in propolis responsible [3]. An excellent overview of the immunomodulatory and antitumour activity of bee honey in experimental and clinical studies was published in 2009 [32]. Further recent progress has been made in understanding more details of the anticancer properties of the mixture of polyphenols present in honey, propolis, and royal jelly [20]. An indication of the complexity of the phenolic mixture in honey is given in Table 1.

tab1
Table 1: Examples of phenols present in honey with anticancer properties .

Of these compounds, quercetin has been shown to enhance the apoptotic ability of anti-CD95 and rTRAIL (recombinant tumor necrosis factor-related apoptosis inducing ligand) in acute lymphocytic leukemia [33]. In addition, details of the ability of polyphenols isolated from propolis to overcome the resistance of cancer cells to TRAIL-mediated apoptosis have recently been reviewed [34]. The possible use of propolis as a dietary supplement in a cancer preventative strategy was emphasized [34].

Other phenolic compounds in honey in Table 1, with anticancer properties, include apigenin and acacetin which not only induce caspase-dependent apoptosis in human leukemia cells in vitro but the former also produced apoptosis-mediated inhibition of U937 leukemic cell xenografts in mice [35]. Other phenolic compounds in Table 1 also have antileukemic cell growth inhibition in vitro mediated by apoptosis [20]. None of these researches has, to date, led to new chemotherapeutic agents but the information from in vitro studies on human cancer cells should provide clues to help the future development of new medicines [20].

More promising, for the more immediate development of new anticancer therapeutics from honey products, is the work of Fernandez-Cabezudo et al. [36]. Initially, they confirmed the killing properties of Manuka honey on three cancer cell lines via a caspase 9-dependent apoptotic pathway inducing caspase 3, reducing Bcl-2 expression, and leading to DNA fragmentation and cell death. Subsequently, they injected Manuka honey alone or in combination with a chemotherapeutic agent (taxol) into mice implanted with syngeneic melanoma cells and recorded inhibition of tumour growth and host survival. Controls injected solely with Manuka honey showed 33% inhibition of tumour growth. The combination group of Manuka honey plus taxol showed no increase in tumour inhibition in comparison with the taxol group alone; however, what was remarkable was the highly significant improvement in survival of mice in the combination group. This study indicates the potential of Manuka honey in alleviating chemotherapeutic toxicity [36] and improving patient survival.

3.2. Bee, Wasp, and Ant Venoms

Bee venom therapy has been used in Folk Medicine for many thousands of years for treating a range of ailments from arthritis, rheumatism, skin diseases, multiple sclerosis, cancer, infections, and pain (reviewed in [1, 3]). Apart from bee venom, the venoms of many other stinging insects, such as wasps and ants, contain a large range of practically unexplored compounds awaiting discovery and development into the medicines of tomorrow. For example, some ant and parasitoid wasp venoms may contain 75 or more different components [37, 38].

Although bee venom therapy has been widely used, it has neither, as yet, been approved by drug safety authorities nor commonly adopted by conventional medicine. However, there are some crude formulations available, including Apiven in France, produced from the crude venom of honey bees [39].

Honey bee venom is a mixture of at least 20 compounds, including 1/. active peptides such as melittin, apamine, mast cell degranulating peptide (MCD), and adolapin, 2/. the enzymes phospholipase A2 (PLA2), and hyaluronidase, and 3/. the active amines, histamine, serotonin, and catecholamine. Of these components, melittin and phospholipase A2 make up 40–60% and 10–12% dry weight of venom, respectively [3, 40].

Despite the multifunctional use of honey bee venom in Folk Medicine, recent research has focused mainly on melittin and its anticancer properties, although apamine and phospholipase A2 have also received some attention [3, 40]. There is an extensive literature on melittin which probably reflects the great potential of this peptide for development as a therapeutic medicine for treating different types of cancers. Melittin is a water soluble molecule, with cationic and amphipathic properties which enhance the electrostatic binding to the anionic cell membranes of many bacteria and cancer cells. Melittin contains 26 amino acids (GIGAVLKVLTTGLPALISWIKRKRQQ-NH2) which in the venom reservoir have a tetrameric structure (reviewed in [3, 41]). Upon binding, melittin induces cytolysis of most membranes such as those of normal mammalian cells. Thus, melittin is cytotoxic in vivo which has hindered its therapeutic development, despite the fact that it inhibits or kills a range of cancer cell types, such as melanoma, osteosarcoma, leukemic, ovarian, prostate, hepatic, renal, bladder, and mammary gland cells [42].

The precise mode of action of melittin in killing cancer cells is not fully understood although recent advances in understanding its cytolytic effect have been made [43]. At low concentrations, melittin induces transient pore formation in the cell membrane due to tension resulting from one-sided binding of melittin to the outer cell membrane leaflet. At higher concentrations, melittin binding results in the formation of stable pores in the cell membrane leading to cell lysis as the melittin concentration increases and the pores coalesces. Melittin has multiple effects on cells (reviewed in [42]). These effects range from hormone induction, membrane protein aggregation, and changes in membrane potential to stimulation of G-protein enzymes and PLA2, as well as a role in cell signal induction [42]. The possible effects of melittin and other bee venom components on cancer cells and host immunity involve inhibition of calmodulin and . These effects, in turn, would inhibit cancer cell proliferation, invasion and metastasis, and angiogenesis and induce apoptosis [42].

It appears that bee venom induces apoptosis, necrosis, and lysis of tumour cells and, at the same time, can produce immunosuppressive and/or immunostimulation in the host [42]. Melittin apparently induces apoptosis via activation of the PLA2 in cancer cells, especially those transformed by the ras oncogene [44]. Excellent detailed reviews of the interaction of melittin and other bee components with tumour cells and the therapeutic potential of bee venom have been published by Gajski and Garaj-Vrhovac [40] and Oršolić [42].

In efforts to overcome the cytolytic properties of melittin and to harness its anticancer properties, scientists have adopted several strategies (Table 2). First, since cancer cells have higher anionic surface charges and are more sensitive to melittin than normal cells then melittin can be diluted to levels able to kill lung cancer cells in vitro, while normal cells are unaffected [45]. Second, Zhao et al. [46] modified the melittin chain by mutating Val 5 to Arg, Ala 15 to Arg and deleting Leu 15 which significantly reduces the haemolytic properties but maintains its inhibitory effects. Third, an alternative strategy involves using a synthetic melittin peptide coupled to a delivery vehicle such as the beta chain of human chorionic gonadotropin (hecate-CGb). Cells with upregulated expression of hormone receptors, such as ovarian, testicular, and adrenocortical tumours in mice, can then be specifically targeted in vivo (e.g., [47]). Fourth, is similar to three (above) but uses melittin linked to a specific homing peptide for hepatocellular carcinoma cells in vitro [48]. The importance of this study is that it identified a specific homing peptide for the cancer cells using a phage display technique for screening and identification of the novel peptide. Fifth, by using gene therapy in which expression constructs carry the gene for melittin into tumours and induce antitumour effects and increased tumour latency [49]. Many of the previous bioconjugate techniques, however, still induce some haemolysis of normal cells. The sixth, and final strategy, is probably the most promising for the therapeutic use of melittin. It involves using nanoparticles to deliver melittin specifically to kill melanomas and other cancers in vivo with no cytotoxicity towards normal cells [50]. The nanoparticles were targeted to the tumours by incorporating an avb3 integrin-binding ligand [3, 50]. The resultant reduction of the tumour load in the experimental mice was quite startling. This technology has been taken a step further since the nanoparticles used in the Soman et al. [50] study were quite large (ca. 270 nm) and probably failed to penetrate solid tumours efficiently [51]. Thus, Huang et al. [51] designed an ultrasmall, neutral charged, lipid nanoparticle (ca. 20 nm) containing a hybrid α-melittin which inhibited the growth of the melanoma cells in mice in vivo by 82.3% compared with the PBS controls (Figure 2).

tab2
Table 2: Examples of strategies to overcome the cytolytic properties of melittin.
fig2
Figure 2: Evaluation in vivo of the effect of α-melittin nanoparticles on the inhibition of melanoma development. (a) Tumor volume over time showing that only the α-melittin nanoparticle group was significantly inhibited. (b) Comparative sizes and (c) volumes of the excised tumors between different groups after 13 days growth. Means ± SD, , . Reprinted with permission from C. Huang, H. Jin, and Y. Qian et al., “Hybrid melittin cytolytic peptide-driven ultrasmall lipid nanoparticles block melanoma growth in vivo,” ACS Nano, volume 7, number 7, 5791-5800, 2013. (DOI: 10.1021/nn400683s). Copyright (2013) American Chemical Society.

Apart from the role of melittin in killing cancer cells, PLA2 and apamine in bee venom also have anticancer activities. For example, venom PLA2 acting synergistically with the cell membrane phospholipid, phosphatidylinositol-(3,4)-bisphosphate, has been shown to be involved in inhibition of tumour cell growth and potent cell lysis (detailed in [42]). Apamine too could potentially be developed as an anticancer therapeutic agent since it reactivates the p53 tumour suppressor pathway and would trigger the rapid elimination of tumours (reviewed in [42]).

Finally, the antimicrobial properties of melittin are well known and activity in vitro has been recorded against a range of microbes including not only Escherichia coli and Staphylococcus aureus but also Borrelia burgdorferi and Candida albicans [3]. Again, the cytolytic activity of this molecule for mammalian cells has been a barrier to its development as a therapeutic drug [3]. The insect antimicrobial peptides are discussed later in this review (see Section 6, “Antimicrobial Peptides” (AMPs)). Recent developments in the use of melittin as an AMP have reported a synergistic effect when melittin was combined with antibiotics against Gram-positive bacteria even at concentrations as low as 0.5× MIC [52]. In addition, melittin loaded nanoparticle constructs have been shown to inhibit HIV-1 infectivity of TZM-bl reporter cells (a strain of HaLa cells) but, at the same time, to be nontoxic to these and to VK2 vaginal epithelial cells. Thus, melittin nanoparticle constructs have the potential to be developed for use as topical therapeutic vaginal virucides [53].

4. Silk

Silk has been produced for at least 5,000 years with nearly 75% now originating from China [3]. In Chinese medicine, silk has been used for a variety of human conditions including the relief of spasms and flatulence. Interestingly, silkworm larvae have also been prescribed for treating impotence [54] only for, subsequently, a vasodilator compound enhancing NO production to be extracted from Bombyx mori larvae and to be a candidate for the therapeutic treatment of vascular impotency [54].

Interest in the medical or industrial use of silk is not confined to the silk produced by silkworms since many other insects such as the Hymenoptera (bees, wasps, hornets, and ants) and the Trichoptera (caddis flies) [55], as well as the Arachnida (spiders) [56], produce silk. The macromolecular structure of the silks from different arthropods varies according to their function in the life of the animal. Basically, the main structure of silkworm silk consists of fibroin protein fibres held together by a sticky protein called serecin. Boiling B. mori cocoons remove the serecin glue to release the fibroin fibres for subsequent processing (3). In the larvae of bees, ants, and hornets, the silk produced has a coiled coil molecular structure, in contrast to other hymenopterans, as well as spider draglines (safety lines) and B. mori cocoons, in which the silk proteins form extended ß-sheets [57]. The coiled coil silk proteins are small and ideal as structural materials to strengthen the walls of the brood comb cells. The silk also absorbs water and maintains the high humidity and constant temperature necessary for pupal development [57].

Silk is not prescribed in modern medicine; however, it was used previously for medical sutures but now has been replaced by synthetic polymers. The ingenuity of science continues to amaze with silk recently produced as biomaterials for the transport and delivery of dugs around the human body [58, 59] and for tissue engineering [60]. This progress in the use of silk resulted from the publication of the B. mori genome in 2008 [61] which led to gene cloning and modification to allow the expression of silk in a variety of vectors. It was then possible to produce synthetic silk in different conformations, such as scaffolds, films, and nanoparticles, for use in medicine [60].

What are the properties of silk that make it so attractive for use in medicine and which have fuelled recent intensive study? Silk is slow to biodegrade and biocompatible with the human body, although inflammatory responses have been recorded [56]. In addition, silk has good self-assembly properties and high tensile strength with manipulatable structure and composition [62]. Finally, silk can be produced in aqueous solutions in order to avoid inactivation of the associated drug or gene and the rate of delivery of which can be modulated by controlling the speed of degradation of the silk vehicle [59].

Scientists have been developing both kinds of spider and silkworm silk for potential uses in medicine. Silkworms silk is available in large quantities without recombinant methods necessary. However, interest persists in spider silk, despite the fact that it is impossible to develop large-scale farming of spiders, due to the fact that spider silk is extremely strong, flexible, and tough and therefore particularly promising for the production of biomaterials. The toughness of silk is due to the presence of numerous interlocking poly-alanine and glycine-alanine subunits which strengthen the silk proteins [63]. However, the spider silk proteins are long and this has caused problems in recombinant technology due to, for example, the repetitive sequences inducing genetic instability [56]. Some of these problems with spider silk have, however, been resolved, by various strategies. Thus, recombinant technology has been used to produce spider silk in E. coli, yeast, plants, and mammalian cells, as well as in the milk of mice and goats, all of which present unique problems in execution [56]. One study even reports the use of piggyBac vectors to create transgenic silkworms producing chimera silkworm/spider silk proteins in which the composite fibres are as tough as native spider dragline silk [64].

The recent work of Numata et al. [58, 59, 62, 6567] indicates that rapid progress is being made in the development of silk for use in medicine (Table 3). They have used recombinant synthesis of spider silk in E. coli to produce silk polymers which were then used for the production of microspheres/nanoparticles and block copolymers for the targeted delivery of drugs to cancer cells or to act as gene vectors [58, 59]. For example, nanoparticles enclosing curcumin have been shown to be promising for treating breast cancer [59]. The block copolymers are engineered containing silk with polylysine, for example, and cell-binding motifs such as RGD for targeting cells together with a therapeutic drug. A variation of the copolymer is to include plasmid DNA for transfecting target cells with specific genes [58, 59]. More recently, further improvements have been made in the specificity of the silk polymer delivery system by introducing cationic motifs and tumour specific homing peptides and reducing the size of the silk carrier and the pDNA [6567].

tab3
Table 3: Examples of potential use of silk biopolymers in medicine.

There are also numerous recent studies of the use of silk in tissue engineering with an enormously active group based in the Department of Biomedical Engineering at Tufts University working on both spider and silkworm silks. The work under Drs. Kaplan and Omenetto has looked at the use of silk polymers for tissue engineering, vaccine production without the need for refrigerated storage, and cosmetic surgery. A number of start-up companies have been spawned and the future prospects have great potential (see http://www.techtransfer.tufts.edu/tufts-silk-portfolio/). Recent research from this group has reviewed the strategies to produce spider silk by recombinant DNA [75]. In addition, they have looked at silk-heparin biomaterials for vascular tissue engineering [69], silk hydrogels for treating breast cancer [70], antibiotic-releasing silk biomaterials for infections [71], electrical stimulation of silk films for enhancement of neural growth and silk containing dressings for increased wound healing [72], and silk protein matrices which thermostabilize labile vaccines and antibiotics [73]. The latter development is very exciting and could potentially solve the problem of transporting vaccines to remote parts of Africa when vaccines against malaria are finally produced (Table 3). In many of these studies, growth stimulating factors or drugs are incorporated into the polymers and slowly released into the target tissues [6971].

Finally, many other studies have described the potential use of silk polymers in medicine [74, 76]. For example, Sheng et al. [74] using vitamin-E loaded silk nanofibrous mats showed enhancement of skin fibroblast growth, and therefore this technique can be developed for skin regeneration in the future (Table 3). The FDA approval of silkworm silk for use in the human body has no doubt stimulated interest in this exciting research area.

5. Cantharidin from Blister Beetles and Other Small Molecules

Blister beetles belong to the Coleopteran Family Meloidae which contains ca. 2500 species [77]. Many of these insects produce toxic defensive secretions which upon contact with the skin cause blistering. One such toxin is cantharidin which has been extracted from Mylabris caragnae, the dried bodies of which have been used in Chinese Folk Medicine since the 13th century for the removal of warts [78] and for over 2000 years for the treatment of cancer. Other uses include the treatment of rabies and impotence although it is highly toxic affecting the gut and kidneys [3, 78]. The fatal dose, causing renal failure, is between 10 and 65 mg and this toxicity has hindered cantharidin development as an anticancer drug [78]. In addition, the dried bodies of another beetle, Lytta vesicatoria, supposedly have aphrodisiac properties and were sold as a powder called “Spanish Fly” [3]. In fact, the male beetle produces cantharidin and offers it to the female as a precopulatory incentive and she uses it to protect her eggs.

There is increasing interest in the use of cantharidin and its derivatives for the treatment of a range of cancers including hepatic, colorectal, bladder, breast, melanomas, pancreatic, and leukemia [3]. The anticancer properties of cantharidin result in arrest of the cell cycle in G2/M phase, apoptosis, and oxygen radical damage to DNA [79]. However, the potential of this small molecule and its derivatives in medicine is not confined to their anticancer properties as they have also been reported to have activity against parasites such as Plasmodium falciparum and Leishmania major [80, 81].

Cantharidin is a monoterpene (exo,exo-2,3-dimethyl-7-oxabicyclo[2.2.1]heptane-2,3-dicarboxylic acid anhydride), stored in the beetle haemolymph and making up about 5% of body dry weight [78]. Organic chemists have been working to produce derivatives which are bioactive but less toxic. In consequence, the norcantharidins have been produced with anticancer activity but reduced toxicity [78]. In addition, a new class of anticancer compounds, the cantharimides, has been discovered from a Chinese blister beetle, Mylabris phalerate, closely related to cantharidin but with improved water solubility and toxicity against human hepatocellular carcinoma cell lines [82]. An excellent account of the strategies adopted to produce improved cantharidin and cantharimide analogues is given in a review by Galvis et al. [78] and many of the derivatives described have higher bioactivity and less toxicity.

Despite the development of less toxic analogues, there is still concern about the use of cantharidin in the clinical situation with trials mainly limited to external use on warts [3]. However, scientists have continued their research and now much more is known about the mode of action of cantharidin so that new strategies for drug administration are being developed. A recent limited clinical trial involving combining cantharidin with chemotherapy for the treatment of gastric cancer has been completed. The results showed the beneficial effects of the cantharidin by a reduction of the serious side effects usually associated with chemotherapy for gastric cancer [83].

Research has also shown that cantharidin is an inhibitor of phosphoprotein phosphatases 1 (PP1) and 2A (PP2A) which results in DNA damage and apoptosis [78, 84]. These enzymes are involved in regulation of metabolism and the initiation of signal transduction in cells resulting in cell division. Thus, cantharidin may represent a small molecule able to switch cancer cells division and carcinogenesis off/on as well as to probe the key regulatory role of PPA2 in cell metabolism [78]. A detailed account of the interaction of cantharidin analogues with PP1 and PP2A is given in Galvis et al. [78].

Recently, a number of papers have been published showing that cantharidin, apart from inhibiting PP1 and PP2A, has multiple effects on cancer cells. Huang et al. [85] showed that growth inhibition and killing of human colorectal cancer cells by cantharidin was both time- and dose-dependent (Figure 3). The cantharidin exposure reduced CDK1 kinase activity which led to failure of the cells to progress from G2 to M phases in the cell cycle. In addition, the colorectal cells were killed by apoptosis which was induced through the mitochondrial and death receptor pathways and activation of caspases 8, 9, and 3 (Table 4).

tab4
Table 4: Examples of recent studies on the use of cantharidin.
fig3
Figure 3: Effects of cantharidin on cell viability and morphological changes of human colorectal cancer cells. (a) Cells treated with 0, 5, 10, 20, or 40 μM cantharidin for 0, 24, 48, and 72 h and then harvested for determination of cell viability. (b) Cells exposed to 20 μM cantharidin for 24 h and then examined for morphological changes under phase-contrast microscopy. Data represent the mean ± SD of three experiments. From Huang et al., “Cantharidin induces G2/M phase arrest and apoptosis in human colorectal cancer colo 205 cells through inhibition of CDK1 activity and caspase-dependent signaling pathways,” International Journal of Oncology, volume 38, pp. 1067-1073, 2011. Reprinted with permission of Spandidos Publications 2013.

Another study by Huang et al. [86] on metastasis of human bladder carcinoma cells, showed that exposure to cantharidin blocked the gene expression, protein levels, and activities of the matrix metalloproteinase-2 (MMP-2) and/or MMP-9. These enzymes are associated with invasive properties of many cancers so that cantharidin had an antimetastatic effect possibly by targeting the p38 and JNK1/2 MAPKs pathway of the bladder cancer cells. Other effects of cantharidin have been studied in human breast cancer cells by Shou et al. [87]. They reported that cantharidin resulted in apoptosis and reduced growth, adhesion, and migration of the cancer cells. The reduced adhesion resulted from repression of cell adhesion to platelets through downregulation of the 2 integrin adhesion molecule on the surface of the cancer cells. The repression of the 2 integrin occurred through the protein kinase C pathway probably due to PP2A inhibition (Table 4).

Three further studies indicate novel approaches in the use of cantharidin. Lissina et al., [79] in a chemical-genomics study, showed that cantharidin is an effective gene probe of transcriptional regulation of the CRG1 gene, an uncharacterised methyltransferase, during cantharidin stress. Therefore by using such small molecules the authors showed how it was possible to elucidate unknown mechanisms of therapeutic action in cells involving, for example, the methyltransferase. Li et al. [88] have used the knowledge of the inhibition of PP1 and PP2A by cantharidin, and the resulting apoptosis of cancer cells, to design a new gene therapy approach to kill hepatocellular carcinoma cells. They inhibited PP2A using the α-fetoprotein promoter enhancer linked to the pgk promoter to drive the dominant negative form of the PP2A catalytic subunit. Finally, and most important for therapeutic use of cantharidin, Dang and Zhu [89] have tackled the problems of toxicity, insolubility, and short half-life in circulation of this drug by designing cantharidin solid lipid nanoparticles as drug carriers which can be given orally (Table 4).

6. Antimicrobial Peptides (AMPs)

The dried bodies and secretions of insects have been widely used in Folk Medicine to treat numerous diseases and illnesses including many different types of infections and cancers [13]. In Chinese Medicine, numerous species of insects have been used to treat cancer [2]. Considering that many insects thrive in inhospitable environments teeming with microorganisms, such as dung or rotting corpses, it is not surprising that they have robust immune defences to counter infection. These insect innate immune defences have both cellular and humoral components [90, 91], but it is the humoral antimicrobial peptides (AMPs) that are of most interest for the development of new antibiotic drugs.

Insect AMPs have been actively researched for over 50 years and in 2011 work involving these molecules led to the Nobel Prize for Physiology and Medicine being awarded to Jules Hoffmann and Bruce A. Beutler for their discovery of the Toll receptors and mechanisms of activation of innate immunity. Their work did much to increase interest in AMPs which have recently been the subject of extensive reviews [9296]. This interest has also been fuelled by the urgent need to combat the ever increasing number of antibiotic-resistant pathogens such as MRSA, TB, and gonorrhoea. Despite this urgency, and the length of time AMPs have been studied, very few of these molecules have undergone clinical trials or, those that have, failed to complete the trials [97]. There are many reasons for the slow development of AMPs into new therapeutic drugs and these are discussed in detail below together with recent progress in this area.

6.1. Basic Characteristics of Insect AMPs

The LAMP 2013 database, links information on AMPs and holds 5547 AMP sequences of which 3904 are natural AMPs, while the other 1643 are synthetic peptides [97]. Interestingly, of the 5547 AMPs, 5362 have antibacterial activity, 1616 antiviral, 1579 antifungal, 138 antitumour, and 14 antiparasitic activities. The amino acids composing these AMPs range from 4 to 99 in number [97]. Insect natural AMPs previously identified are estimated as 400–500 in number [3]. AMPs are produced by bacteria, fungi, numerous invertebrates, vertebrates and plants, and are usually associated with killing microbes although they may also be involved in wound repair, inflammation, development, chemotaxis, and cytokine activity (e.g., [95, 96, 98]).

Insect AMPs are mainly cationic (although anionic forms do exist) which facilitates their binding electrostatically to negatively charged bacteria and tumour cell surfaces, whilst neutrally charged normal cells are unaffected [3]. They are also amphipathic in their folded state with hydrophilic and hydrophobic regions mediating their solubility in phospholipid cell membranes. These interactions of the AMPs result in their membrane disruptive properties which characterise these molecules [99]. Most of the insect AMPs are freely circulating or associated with the gut or other epithelia and often placed strategically at external openings on the body to combat infection [3]. Some AMPs are constitutively expressed but the majority is rapidly induced following exposure to would-be invaders. Any one insect can produce multiple AMPs which enable it to differentiate between invading organisms and to respond selectively. Many of the venom proteins such as melittin, described in Section 3.2, above, are also polypeptides with amphipathic and cationic properties but are highly toxic and confined to venom sacs to combat other predatory insects and animals.

Insect AMPs can be classified into 3 groups [3], although 4 or 5 groups have also been recognised [92, 93].

(1) Linear α-helical AMPs, which in insects include the cecropins, moricin, sarcotoxin, and melittin, are present in a wide range of insect orders, including coleopterans, dipterans, and lepidopterans. Cecropins are active against Gram-positive and Gram-negative bacteria, viruses, protozoans, fungi, nematodes, and tumour cells [3, 100]. Cecropins are promising anticancer drugs when combined with melittin (see Section 3.2) or with chemotherapy agents to reduce their toxic side effects [101]. Also, overexpressed defensin A and cecropin A genes in transgenic Aedes aegypti blocked the transmission of Plasmodium gallinaceum [102]. Recently, the potential development of engineered cecropin A-melittin analogues and other AMPs as drugs against protozoan parasites such as Leishmania has been reviewed [103].

(2) Linear proline or glycine-rich AMPs include drosocin, apidaecin, formaecin, and pyrrhocoricin. These are short, proline-rich with specific intracellular targets in bacteria, while mammalian cells are unaffected [3]. They generally target Gram-negative bacteria such as Escherichia coli and kill over several hours, in contrast to the other two groups of AMPs which kill rapidly. The bacterial target of the proline-rich AMPs is believed to be the intracellular chaperone DnaK [104]. Ostorhazi et al. [104] synthesised a proline-rich, designer peptide, A3-APO, and showed its efficacy against multidrug resistant bacterial infections in the wounds and lungs of mice. A3-APO upregulated the expression of the antiinflammatory cytokines interleukin-4 and interleukin-10 so that wounds lacked pus [104]. A shortened version of apidaecin, Api88, has similar activity to A3-APO against pathogenic E. coli but is unstable in serum. Simply substituting Arg-17 with l-ornithine increased, by more than 20-fold, the serum stability of Api88 [105].

(3) Cysteine-stabilised AMPs are small cationic peptides with 33–46 amino acids, and are stabilised by cysteine residues forming disulphide bridges [3]. They are common in most insects and include defensins or defensin-like compounds such as gallerimycin, heliomycin, sapecins, drosomycin, spodoptericin, and phormicins [106]. They are mainly active against Gram-positive bacteria and fungi but are also antiparasitic [103]. The defensins, like the cecropins and analogues of pyrrhocoricin, have considerable potential for development as drugs since short synthetic forms of insect defensins inhibit MRSA and disrupt myeloma cancer cells [3]. Furthermore, in mammals, defensins have the dual activities of killing bacteria as well as modulating the immune response by recruiting and activating immune cells [107]. Invertebrate defensins exhibit high affinity binding to the bacterial cell wall precursor, lipid II, and inhibit its incorporation into the peptidoglycan network [107].

6.2. Killing Mechanisms of AMPs

This is considered briefly as it is relevant to understanding the therapeutic use of AMPs. The cationic AMPs are amphipathic with a net positive charge with large numbers of cationic amino acids such as arginine, histidine, and/or lysine and also contain hydrophobic residues [95]. The prevalent negative net charge of bacterial membranes due to the composition of their phospholipids (predominantly with negative charge) plays a major role in the attraction of the cationic AMPs, while membranes of eukaryotic cells enriched in zwitterionic phospholipids and cholesterol are refractory to the AMPs. The cationic AMPs bind to the anionic residues of the outer bacterial envelope, which include the lipopolysaccharides of Gram-negative bacteria and the lipoteichoic acids of Gram-positive forms [93]. Binding to the outer bacterial cell membrane does not, in contrast to antibiotics, involve specific receptors for the AMPs so that it is more difficult for the bacteria to mutate and evolve resistance to the AMPs [93]. This binding results in disruption and permabilisation of the outer bacterial cell membrane and eventually microbial death.

There are a number of models for the mechanisms involved in bacterial membrane disruption. These include the barrel stave, the carpet, the toroidal, and ion channel forming models. These models have been extensively reviewed previously (e.g., [92, 99, 108, 109]). In the barrel stave model, clusters of α-helical AMPs are inserted in the membrane like a barrel with the staves (strips of wood forming the wall) forming a transmembrane pore. The hydrophilic side groups of the AMPs line the aqueous pore, while the hydrophobic tails of the phospholipid membrane fatty acids interact with the nonpolar side groups of the AMP. In the carpet model, the AMPs attach parallel with the membrane, form a carpet resulting in holes in the membrane which then, at a critical concentration, collapses. With the toroidal model, the AMPs are inserted perpendicular into the membrane to form pores lined by the AMPs and the lipid head groups. Finally, with the ion channel forming model, the AMPs bind to the polar head groups, insert into the membrane, aggregate, and span the membrane to form pores through which ions leak from the bacterial cell [93]. The same membanolytic activities of AMPs would apply to their killing of anionic cancer cells [100].

Evidence, however, is accumulating that the activity of AMPs is probably not confined to cell membrane lysis. Thus, AMPs may disrupt mitochondrial membranes, inhibit cell wall synthesis, inhibit DNA synthesis, inhibit protein synthesis, interact with membrane receptors and heat-shock proteins, and have antiangiogenesis effects [92, 99, 100]. One example is apidaecin which kills Gram-negative bacteria without forming pores and interferes with protein synthesis [99].

6.3. Therapeutic Use of AMPs

AMPs have great potential for development as new classes of antibiotics for a number of reasons.(a)There is a huge variety, targeting a broad range of microorganism and cancer cells and lending themselves to synthetic improvement.(b)They seem to have multiple targets and do not generally rely on specific receptor binding so that development of resistance by bacteria is difficult.(c)They generally kill rapidly and within minutes while conventional antibiotics usually take hours.(d)They can kill antibiotic-resistant bacteria such as MRSA as well as cancer cells.(e)Their antimicrobial activity occurs even with low micromolar, concentrations.(f)They may have dual effects to kill microbes and to modulate the immune system.(g)They can destroy biofilms on medical devices even when used at low concentrations.

Despite the advantages of AMPs, progress to date in developing them for clinical use has been disappointing. The main advance has been with vertebrate AMPs for use in topical applications and a few AMPs have entered clinical trials [3, 92, 108, 110]. These AMPs were designed for a number of external uses such as skin care, acne, eye infections, and catheter-related pathogens.

There have been a number of reasons for this slow progress in AMPs becoming available for clinical use.

(1) Lack of interest by large pharmaceutical companies for many years. Thus, between 1998 and 2004, of the 290 new antibacterial drugs under development, only 4 involved the major pharmaceutical companies [3]. This attitude is now changing for various reasons including the emergence, in the last 10 years, of more and more antibiotic-resistant bacteria and fewer and fewer antibiotics available to treat these pathogens. In addition, research has revealed the dual function of some of these AMPs with the ability not only to kill microbes but also to modulate the immune system [111]. No doubt this fact has not escaped the attention of the pharmaceutical companies with the potential of developing new classes of drugs able to control immune reactivity. In addition, much progress has also been made in understanding the functioning of the AMPs which can be produced at much lower costs than their natural counterparts [95]. The more effective delivery of AMPs by gene therapy or nanoparticles is also being developed and will enhance the therapeutic potential of AMPs ([50, 51], see Section 3.2) and again raise interest in this rapidly evolving subject.

(2)  High production costs have always been a major hurdle to development of the AMPs since they only occur at low concentrations naturally and the cost of solid phase synthesis is very high [3]. Advances, however, are rapidly being made to reduce manufacturing costs. Thus, numerous reports describe the synthesis of truncated synthetic analogues with enhanced killing activities and with potential for cheaper production costs. For example, Ausbacher et al. [112] designed a series of small antimicrobial β2,2-amino acid derivatives of Mw < 500, with potent activity against both MRSA and cancer cells, and Gaspar et al. [100] also described a number of short, synthetic peptides for use against different types of solid tumours. These latter peptides included four enantiomeric AMP analogues (D-peptides A, B, C, and D) designed from beetle defensins [113]. An alternative strategy to reduce costs of mass production is to use recombinant technology but this has been hindered by the antibacterial activity of the AMPs and their proteolytic degradation during production [114]. Recent studies, however, have used cost effective, modified recombinant techniques with E.coli or with the methylotrophic yeast Pichia pastoris as vectors, to produce fully functional insect cecropins capable of killing a range of bacteria, including MRSA [115, 116]. Finally, regulatory rules governing the required performance prior to approval for the release of drugs in the USA (FDA) and Europe have all to be navigated at extra cost [3]. It is noteworthy that much of the significant research on AMPs is now being conducted in China.

(3) There are also concerns about the stability and toxicity of the AMPs towards mammalian cells [93, 94] as well as the development of bacterial resistance to these molecules. However, as a result of better understanding of the structural-functional relationships of AMPs and the introduction of computer modelling, it is now possible to design and synthesise AMPs with increased stability in serum and saline, no toxicity, and greater killing activities [3, 117]. These AMPs have been produced by amino acid substitutions, sequence splicing, and changes in ratios of hydrophobic amino acids to produce truncated designer compounds against clinically isolated, antibiotic resistant pathogens at low MICs of <10 μg/mL [117]. Further advances will occur in isolating and synthesising active AMPs with the introduction of new discovery pipelines utilising in silico designed AMP-encoding oligonucleotide libraries [118] and advanced quantitative structure-activity relationship (QSAR) models [119].

Regarding development of resistance of bacteria to AMPs, this was thought to be less likely to occur than with conventional antibiotics as AMPs may have multiple sites of action within the bacterial cell and involve fundamental changes in the membrane (e.g., [120]). This view, however, has been shown to be over optimistic as reports have appeared of resistance to AMPs [3], including resistance to insect melittin and cecropin [121, 122]. In addition, the evolution of resistance to a cationic AMP has been shown through continual selection in the laboratory [123] although conditions in nature are very different. Thus, each host will contain a different range of AMPs in the various tissues of the body. This point is emphasised by Chernysh and Gordja [124] who prepared a Calliphora vicina maggot peptide complex called FLIP7 (from Fly Larvae Immune Peptides) containing cecropins, defensins, diptericins, and a proline-rich peptide and compared its ability with the antibiotic, meropenem, to kill a multiresistant strain of Klebsiella pneumonia over many generations. The results showed that after 25 passages with the meropenem, the resistance of the bacteria was increased 128 times, while there was no change in resistance towards the C. vicinia FLIP7 complex. Thus, although resistance to AMPs can occur, this should not deter their development as therapeutics but their widespread use should be carefully regulated [123]. The use of hybrid molecules constructed, for example, from cecropin and melittin or cecropin and rifampicin should also help to solve this problem [125].

In conclusion, the future of the development of AMPs as new classes of drugs for killing antibiotic resistant bacteria and cancer cells looks very bright. The versatility of these potential drugs seems to increase daily with, for example, recent reports of the use of AMPs to coat titanium bone implants to prevent infection [126] and the inhibition of biofilm formation by these compounds [125].

7. Maggot Molecules

Maggots have been used for wound healing in Folk Medicine by the aborigines and Mayan Indians for thousands of years. Maggots for cleaning wounds also occurred in the Napoleonic and American Civil Wars [3, 127]. However, maggot therapy only obtained wider recognition for treating infected wounds after its introduction into USA hospitals in the 1920s by Professor William Baer at John Hopkins University. By the 1930s and 1940s over 300 USA hospitals used this procedure and it had also spread to Europe [3, 127]. In the 1940s, however, the newly discovered antibiotics soon dampened the enthusiasm for maggot therapy and only the appearance of antibiotic-resistant bacteria in the 1980s rekindled interest in this procedure. Maggot therapy is now commonly used for many types of infected wounds such as diabetic foot wounds, postoperative infections, bed sores, and leg ulcers, in the USA, Israel, and Europe [3, 127]. It is estimated to have saved the NHS, UK over 500 million pounds. The larvae of the blowfly, Lucilia sericata, are frequently used (Figure 4) although other species have also been tried such as Lucilia cuprina, Phormia regina, and Calliphora vicina [127]. Thus, a wide spectrum of dipteran species has potential as sources of new medicinal drugs, especially since the larval stage of L. sericata can kill MRSA [128]. Recent reviews of maggot therapy provide more details of the processes involved [129131].

904958.fig.004
Figure 4: Showing newly washed final instar Lucilia sericata larvae prior to incubation for production of extracorporeal secretions. Photograph by kind permission of Mr. I.F. Tew, Swansea University.

The use of L. sericata larvae for treating wounds has been recognised by the U.S. Food and Drug Administration and the UK Prescription Pricing Authority. Sterile maggots can therefore be officially prescribed (http://www.medicaledu.com/maggots.htm).

Maggot therapy can be divided into 3 processes:(i)debridement of wounds;(ii)wound healing;(iii)disinfection of wounds.

7.1. Debridement of Wounds

Once maggots are applied to the wound then debridement or cleaning and removal of necrotic tissue and debris (eschar) occur so that granulation and healing can begin. Maggots clean wounds by the extracorporeal production of enzymes (Table 5) that digest the debris which the maggots then feed upon [3]. Initially, the main enzymes identified in the maggot excretions/secretion (ES) were chymotrypsin- and trypsin-like serine proteases, an aspartyl proteinase and a metalloproteinase [132]. The secretion of ammonia by the maggots increases the pH to activate the serine proteases. The most active enzymes are produced by first instar larvae [132].

tab5
Table 5: Summary of factors/processes involved in maggot therapy of infected wounds.

More recent work from the Pritchard group in Nottingham University has revealed more information about the maggot proteases and also detected other enzymes present in the MS. First; the L. sericata chymotrypsin I is resistant to the endogenous wound protease inhibitors, α1-antichymotrypsin and α1-antitrypsin, present in eschar and which could potentially inhibit debridement [146]. In contrast, mammalian α-chymotrypsin is inhibited by these enzymes so that maggot chymotrypsin I can survive in the wound to undertake debridement, whilst the mammalian enzyme cannot. Second, the MS have also been shown to contain a DNase able to degrade genomic bacterial DNA, the extracellular bacterial DNA in preformed biofilms from a Pseudomonas aeruginosa clinical isolate, and DNA from the slough/eschar of a venous leg ulcer [133]. This DNase must make a valuable contribution to debridement and healing by clearing tissue DNA as well as that of biofilms, thus freeing tissue protein for digestion by the ES proteases [133]. Third, the ES also contain glycosidases which would remove sugars from the wound debris and contribute to the debridement process [134]. All these enzymes (Table 5) in the ES remove the extracellular matrix debris, fibrin clots, and any biofilms associated with infecting bacteria and allow healing to begin [147150]. All the above work was undertaken in L. sericata but recent work investigating the potential of another calliphorid species, Sarconesiopsis magellanica, for use in maggot therapy has shown that larval ES of this insect also contain trypsin-like serine proteases [151].

Pritchard and colleagues have applied their findings to develop hydrogel bandages containing these enzymes in order to accelerate debridement and healing processes [152]. Recently, they have made additional progress by producing a recombinant chymotrypsin I, using good medical practice guidelines, which successfully digested wound debris and is now available for clinical trials [153, 154].

7.2. Wound Healing

There is no doubt about the benefits of maggots in debriding chronic wounds but the outcome of clinical trials on their use in wound healing is more uncertain [155]. The ES enzymes or other constituents have been shown to activate the fibroblasts [156] and evidence is accumulating for an active role for ES in wound healing. Thus, specific amino acids derivatives and fatty acids extracts (Table 5) from L. sericata ES induce mitosis in human endothelial cells and activate angiogenesis and wound healing [135, 136].

In addition, there is accumulating evidence that ES have an immunomodulatory role in the wound healing process (Table 5) and this has been reviewed in detail previously [131]. In particular, neutrophils, macrophages, lymphocytes, and the complement system respond to exposure to the MS. With neutrophils, the ES inhibit elastase, the respiratory burst, hydrogen peroxide production, and migration of these cells. Elastase breaks down the extracellular matrix and delays epithelial repair, while oxygen radicals would probably have a similar effect. Concomitantly, the inhibition of neutrophil migration would help resolve the prolonged inflammatory response, to which they contribute, present in a chronic wound [131, 137]. Macrophages are similarly affected by the ES and show reduced migration and inhibited production of proinflammatory cytokines such as migration inhibitory factor and TNF-α. At the same time, the production of the anti-inflammatory cytokine IL-10 is increased so that the ES appear to be reducing the inflammatory response [138]. In addition, in the presence of ES, macrophages develop into anti-inflammatory rather than proinflammatory forms [139]. The anti-inflammatory macrophages suppress inflammation and secrete basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) which mediate mitosis and migration of endothelial cells resulting in angiogenesis and eventual healing of wounds [157]. Recently, these results were confirmed by applying ES to acute skin wounds made in rats since levels of the acute inflammatory cytokines, TNF-α and IL-6, remained significantly lower than in the rats with untreated wounds [157]. Lymphocytes activation too is inhibited by the ES so that the wound site would be protected from the induction of an adaptive response to the maggot proteins [140].

Even more interesting is the study by Cazander et al. [141] who have shown that ES could reduce complement activation by 99.99% in the sera of healthy and postoperatively immune-activated human patients. The ES break down complement components C3 and C4 which could explain, in part, the improved wound healing following maggot therapy (Table 5).

7.3. Disinfection of Wounds

There is good evidence that ES can kill bacteria infecting wounds, including antibiotic-resistant strains such as MRSA [3]. There are reports of many different antibacterial factors in dipterans, including a range of AMPs such as Sarcotoxin 1A, a cecropin-like molecule from the flesh fly Sarcophaga peregrine, which is more active against Gram-negative bacteria than Gram-positive forms [158]. However, focus is now on calliphorid flies used in wound healing in which one AMP, lucifensin (Table 5), has received particular attention recently as it is active against clinically relevant bacteria such as Streptococcus species (e.g., [143]). Most of the other antibacterial factors described from calliphorids are <1300 Da in size [3], although Altincicek and Vilcinskas [149], and Andersen et al. [143] have shown that L. sericata has 65 immune-inducible genes including lysozyme- and transferrin-likegenes and 3 proline-rich AMPs.

Lucifensin was first purified in 2010 from an extract of the gut of L. sericacta larvae by Čeřovský et al. [142]. They showed that the peptide contained 40 amino acid residues and 3 disulphide bridges and was a typical 4 kDa dipteran defensin. Subsequently, Andersen et al. [143] published the primary sequence, and Čeřovský et al. [159] chemically synthesised lucifensin to provide material for a structural-activity study. More recently, lucifensin II was discovered and characterised from Lucilia cuprina and found to be identical to the L. sercata lucifensin except for one amino acid residue [160]. Thus, lucifensins are cationic AMP with main activity against Gram-positive bacteria [143] so that, together with seraticin (see below), they make an important contribution in the ES to cleaning infected wounds of MRSA and other antibiotic-resistant bacteria. This antibacterial activity occurs even at physiological salt levels [138]. Lucifensin is present in the gut, fat body, and haemolymph of L. sericata and appears to be constitutively expressed [142, 160]. In addition, in L. sericata orally challenged with bacterial isolates from wounds, only in the fat body is there an increase in lucifensin expression so that levels in the ES remain unchanged [161]. Lucifensin has also been studied in a detailed structural analysis by NMR [162]. It seems possible that it has two mechanisms of antimicrobial activity against the bacterial cell and interacts both with the bacterial membrane and binds to the cell wall precursor, lipid II [162]. Finally, interest has also increased in the antibacterial factors of the house fly, Musca domestica, because of its possible role as a vector of pathogens such as MRSA [163, 164]. Results show that these insects also produce a defensin that is upregulated upon bacterial ingestion and that this, and probably other factors, is responsible for the antibacterial activity against MRSA and VRE (vancomycin-resistant enterococci) recorded for solvent extracts of maggots [164].

As far as the calliphorid low weight antibacterial factors are concerned, there are two sets of molecules for development as new medicinal drugs, namely, the alloferons and seraticin (Table 5).

Two alloferons were originally isolated from the haemolymph of Calliphora vicinia by Chernysh and colleagues [144] and are peptides with amino acid sequences of HGVSGHGQHGVHG (alloferon 1) and GVSGHGQHGVHG (alloferon 2). Synthetic alloferon in in vitro tests stimulated natural killer cells, while in vivo interferon was induced in mice. There were also indications of antiviral and antitumour activities [144] with alloferon also showing moderate tumoristatic and tumoricidal activities in transplanted tumours in mice [165]. More recently, a derivative of alloferon, allostatin, has been shown to have a significant adjuvant effect in vaccination experiments against tumour cells in mice [166]. Clinical studies by Ryu et al. [167] subsequently showed that alloferon activates immune cells through the NF-kappaB signalling pathway. The Allopharm Company was then formed in Russia and Allomedin was marketed in 2005 for the treatment of genital herpes, cold sores, and gingivitis [3]. A number of detailed structural-functional studies have been undertaken of alloferon by sythesising analogues with amino acid substitutions in position 1, for example, in the peptide chain [7, 168]. Some of these analogues extended the antiviral properties of the native molecules so that they inhibited not only human herpes virus 1 but also coxsackievirus multiplication in vitro. Another study has shown the therapeutic potential of alloferon for the treatment of Kaposi’s sarcoma, caused by the Kaposi’s sarcoma-associated herpesvirus, and a characteristic condition in HIV patients [169].

Seraticin is present in the MS of sterile L. sericata larvae [128, 145]. The MS has antibacterial activity against both Gram-positive and Gram-negative bacteria including S. aureus, MRSA, Bacillus thuringiensis, E. coli, P. aeruginosa, and Enterobacter cloacae. The fact that maggot samples collected with the highest pH also had the highest antibacterial activity probably eliminates phenylacetic acid, produced by the commensal, Proteus mirabilis, as the source of the factor involved [145, 170]. Subsequently, further fractionation of maggot secretions revealed a fraction of <500 Da active against S. aureus, 10 strains of MRSA, and a number of Gram-positive and Gram-negative bacteria [128]. This <500 Da fraction, named “seraticin,” has been the subject of additional research, due to its inhibition and killing of clinical strains of MRSA and Clostridium difficile, and has been isolated and characterised, and an empirical formula was calculated. Mass spectrometry and NMR studies have been carried out and a synthesis has produced fractions having similar antimicrobial properties to the native seraticin molecule. A <1000 Da molecule, active against MRSA, and from sterile L. sericata larvae, has also been reported previously [171]. Unfortunately, lack of funding seriously delays the development of research and commercialization of such interesting and potentially important new medicines, especially if derived from such unfashionable sources as fly maggots.

8. Insect Anticoagulants

The anticoagulants in the salivary glands of blood sucking ticks and insects such as the Hemiptera, Diptera, Siphonaptera, and Anoplura have tremendous potential for development of new anticoagulants and immune modulating medicines [3]. In fact, extracts of the salivary glands of horseflies have been used for centuries in Eastern Medicine as anticlotting agents [3]. Progress, however, has been made in identifying and commercialisation of such invertebrate anticoagulants not from insects but from leeches and ticks [1, 3]. In leeches, recombinant derivatives of hirudin have been made available commercially for some years in Europe and the USA [172] with the approval of the FDA. With ticks, intense research is underway on the bioactive substances produced by their salivary glands and a variety of molecules with diverse functions have been described with potential use as pharmaceuticals (reviewed in [173]). Attention has been focused on ticks probably due to the variety of pathogens vectored by these animals [173].

Regarding insects, much less is known about the anticoagulants in their salivary glands possibly due to the sheer numbers of protein families produced in these glands [174]. However, a recent thorough analysis of the structure and function of thrombin inhibition by anophelin in the salivary glands of Anopheles mosquitoes has been made and discovered a unique thrombin inhibition mechanism [175]. Thrombin is an atypical (chymo) trypsin-like enzyme, with a narrow active site cleft for specific substrate recognition and also has secondary recognition surfaces (exosites) [175] In contrast to other natural bivalent inhibitors of thrombin which bind to one of the thrombin exosites through their C-terminals, anophelin shows reverse binding to an exosite by means of the N-terminal and the C-terminal binds to the active site as shown in Figure 5 [175]. The significance of this finding is that it imparts anophelin with potent inhibitory properties as well as high resistance to proteolysis by thrombin and this may have implications for the design of novel antithrombotics [175].

fig5
Figure 5: Comparison of mechanism of thrombin recognition by anophelin with other substrates and inhibitors. Thrombin is represented by an orange ellipse, with exosites in blue and the active site in red. Anophelin inhibitor binds to thrombin in a reverse orientation relative to the other molecules, such that the N-terminal portion recognises exosite I, whereas the C-terminal acidic segment binds to the active site of thrombin. From original Figure 4 of Ana C. Figueiredo, Daniele de Sanctis, Ricardo Gutiérrez-Gallego, Tatiana B. Cereija, Sandra Macedo-Ribeiro, Pablo Fuentes-Prior, and Pedro José Barbosa Pereira, “Unique thrombin inhibition mechanism by anophelin, an anticoagulant from the malaria vector” which appeared in Proceedings of the National Academy of Sciences of the United States of America.” Volume, 109, Issue 52, pages E3649 to E3658, 2013 (doi: 10.1073/pnas.1211614109). Reprinted with permission of PNAS.

Final Comment

The authors apologise to those scientists who have provided invaluable information for this review but whose publications have only been cited indirectly via relevant reviews.

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

Acknowledgments

The Fluminense Federal University, IOC-FIOCRUZ-RJ, and CNPq/Brazil, are gratefully acknowledged for their support.

References

  1. E. P. Cherniack, “Bugs as drugs, part 1: insects. The “new” alternative medicine for the 21st century?” Alternative Medicine Review, vol. 15, no. 2, pp. 124–135, 2010. View at Scopus
  2. A. T. Dossey, “Insects and their chemical weaponry: new potential for drug discovery,” Natural Product Reports, vol. 27, no. 12, pp. 1737–1757, 2010. View at Publisher · View at Google Scholar · View at Scopus
  3. N. A. Ratcliffe, C. B. Mello, E. S. Garcia, T. M. Butt, and P. Azambuja, “Insect natural products and processes: new treatments for human disease,” Insect Biochemistry and Molecular Biology, vol. 41, no. 10, pp. 747–769, 2011. View at Publisher · View at Google Scholar · View at Scopus
  4. F. Zhu, X. H. Ma, and C. Qin, “Drug discovery prospect from untapped species: indications from approved natural product drugs,” PLoS ONE, vol. 7, no. 7, Article ID e39782, 2012. View at Publisher · View at Google Scholar
  5. P. W. Taylor, “Alternative natural sources for a new generation of antibacterial agents,” International Journal of Antimicrobial Agents, vol. 42, pp. 195–201, 2013.
  6. H. Zhao, X. Feng, W. Han, et al., “Enhanced binding to and killing of hepatocellular carcinoma cells in vitro by melittin when linked with a novel targeting peptide screened from phage display,” Journal of Peptide Science, vol. 19, pp. 639–650, 2013.
  7. M. Kuczer, A. Majewska, and R. Zahorska, “New alloferon analogues: synthesis and antiviral properties,” Chemical Biology and Drug Design, vol. 81, pp. 302–309, 2013.
  8. C. Y. Koh, S. Kumar, M. Kazimirova et al., “Crystal structure of thrombin in complex with s-variegin: insights of a novel mechanism of inhibition and design of tunable thrombin inhibitors,” PLoS ONE, vol. 6, no. 10, Article ID e26367, 2011. View at Publisher · View at Google Scholar · View at Scopus
  9. R. W. Pemberton, “Insects and other arthropods used as drugs in Korean traditional medicine,” Journal of Ethnopharmacology, vol. 65, no. 3, pp. 207–216, 1999. View at Publisher · View at Google Scholar · View at Scopus
  10. A. Gomes, M. A. Alam, S. Bhattacharya et al., “Ethno biological usage of zoo products in rheumatoid arthritis,” Indian Journal of Experimental Biology, vol. 49, no. 8, pp. 565–573, 2011. View at Scopus
  11. G. J. Lockhart, “Ants and other great medicines,” partially published online by A. L. Jacobson, 2007, http://www.arthurleej.com/ants.pdf.
  12. R. Dunn, “Insects as medicines: the ant and the grasshopper,” http://www.robrdunn.com/.
  13. S. K. Srivastava, N. Babau, and H. Pandey, “Traditional insect bioprospecting-as human food and medicine,” Indian Journal of Traditional Knowledge, vol. 8, no. 4, pp. 485–494, 2009.
  14. E. M. Costa-Neto, “The use of insects in folk medicine in the state of Bahia, northeastern Brazil, with notes on insects reported elsewherein Brazilian folk medicine,” Human Ecology, vol. 30, no. 2, pp. 245–263, 2002. View at Publisher · View at Google Scholar · View at Scopus
  15. D. S. Lee, S. Sinno, and A. Khachemoune, “Honey and wound healing: an overview,” The American Journal of Clinical Dermatology, vol. 12, no. 3, pp. 181–190, 2011. View at Publisher · View at Google Scholar · View at Scopus
  16. N. S. Al-Waili, K. Salom, and A. A. Al-Ghamdi, “Honey for wound healing, ulcers, and burns; data supporting its use in clinical practice,” TheScientificWorldJournal, vol. 11, pp. 766–787, 2011. View at Publisher · View at Google Scholar · View at Scopus
  17. A. Seckam and R. Cooper, “Understanding how honey impacts on wounds: an update on recent research findings,” Wounds International, vol. 4, no. 1, pp. 20–24, 2013.
  18. A. B. Jull, A. Rodgers, and N. Walker, “Honey as a topical treatment for wounds,” Cochrane Database of Systematic Reviews, no. 4, Article ID CD005083, 2008. View at Publisher · View at Google Scholar · View at Scopus
  19. F. E. Brölmann, D. T. Ubbink, E. A. Nelson, et al., “Evidence based decisions for local and systemic wound care,” British Journal of Surgery, vol. 99, no. 9, pp. 1172–1183, 2012.
  20. M. B. Abubakar, W. Z. Abdullah, S. A. Sulaiman, and A. B. Suen, “A review of molecular mechanisms of the anti-leukemic effects of phenolic compounds in honey,” International Journal of Molecular Sciences, vol. 13, pp. 15054–15073, 2012.
  21. A. J. Tonks, E. Dudley, N. G. Porter et al., “A 5.8-kDa component of manuka honey stimulates immune cells via TLR4,” Journal of Leukocyte Biology, vol. 82, no. 5, pp. 1147–1155, 2007. View at Publisher · View at Google Scholar · View at Scopus
  22. P. H. S. Kwakman, A. A. te Velde, L. de Boer, C. M. J. E. Vandenbroucke-Grauls, and S. A. J. Zaat, “Two major medicinal honeys have different mechanisms of bactericidal activity,” PLoS ONE, vol. 6, no. 3, Article ID e17709, 2011. View at Publisher · View at Google Scholar · View at Scopus
  23. S. Alnaimat, M. Wainwright, and K. Al’Abri, “Antibacterial potential of honey from different origins: a comparison with Manuka honey,” Journal of Microbiology, Biotechnology and Food Sciences, vol. 1, no. 5, pp. 1328–1338, 2012.
  24. R. E. Jenkins and R. Cooper, “Synergy between oxacillin and manuka honey sensitizes methicillin-resistant Staphylococcus aureus to oxacillin,” Journal Antimicrobial Chemotherapy, vol. 67, no. 6, pp. 1405–1407, 2012. View at Publisher · View at Google Scholar
  25. R. A. Cooper, E. Lindsay, and P. C. Molan, “Testing the susceptibility to manuka honey of streptococci isolated from wound swabs,” Journal of ApiProduct & ApiMedical Science, vol. 3, no. 3, pp. 117–122, 2011.
  26. A. F. Henriques, R. E. Jenkins, N. F. Burton, and R. A. Cooper, “The effect of manuka honey on the structure of Pseudomonas aeruginosa,” European Journal of Clinical Microbiology and Infectious Diseases, vol. 30, no. 2, pp. 167–171, 2011. View at Publisher · View at Google Scholar · View at Scopus
  27. A. E. Roberts, S. E. Maddocks, and R. A. Cooper, “Manuka honey is bactericidal against Pseudomonas aeruginosa and results in differential expression of OprF and algD,” Microbiology, vol. 158, no. 12, pp. 3005–3013, 2012.
  28. K. Brudzynski, K. Abubaker, and T. Wang, “Powerful killing by buckwheat honeys is concentration-dependent, involves complete DNA degradation and requires hydrogen peroxide,” Frontiers in Microbiology, vol. 3, article 242, 2012. View at Publisher · View at Google Scholar
  29. S. E. Maddocks, M. S. Lopez, R. S. Rowlands, and R. A. Cooper, “Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins,” Microbiology, vol. 158, no. 3, pp. 781–790, 2012. View at Publisher · View at Google Scholar · View at Scopus
  30. L. Boukraâa and S. A. Sulaiman, “Rediscovering the antibiotics of the hive,” Recent Patents on Anti-Infective Drug Discovery, vol. 4, no. 3, pp. 206–213, 2009. View at Publisher · View at Google Scholar · View at Scopus
  31. J. M. Sforcin and V. Bankova, “Propolis: is there a potential for the development of new drugs?” Journal of Ethnopharmacology, vol. 133, no. 2, pp. 253–260, 2011. View at Publisher · View at Google Scholar · View at Scopus
  32. N. Oršolić, “Bee honey and cancer,” Journal of ApiProduct and ApiMedical Science, vol. 1, no. 4, pp. 93–103, 2009.
  33. C. Spagnuolo, M. Russo, S. Bilotto, et al., “Dietary polyphenols in cancer prevention: the example of the flavonoid quercetin in leukemia,” Annals New York Academy of Science, vol. 1259, pp. 95–103, 2012.
  34. E. Szliszka and W. Krol, “Polyphenols isolated from propolis augment TRAIL-induced apoptosis in cancer cells,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 731940, 10 pages, 2013. View at Publisher · View at Google Scholar
  35. A. Budhraja, N. Gao, Z. Zhang et al., “Apigenin induces apoptosis in human leukemia cells and exhibits anti-leukemic activity in vivo,” Molecular Cancer Therapeutics, vol. 11, no. 1, pp. 132–142, 2012. View at Publisher · View at Google Scholar · View at Scopus
  36. M. J. Fernandez-Cabezudo, R. El-Kharrag, F. Torab, et al., “Intravenous administration of manuka honey inhibits tumor growth and improves host survival when used in combination with chemotherapy in a melanoma mouse model,” PLoS ONE, vol. 8, no. 2, Article ID e55993, 2013. View at Publisher · View at Google Scholar
  37. D. R. Hoffman, “Ant venoms,” Current Opinion in Allergy and Clinical Immunology, vol. 10, no. 4, pp. 342–346, 2010. View at Publisher · View at Google Scholar · View at Scopus
  38. E. L. Danneels, D. B. Rivers, and D. C. de Graaf, “Venom proteins of the parasitoid wasp Nasonia vitripennis: recent discovery of an untapped pharmacopee,” Toxins, vol. 2, no. 4, pp. 494–516, 2010. View at Publisher · View at Google Scholar · View at Scopus
  39. J. Matysiak, C. E. H. Schmelzer, R. H. H. Neubert, and Z. J. Kokot, “Characterization of honeybee venom by MALDI-TOF and nanoESI-QqTOF mass spectrometry,” Journal of Pharmaceutical and Biomedical Analysis, vol. 54, no. 2, pp. 273–278, 2011. View at Publisher · View at Google Scholar · View at Scopus
  40. G. Gajski and V. Garaj-Vrhovac, “Melittin: a lytic peptide with anticancer properties,” Environmental Toxicology and Pharmacology, vol. 36, no. 2, pp. 697–705, 2013.
  41. T. C. Terwilliger and D. Eisenberg, “The structure of melittin. II. Interpretation of the structure,” Journal of Biological Chemistry, vol. 257, no. 11, pp. 6016–6022, 1982. View at Scopus
  42. N. Oršolić, “Bee venom in cancer therapy,” Cancer Metastasis Reviews, vol. 31, pp. 173–194, 2012.
  43. M.-T. Lee, T.-L. Sun, W.-C. Hung, et al., “Process of inducing pores in membranes by melittin,” Proceedings of the National Academy of Sciences of the United States of America, vol. 110, no. 35, pp. 14243–14248, 2013. View at Publisher · View at Google Scholar
  44. S. V. Sharma, “Melittin resistance: a counterselection for ras transformation,” Oncogene, vol. 7, no. 2, pp. 193–201, 1992. View at Scopus
  45. H. G. Zhu, I. Tayeh, L. Israel, and M. Castagna, “Different susceptibility of lung cell lines to inhibitors of tumor promotion and inducers of differentiation,” Journal of Biological Regulators and Homeostatic Agents, vol. 5, no. 2, pp. 52–58, 1991. View at Scopus
  46. Y. H. Zhao, Y. Bai, H. Cui, et al., “Design and expression in Pichia pastoris of melittin and research of antibacterial activity increasing of melittin,” Shengming Kexue Yanjiu, vol. 10, no. 4, pp. 313–319, 2006 (Chinese).
  47. S. Vuorenoja, A. Rivero-Müller, A. J. Ziecik, I. Huhtaniemi, J. Toppari, and N. A. Rahman, “Targeted therapy for adrenocortical tumors in transgenic mice through their LH receptor by Hecate-human chorionic gonadotropin β conjugate,” Endocrine-Related Cancer, vol. 15, no. 2, pp. 635–648, 2008. View at Publisher · View at Google Scholar · View at Scopus
  48. H. Zhao, X. Feng, W. Han, et al., “Enhanced binding to and killing of hepatocellular carcinoma cells in vitro by melittin when linked with a novel targeting peptide screened from phage display,” Journal of Peptide Science, vol. 19, pp. 639–650, 2013.
  49. D. Winder, W. H. Günzburg, V. Erfle, and B. Salmons, “Expression of antimicrobial peptides has an antitumour effect in human cells,” Biochemical and Biophysical Research Communications, vol. 242, no. 3, pp. 608–612, 1998. View at Publisher · View at Google Scholar · View at Scopus
  50. N. R. Soman, S. L. Baldwin, G. Hu et al., “Molecularly targeted nanocarriers deliver the cytolytic peptide melittin specifically to tumor cells in mice, reducing tumor growth,” Journal of Clinical Investigation, vol. 119, no. 9, pp. 2830–2842, 2009. View at Publisher · View at Google Scholar · View at Scopus
  51. C. Huang, H. Jin, Y. Qian, et al., “Hybrid melittin cytolytic peptide-driven ultrasmall lipid nanoparticles block melanoma growth in vivo,” ACS Nano, vol. 7, no. 7, pp. 5791–5800, 2013.
  52. S. Dosler and A. A. Gerceker, “In vitro activities of antimicrobial cationic peptides: melittin and nisin, alone or in combination with antibiotics against Gram-positive bacteria,” Journal of Chemotherapy, vol. 24, no. 3, pp. 137–143, 2012.
  53. J. L. Hood, A. P. Jallouk, N. Campbell, et al., “Cytolytic nanoparticles attenuate HIV-1 infectivity,” Antiviral Therapy, vol. 18, no. 1, pp. 95–103, 2013.
  54. M. Y. Ahn, S. H. Shim, H. K. Jeong, and K. S. Ryu, “Purification of a dimethyladenosine compound from silkworm pupae as a vasorelaxation substance,” Journal of Ethnopharmacology, vol. 117, no. 1, pp. 115–122, 2008. View at Publisher · View at Google Scholar · View at Scopus
  55. T. D. Sutherland, J. H. Young, S. Weisman, C. Y. Hayashi, and D. J. Merritt, “Insect silk: one name, many materials,” Annual Review of Entomology, vol. 55, pp. 171–188, 2010. View at Publisher · View at Google Scholar · View at Scopus
  56. M. Widhe, J. Johansson, M. Hedhammar, and A. Rising, “Current progress and limitations of spider silk for biomedical applications,” Biopolymers, vol. 97, no. 6, pp. 468–478, 2012. View at Publisher · View at Google Scholar · View at Scopus
  57. T. D. Sutherland, S. Weisman, A. A. Walker, and S. T. Mudie, “The coiled coil silk of bees, ants, and hornets,” Biopolymers, vol. 97, no. 6, pp. 446–454, 2012. View at Publisher · View at Google Scholar · View at Scopus
  58. K. Numata, B. Subramanian, H. A. Currie, and D. L. Kaplan, “Bioengineered silk protein-based gene delivery systems,” Biomaterials, vol. 30, no. 29, pp. 5775–5784, 2009. View at Publisher · View at Google Scholar · View at Scopus
  59. K. Numata and D. L. Kaplan, “Silk-based delivery systems of bioactive molecules,” Advanced Drug Delivery Reviews, vol. 62, no. 15, pp. 1497–1508, 2010. View at Publisher · View at Google Scholar · View at Scopus
  60. A. C. MacIntosh, V. R. Kearns, A. Crawford, and P. V. Hatton, “Skeletal tissue engineering using silk biomaterials,” Journal of Tissue Engineering and Regenerative Medicine, vol. 2, no. 2-3, pp. 71–80, 2008. View at Publisher · View at Google Scholar · View at Scopus
  61. The International Silkworm Genome Consortium, “The genome of a lepidopteran model insect, the silkworm Bombyx mori,” Insect Biochemistry and Molecular Biology, vol. 38, no. 12, pp. 1036–1045, 2008. View at Publisher · View at Google Scholar · View at Scopus
  62. S. K. Nitta and K. Numata, “Biopolymer-based nanoparticles for drug/gene delivery and tissue engineering,” International Journal of Molecular Sciences, vol. 14, pp. 1629–1654, 2013.
  63. M. Xu and R. V. Lewis, “Structure of a protein superfiber: spider dragline silk,” Proceedings of the National Academy of Sciences of the United States of America, vol. 87, no. 18, pp. 7120–7124, 1990. View at Scopus
  64. F. Teulé, Y.-G. Miao, B.-H. Sohn et al., “Silkworms transformed with chimeric silkworm/spider silk genes spin composite silk fibers with improved mechanical properties,” Proceedings of the National Academy of Sciences of the United States of America, vol. 109, no. 3, pp. 923–928, 2012. View at Publisher · View at Google Scholar · View at Scopus
  65. K. Numata, J. Hamasaki, B. Subramanian, and D. L. Kaplan, “Gene delivery mediated by recombinant silk proteins containing cationic and cell binding motifs,” Journal of Controlled Release, vol. 146, no. 1, pp. 136–143, 2010. View at Publisher · View at Google Scholar · View at Scopus
  66. K. Numata, M. R. Reagan, R. H. Goldstein, M. Rosenblatt, and D. L. Kaplan, “Spider silk-based gene carriers for tumor cell-specific delivery,” Bioconjugate Chemistry, vol. 22, no. 8, pp. 1605–1610, 2011. View at Publisher · View at Google Scholar · View at Scopus
  67. K. Numata, A. J. Mieszawska-Czajkowska, L. A. Kvenvold, and D. L. Kaplan, “Silk-based nanocomplexes with tumor-homing peptides for tumor-specific gene delivery,” Macromolecular Bioscience, vol. 12, no. 1, pp. 75–82, 2012. View at Publisher · View at Google Scholar · View at Scopus
  68. Q. Zhang, S. Q. Yan, and M. Z. Li, “Porous materials based on Bombyx mori silk fibroin,” Journal of Fiber Bioengineering and Informatics, vol. 3, no. 1, pp. 1–8, 2010. View at Publisher · View at Google Scholar
  69. F. P. Seib, M. Herklotz, K. A. Burke, et al., “Multifunctional silk-heparin biomaterials for vascular tissue engineering applications,” Biomaterials, vol. 35, no. 1, pp. 83–91, 2014.
  70. F. P. Seib, E. M. Pritchard, and D. L. Kaplan, “Self-assembling doxorubicin silk hydrogels for the focal treatment of primary breast cancer,” Advanced Functional Materials, vol. 23, no. 1, pp. 58–65, 2013.
  71. E. M. Pritchard, T. Valentin, B. Panilaitis, et al., “Antibiotic-releasing silk biomaterials for infection prevention and treatment,” Advanced Functional Materials, vol. 23, no. 7, pp. 854–861, 2012.
  72. M. Hronik-Tupaj, W. K. Raja, M. Tang-Schomer, F. G. Omenetto, and D. L. Kaplan, “Neural responses to electrical stimulation on patterned silk films,” Journal of Biomedical Materials Research A, vol. 101, no. 9, pp. 2559–2572, 2013.
  73. J. Zhang, E. Pritchard, X. Hu, et al., “Stabilization of vaccines and antibiotics in silk and eliminating the cold chain,” Proceedings of the National Academy of Sciences of the United States of America, vol. 109, no. 30, pp. 11981–11986, 2013. View at Publisher · View at Google Scholar
  74. X. Sheng, L. Fan, C. He, et al., “Vitamin E-loaded silk fibroin nanofibrous mats fabricated by green process for skin care application,” International Journal of Biological Macromolecules, vol. 56, pp. 49–56, 2013.
  75. O. Tokareva, V. A. Michalczechen-Lacerda, E. L. Rech, et al., “Recombinant DNA production of spider silk proteins,” Microbial Biotechnology, vol. 6, no. 6, pp. 651–663, 2013.
  76. R. Rajkhowa, T. Tsuzuki, and X. G. Wang, “Recent innovations in silk biomaterials,” Journal of Fiber Bioengineering and Informatics, vol. 2, no. 4, pp. 202–213, 2010.
  77. M. A. Bologna and J. D. Pinto, “Phylogenetic studies of Meloidae (Coleoptera), with emphasis on the evolution of phoresy,” Systematic Entomology, vol. 26, no. 1, pp. 33–72, 2001. View at Publisher · View at Google Scholar · View at Scopus
  78. C. E. P. Galvis, L. Y. V. Mendez, and V. V. Kouznetsov, “Cantharidin-based small molecules as potential therapeutic agents,” Chemical Biology and Drug Design, vol. 82, pp. 477–499, 2013.
  79. E. Lissina, B. Young, M. L. Urbanus et al., “A systems biology approach reveals the role of a novel methyltransferase in response to chemical stress and lipid homeostasis,” PLoS Genetics, vol. 7, no. 10, Article ID e1002332, 2011. View at Publisher · View at Google Scholar · View at Scopus
  80. J. Bajsa, A. McCluskey, C. P. Gordon et al., “The antiplasmodial activity of norcantharidin analogs,” Bioorganic and Medicinal Chemistry Letters, vol. 20, no. 22, pp. 6688–6695, 2010. View at Publisher · View at Google Scholar · View at Scopus
  81. F. Ghaffarifar, “Leishmania major: in vitro and in vivo anti-leishmanial effect of cantharidin,” Experimental Parasitology, vol. 126, no. 2, pp. 126–129, 2010. View at Publisher · View at Google Scholar · View at Scopus
  82. I. J. Tseng, S. Y. Sheu, P. Y. Li, et al., “Synthesis and evaluation of cantharidinimides on human cancer cells,” Journal of Experimental Clinical Medicine, vol. 4, pp. 280–283, 2012.
  83. Y.-P. Zhan, X.-E. Huang, and J. Cao, “Clinical study on safety and efficacy of Qinin (cantharidin sodium) injection combined with chemotherapy in treating patients with gastric cancer,” Asian Pacific Journal of Cancer Prevention, vol. 13, no. 9, pp. 4773–4776, 2012.
  84. W. Li, L. Xie, Z. Chen et al., “Cantharidin, a potent and selective PP2A inhibitor, induces an oxidative stress-independent growth inhibition of pancreatic cancer cells through G2/M cell-cycle arrest and apoptosis,” Cancer Science, vol. 101, no. 5, pp. 1226–1233, 2010. View at Publisher · View at Google Scholar · View at Scopus
  85. W.-W. Huang, S.-W. Ko, H.-Y. Tsai et al., “Cantharidin induces G2/M phase arrest and apoptosis in human colorectal cancer colo 205 cells through inhibition of CDK1 activity and caspase-dependent signaling pathways,” International Journal of Oncology, vol. 38, no. 4, pp. 1067–1073, 2011. View at Publisher · View at Google Scholar · View at Scopus
  86. Y.-P. Huang, C.-H. Ni, C.-C. Lu, et al., “Suppressions of migration and invasion by cantharidin in TSGH-8301 human bladder carcinoma cells through the inhibitions of matrix metalloproteinase-2/-9 signaling,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 190281, 8 pages, 2013. View at Publisher · View at Google Scholar
  87. L. M. Shou, Q. Y. Zhang, W. Li, et al., “Cantharidin and norcantharidin inhibit the ability of MCF-7 cells to adhere to platelets via protein kinase C pathway-dependent downregulation of α2 integrin,” Oncology Reports, vol. 30, pp. 1059–1066, 2013.
  88. W. Li, D. M. Li, and K. Chen, “Development of a gene therapy strategy to target hepatocellular carcinoma based inhibition of protein phosphatase 2A using the α-fetoprotein promoter enhancer and pgk promoter: an in vitro and in vivo study,” BMC Cancer, vol. 12, article 547, 2012. View at Publisher · View at Google Scholar
  89. Y.-J. Dang and C.-Y. Zhu, “Oral bioavailability of cantharidin-loaded solid lipid nanoparticles,” BMC Chinese Medicine, vol. 8, article 1, 2013. View at Publisher · View at Google Scholar
  90. M. D. Lavine and M. R. Strand, “Insect hemocytes and their role in immunity,” Insect Biochemistry and Molecular Biology, vol. 32, no. 10, pp. 1295–1309, 2002. View at Publisher · View at Google Scholar · View at Scopus
  91. G. Wang, Ed., Antimicrobial Peptides, Advances in Molecular and Cellular Biology Series, CABI, 2010, http://ebookee.org/Antimicrobial-Peptides-Advances-in-Molecular-and-Cellular-Biology-Series-_912403.html.
  92. J. B. Peravali, S. R. Kotra, K. Sobha, et al., “Antimicrobial peptides: an effective alternative for antibiotic therapy,” Mintage Journal of Pharmaceutical & Medical Sciences, vol. 2, no. 2, pp. 1–7, 2013.
  93. S. J. Kang, D. H. Kim, T. Mishig-Ochir, et al., “Antimicrobial peptides: their physicochemical properties and therapeutic application,” Archives of Pharmal Research, vol. 35, no. 3, pp. 409–413, 2012.
  94. M. Ntwasa, A. Goto, and S. Kurata, “Coleopteran antimicrobial peptides: prospects for clinical applications,” International Journal of Microbiology, vol. 2012, Article ID 101989, 8 pages, 2012. View at Publisher · View at Google Scholar · View at Scopus
  95. G. Laverty, S. P. Gorman, and B. F. Gilmore, “The potential of antimicrobial peptides as biocides,” International Journal of Molecular Sciences, vol. 12, no. 10, pp. 6566–6596, 2011. View at Publisher · View at Google Scholar · View at Scopus
  96. E. Guaní-Guerra, T. Santos-Mendoza, S. O. Lugo-Reyes, and L. M. Terán, “Antimicrobial peptides: general overview and clinical implications in human health and disease,” Clinical Immunology, vol. 135, no. 1, pp. 1–11, 2010. View at Publisher · View at Google Scholar · View at Scopus
  97. X. Zhao, H. Wu, and H. Lu, “LAMP: a database linking antimicrobial peptides,” PLoS ONE, vol. 8, no. 6, Article ID e66557, 2013. View at Publisher · View at Google Scholar
  98. N. K. Brogden and K. A. Brogden, “Will new generations of modified antimicrobial peptides improve their potential as pharmaceuticals?” International Journal of Antimicrobial Agents, vol. 38, no. 3, pp. 217–225, 2011. View at Publisher · View at Google Scholar · View at Scopus
  99. M. Ntwasa, “Cationic peptide interactions with biological macromolecules,” in Binding Protein, K. Abdelmohsen, Ed., pp. 139–164, InTech Open Access Publishing, 2012. View at Publisher · View at Google Scholar
  100. D. Gaspar, A. S. Veiga, and M. A. R. B. Castanho, “From antimicrobial to anticancer peptides. A review,” Frontiers in Microbiology, vol. 4, article 294, 2013. View at Publisher · View at Google Scholar
  101. D. W. Hoskin and A. Ramamoorthy, “Studies on anticancer activities of antimicrobial peptides,” Biochimica et Biophysica Acta—Biomembranes, vol. 1778, no. 2, pp. 357–375, 2008. View at Publisher · View at Google Scholar · View at Scopus
  102. V. Kokoza, A. Ahmed, S. W. Shin, N. Okafor, Z. Zou, and A. S. Raikhel, “Blocking of Plasmodium transmission by cooperative action of cecropin A and defensin A in transgenic Aedes aegypti mosquitoes,” Proceedings of the National Academy of Sciences of the United States of America, vol. 107, no. 18, pp. 8111–8116, 2010. View at Publisher · View at Google Scholar · View at Scopus
  103. M. Torrent, D. Pulido, and L. Rivas, “Antimicrobial peptide action on parasites,” Current Drug Targets, vol. 13, pp. 1138–1147, 2012.
  104. E. Ostorhazi, M. C. Holub, F. Rozgonyi et al., “Broad-spectrum antimicrobial efficacy of peptide A3-APO in mouse models of multidrug-resistant wound and lung infections cannot be explained by in vitro activity against the pathogens involved,” International Journal of Antimicrobial Agents, vol. 37, no. 5, pp. 480–484, 2011. View at Publisher · View at Google Scholar · View at Scopus
  105. N. Berthold, P. Czihal, S. Fritsche, et al., “Novel apidaecin 1b analogs with superior serum stabilities for treatment of infections by gram-negative pathogens,” Antimicrobial Agents and Chemotherapy, vol. 57, no. 1, pp. 402–409, 2013.
  106. P. Bulet and R. Stöcklin, “Insect antimicrobial peptides: structures, properties and gene regulation,” Protein and Peptide Letters, vol. 12, no. 1, pp. 3–11, 2005. View at Publisher · View at Google Scholar · View at Scopus
  107. H. Ulm, M. Wilmes, Y. Shai, et al., “Antimicrobial host defensins—specific antibiotic activities and innate defense modulation,” Frontiers in Immunology, vol. 3, article 249, 2012. View at Publisher · View at Google Scholar
  108. J. Wiesner and A. Vilcinskas, “Antimicrobial peptides: the ancient arm of the human immune system,” Virulence, vol. 1, no. 5, pp. 440–464, 2010. View at Publisher · View at Google Scholar · View at Scopus
  109. Y. Huang, J. Huang, and Y. Chen, “Alpha-helical cationic antimicrobial peptides: relationships of structure and function,” Protein and Cell, vol. 1, no. 2, pp. 143–152, 2010. View at Publisher · View at Google Scholar · View at Scopus
  110. M. Zaiou, “Multifunctional antimicrobial peptides: therapeutic targets in several human diseases,” Journal of Molecular Medicine, vol. 85, no. 4, pp. 317–329, 2007. View at Publisher · View at Google Scholar · View at Scopus
  111. S. M. Paranjape, T. W. Lauer, R. C. Montelaro, et al., “Modulation of proinflammatory activity by the engineered cationic antimicrobial peptide WLBU-2,” F1000Research, vol. 2, article 36, 2013. View at Publisher · View at Google Scholar
  112. D. Ausbacher, G. Svineng, T. Hansen, et al., “Anticancer mechanisms of action of two small amphipathic β2, 2-amino acid derivatives derived from antimicrobial peptides,” Biochimica et Biophysica Acta, vol. 1818, pp. 2917–2925, 2012.
  113. T. Iwasaki, J. Ishibashi, H. Tanaka et al., “Selective cancer cell cytotoxicity of enantiomeric 9-mer peptides derived from beetle defensins depends on negatively charged phosphatidylserine on the cell surface,” Peptides, vol. 30, no. 4, pp. 660–668, 2009. View at Publisher · View at Google Scholar · View at Scopus
  114. B. Bommarius, H. Jenssen, M. Elliott et al., “Cost-effective expression and purification of antimicrobial and host defense peptides in Escherichia coli,” Peptides, vol. 31, no. 11, pp. 1957–1965, 2010. View at Publisher · View at Google Scholar · View at Scopus
  115. H. Wang, X.-L. Meng, J.-P. Xu, J. Wang, H. Wang, and C.-W. Ma, “Production, purification, and characterization of the cecropin from Plutella xylostella, pxCECA1, using an intein-induced self-cleavable system in Escherichia coli,” Applied Microbiology and Biotechnology, vol. 94, pp. 1031–1039, 2012. View at Publisher · View at Google Scholar · View at Scopus
  116. X. Wang, M. Zhu, G. Yang et al., “Expression of cecropin B in Pichia pastoris and its bioactivity in vitro,” Experimental and Therapeutic Medicine, vol. 2, no. 4, pp. 655–660, 2011. View at Publisher · View at Google Scholar · View at Scopus
  117. J.-J. Huang, J.-C. Lu, and M. Lu, “The design and construction of K11: a novel α-helical antimicrobial peptide,” International Journal of Microbiology, vol. 2012, Article ID 764834, 6 pages, 2012. View at Publisher · View at Google Scholar
  118. S. A. Guralp, Y. E. Murgha, J.-M. Rouillard, et al., “From design to screening: a new antimicrobial peptide discovery pipeline,” PLoS ONE, vol. 8, no. 3, Article ID e59305, 2013. View at Publisher · View at Google Scholar
  119. G. Maccari, M. di Luca, R. Nifosi, et al., “Antimicrobial peptides design by evolutionary multiobjective optimization,” PLoS Computer Biology, vol. 9, no. 9, Article ID e1003212, 2013. View at Publisher · View at Google Scholar
  120. M. Zasloff, “Antimicrobial peptides of multicellular organisms,” Nature, vol. 415, no. 6870, pp. 389–395, 2002. View at Publisher · View at Google Scholar · View at Scopus
  121. L. F. Fehri, P. Sirand-Pugnet, G. Gourgues, G. Jan, H. Wróblewski, and A. Blanchard, “Resistance to antimicrobial peptides and stress response in Mycoplasma pulmonis,” Antimicrobial Agents and Chemotherapy, vol. 49, no. 10, pp. 4154–4165, 2005. View at Publisher · View at Google Scholar · View at Scopus
  122. A. Giacometti, O. Cirioni, F. Barchiesi, M. Fortuna, and G. Scalise, “In-vitro activity of cationic peptides alone and in combination with clinically used antimicrobial agents against Pseudomonas aeruginosa,” Journal of Antimicrobial Chemotherapy, vol. 44, no. 5, pp. 641–645, 1999. View at Publisher · View at Google Scholar · View at Scopus
  123. G. G. Perron, M. Zasloff, and G. Bell, “Experimental evolution of resistance to an antimicrobial peptide,” Proceedings of the Royal Society B: Biological Sciences, vol. 273, no. 1583, pp. 251–256, 2006. View at Publisher · View at Google Scholar · View at Scopus
  124. S. I. Chernysh and N. A. Gordja, “The immune system of maggots of the blow fly (Calliphora vicina) as a source of medicinal drugs,” Journal of Evolutionary Biochemistry and Physiology, vol. 47, no. 6, pp. 524–533, 2011. View at Publisher · View at Google Scholar · View at Scopus
  125. S.-C. Park, Y. Park, and K.-S. Hahm, “The role of antimicrobial peptides in preventing multidrug-resistant bacterial infections and biofilm formation,” International Journal of Molecular Sciences, vol. 12, no. 9, pp. 5971–5992, 2011. View at Publisher · View at Google Scholar · View at Scopus
  126. M. Kazemzadeh-Narbat, S. Noordin, B. A. Masri et al., “Drug release and bone growth studies of antimicrobial peptide-loaded calcium phosphate coating on titanium,” Journal of Biomedical Materials Research B: Applied Biomaterials, vol. 100, no. 5, pp. 1344–1352, 2012. View at Publisher · View at Google Scholar · View at Scopus
  127. R. A. Sherman, M. J. R. Hall, and S. Thomas, “Medicinal maggots: an ancient remedy for some contemporary afflictions,” Annual Review of Entomology, vol. 45, pp. 55–81, 2000. View at Publisher · View at Google Scholar · View at Scopus
  128. A. Bexfield, A. E. Bond, E. C. Roberts et al., “The antibacterial activity against MRSA strains and other bacteria of a <500 Da fraction from maggot excretions/secretions of Lucilia sericata (Diptera: Calliphoridae),” Microbes and Infection, vol. 10, no. 4, pp. 325–333, 2008. View at Publisher · View at Google Scholar · View at Scopus
  129. R. A. Sherman, “Maggot therapy takes us back to the future of wound care: new and improved maggot therapy for the 21st century,” Journal of Diabetes Science and Technology, vol. 3, no. 2, pp. 336–344, 2009. View at Scopus
  130. A. Vilcinskas, “From traditional maggot therapy to modern biosurgery,” in Insect Biotechnology, A. Vilsinskas, Ed., pp. 67–76, Springer, Dordrecht, The Netherlands, 2010.
  131. J. Bohova, J. Majtan, and P. Takac, “Immunomodulatory properties of medicinal maggots Lucilia sericata in wound healing process,” TANG International Journal of Genuine Traditional Medicine, vol. 2, no. 3, pp. 1–7, 2012.
  132. L. Chambers, S. Woodrow, A. P. Brown et al., “Degradation of extracellular matrix components by defined proteinases from the greenbottle larva Lucilia sericata used for the clinical debridement of non-healing wounds,” British Journal of Dermatology, vol. 148, no. 1, pp. 14–23, 2003. View at Publisher · View at Google Scholar · View at Scopus
  133. A. Brown, A. Horobin, and D. G. Blount, “Blow fly Lucilia sericata nuclease digests DNA associated with wound slough/eschar and with Pseudomonas aeruginosa biofilm,” Medical and Veterinary Entomology, vol. 26, no. 4, pp. 432–439, 2012.
  134. G. Telford, A. P. Brown, A. Rich, et al., “Wound debridement potential of glycosidases of the wound-healing maggot, Lucilia sericata,” Medical and Veterinary Entomology, vol. 26, no. 3, pp. 291–299, 2012.
  135. A. Bexfield, A. E. Bond, C. Morgan et al., “Amino acid derivatives from Lucilia sericata excretions/secretions may contribute to the beneficial effects of maggot therapy via increased angiogenesis,” British Journal of Dermatology, vol. 162, no. 3, pp. 554–562, 2010. View at Publisher · View at Google Scholar · View at Scopus
  136. Z. Zhang, S. Wang, Y. Diao, J. Zhang, and D. Lv, “Fatty acid extracts from Lucilia sericata larvae promote murine cutaneous wound healing by angiogenic activity,” Lipids in Health and Disease, vol. 9, article 24, 2010. View at Publisher · View at Google Scholar · View at Scopus
  137. M. J. A. van der Plas, A. M. van der Does, M. Baldry et al., “Maggot excretions/secretions inhibit multiple neutrophil pro-inflammatory responses,” Microbes and Infection, vol. 9, no. 4, pp. 507–514, 2007. View at Publisher · View at Google Scholar · View at Scopus
  138. M. J. A. van der Plas, M. Baldry, J. T. van Dissel, G. N. Jukema, and P. H. Nibbering, “Maggot secretions suppress pro-inflammatory responses of human monocytes through elevation of cyclic AMP,” Diabetologia, vol. 52, no. 9, pp. 1962–1970, 2009. View at Publisher · View at Google Scholar · View at Scopus
  139. M. J. A. van der Plas, J. T. van Dissel, and P. H. Nibbering, “Maggot secretions skew monocyte-macrophage differentiation away from a pro-inflammatory to a pro-angiogenic type,” PLoS ONE, vol. 4, no. 11, Article ID e8071, 2009. View at Publisher · View at Google Scholar · View at Scopus
  140. R. A. Elkington, M. Humphries, M. Commins, N. Maugeri, T. Tierney, and T. J. Mahony, “A Lucilia cuprina excretory-secretory protein inhibits the early phase of lymphocyte activation and subsequent proliferation,” Parasite Immunology, vol. 31, no. 12, pp. 750–765, 2009. View at Publisher · View at Google Scholar · View at Scopus
  141. G. Cazander, M. W. J. Schreurs, L. Renwarin, et al., “Maggot excretions affect the human complement system,” Wound Repair and Regeneration, vol. 20, pp. 879–886, 2012.
  142. V. Čeřovský, J. Žďárek, V. Fučík, L. Monincová, Z. Voburka, and R. Bém, “Lucifensin, the long-sought antimicrobial factor of medicinal maggots of the blowfly Lucilia sericata,” Cellular and Molecular Life Sciences, vol. 67, no. 3, pp. 455–466, 2010. View at Publisher · View at Google Scholar · View at Scopus
  143. A. S. Andersen, D. Sandvang, K. M. Schnorr et al., “A novel approach to the antimicrobial activity of maggot debridement therapy,” Journal of Antimicrobial Chemotherapy, vol. 65, no. 8, pp. 1646–1654, 2010. View at Publisher · View at Google Scholar · View at Scopus
  144. S. Chernysh, S. I. Kim, G. Bekker et al., “Antiviral and antitumor peptides from insects,” Proceedings of the National Academy of Sciences of the United States of America, vol. 99, no. 20, pp. 12628–12632, 2002. View at Publisher · View at Google Scholar · View at Scopus
  145. A. Bexfield, Y. Nigam, S. Thomas, and N. A. Ratcliffe, “Detection and partial characterisation of two antibacterial factors from the excretions/secretions of the medicinal maggot Lucilia sericata and their activity against methicillin-resistant Staphylococcus aureus (MRSA),” Microbes and Infection, vol. 6, no. 14, pp. 1297–1304, 2004. View at Publisher · View at Google Scholar · View at Scopus
  146. G. Telford, A. P. Brown, A. Kind, J. S. C. English, and D. I. Pritchard, “Maggot chymotrypsin I from Lucilia sericata is resistant to endogenous wound protease inhibitors,” British Journal of Dermatology, vol. 164, no. 1, pp. 192–196, 2011. View at Publisher · View at Google Scholar · View at Scopus
  147. M. J. A. van der Plas, G. N. Jukema, S.-W. Wai et al., “Maggot excretions/secretions are differentially effective against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa,” Journal of Antimicrobial Chemotherapy, vol. 61, no. 1, pp. 117–122, 2008. View at Publisher · View at Google Scholar · View at Scopus
  148. L. G. Harris, A. Bexfield, Y. Nigam, H. Rohde, N. A. Ratcliffe, and D. Mack, “Disruption of Staphylococcus epidermidis biofilms by medicinal maggot Lucilia sericata excretions/secretions,” International Journal of Artificial Organs, vol. 32, no. 9, pp. 555–564, 2009. View at Scopus
  149. B. Altincicek and A. Vilcinskas, “Septic injury-inducible genes in medicinal maggots of the green blow fly Lucilia sericata,” Insect Molecular Biology, vol. 18, no. 1, pp. 119–125, 2009. View at Publisher · View at Google Scholar · View at Scopus
  150. L. G. Harris, Y. Nigam, J. Sawyer, et al., “Lucilia sericata chymotrypsin disrupts protein adhesin-mediated staphylococcal biofilm formation,” Applied and Environmental Microbiology, vol. 79, no. 4, pp. 1393–1395, 2013.
  151. Y. T. Pinilla, D. A. Moreno-Pérez, M. A. Patarroyo, et al., “Proteolytic activity regarding Sarconesiopsis magellanica (Diptera:Calliphoridae) larval excretions and secretions,” Acta Tropica, vol. 128, pp. 686–691, 2013.
  152. A. G. Smith, R. A. Powis, D. I. Pritchard, and S. T. Britland, “Greenbottle (Lucilia sericata) larval secretions delivered from a prototype hydrogel wound dressing accelerate the closure of model wounds,” Biotechnology Progress, vol. 22, no. 6, pp. 1690–1696, 2006. View at Publisher · View at Google Scholar · View at Scopus
  153. D. I. Pritchard, G. Telford, M. Diab, and W. Low, “Expression of a cGMP compatible Lucilia sericata insect serine proteinase debridement enzyme,” Biotechnology Progress, vol. 28, no. 2, pp. 567–572, 2012. View at Publisher · View at Google Scholar · View at Scopus
  154. S. Britland, A. Smith, W. Finter et al., “Recombinant Lucilia sericata chymotrypsin in a topical hydrogel formulation degrades human wound eschar ex vivo,” Biotechnology Progress, vol. 27, no. 3, pp. 870–874, 2011. View at Publisher · View at Google Scholar · View at Scopus
  155. K. Zarchi and G. B. Jemec, “The efficacy of maggot debridement therapy—a review of comparative clinical trials,” International Wound Journal, vol. 9, no. 5, pp. 469–477, 2012. View at Publisher · View at Google Scholar · View at Scopus
  156. P. E. Prete, “Growth effects of Phaenicia sericata larval extracts on fibroblasts: mechanism for wound healing by maggot therapy,” Life Sciences, vol. 60, no. 8, pp. 505–510, 1997. View at Publisher · View at Google Scholar · View at Scopus
  157. X. Li, N. Liu, X. Xia, et al., “The effects of maggot secretions on the inflammatory cytokines in serum of traumatic rats,” African Journal of Traditional and Complementary Alternative Medicine, vol. 10, no. 4, pp. 151–154, 2013.
  158. S. Natori, “Molecules participating in insect immunity of Sarcophaga peregrina,” Proceedings of the Japan Academy Series B: Physical and Biological Sciences, vol. 86, no. 10, pp. 927–938, 2010. View at Publisher · View at Google Scholar · View at Scopus
  159. V. Čeřovský, J. Slaninová, V. Fučík et al., “Lucifensin, a novel insect defensin of medicinal maggots: synthesis and structural study,” ChemBioChem, vol. 12, no. 9, pp. 1352–1361, 2011. View at Publisher · View at Google Scholar · View at Scopus
  160. B. El Shazely, V. Veverka, V. Fucik, et al., “Lucifensin II, a defensin of medicinal maggots of the blowfly Lucilia cuprina (Diptera: Calliphoridae),” Journal of Medical Entomology, vol. 50, no. 3, pp. 571–578, 2013.
  161. I. Valachová, J. Bohová, Z. Pálošová, et al., “Expression of lucifensin in Lucilia sericata medicinal maggots in infected environments,” Cell and Tissue Research, vol. 353, pp. 165–171, 2013.
  162. M. K. E. Nygaard, A. S. Andersen, H.-H. Kristensen, K. A. Krogfelt, P. Fojan, and R. Wimmer, “The insect defensin lucifensin from Lucilia sericata,” Journal of Biomolecular NMR, vol. 52, pp. 277–282, 2012. View at Publisher · View at Google Scholar · View at Scopus
  163. C. Joyner, M. K. Mills, and D. Nayduch, “Pseudomonas aeruginosa in Musca domestica L.: temporospatial examination of bacteria population dynamics and house fly antimicrobial responses,” PLoS ONE, vol. 8, no. 11, Article ID e79224, 2013. View at Publisher · View at Google Scholar
  164. S. O. Park, J. H. Shin, W. K. Choi, B. S. Park, J. S. Oh, and A. Jang, “Antibacterial activity of house fly-maggot extracts against MRSA (Methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant enterococci),” Journal of Environmental Biology, vol. 31, no. 5, pp. 865–871, 2010. View at Scopus
  165. S. Chernysh, K. Irina, and A. Irina, “Anti-tumor activity of immunomodulatory peptide alloferon-1 in mouse tumor transplantation model,” International Immunopharmacology, vol. 12, no. 1, pp. 312–314, 2012. View at Publisher · View at Google Scholar · View at Scopus
  166. S. Chernysh and I. Kozuharova, “Anti-tumor activity of a peptide combining patterns of insect alloferons and mammalian immunoglobulins in naïve and tumor antigen vaccinated mice,” International Immunopharmacology, vol. 17, pp. 1090–1093, 2013. View at Publisher · View at Google Scholar
  167. M.-J. Ryu, V. Anikin, S.-H. Hong et al., “Activation of NF-κB by alloferon through down-regulation of antioxidant proteins and IκBα,” Molecular and Cellular Biochemistry, vol. 313, no. 1-2, pp. 91–102, 2008. View at Publisher · View at Google Scholar · View at Scopus
  168. M. Kuczer, A. Midak-Siewirska, R. Zahorska, M. Łuczak, and D. Konopińska, “Further studies on the antiviral activity of alloferon and its analogues,” Journal of Peptide Science, vol. 17, no. 11, pp. 715–719, 2011. View at Publisher · View at Google Scholar · View at Scopus
  169. N. Lee, S. Bae, H. Kim et al., “Inhibition of lytic reactivation of Kaposi's sarcoma-associated herpesvirus by alloferon,” Antiviral Therapy, vol. 16, no. 3, pp. 439–442, 2011. View at Publisher · View at Google Scholar · View at Scopus
  170. G. R. Erdmann, “Antibacterial action of Myiasis-causing flies,” Parasitology Today, vol. 3, no. 7, pp. 214–216, 1987. View at Scopus
  171. A. Kerridge, H. Lappin-Scott, and J. R. Stevens, “Antibacterial properties of larval secretions of the blowfly, Lucilia sericata,” Medical and Veterinary Entomology, vol. 19, no. 3, pp. 333–337, 2005. View at Publisher · View at Google Scholar · View at Scopus
  172. T. J. Graetz, B. R. Tellor, J. R. Smith, and M. S. Avidan, “Desirudin: a review of the pharmacology and clinical application for the prevention of deep vein thrombosis,” Expert Review of Cardiovascular Therapy, vol. 9, no. 9, pp. 1101–1109, 2011. View at Publisher · View at Google Scholar · View at Scopus
  173. M. Kazimírová and I. Štibrániova, “Tick salivary compounds: their role in modulation of host defences and pathogen transmission,” Cellular and Infection Microbiology, vol. 3, article 43, 2013. View at Publisher · View at Google Scholar
  174. J. M. C. Ribeiro, B. J. Mans, and B. Arcà, “An insight into the sialome of blood-feeding Nematocera,” Insect Biochemistry and Molecular Biology, vol. 40, no. 11, pp. 767–784, 2010. View at Publisher · View at Google Scholar · View at Scopus
  175. A. C. Figueiredo, D. de Sanctis, R. Gutiérrez-Gallego, et al., “Unique thrombin-inhibition mechanism by anophelin, an anticoagulant from the malaria vector,” Proceedings of the National Academy of Sciences of the United States of America, vol. 109, no. 52, pp. E3649–E3658, 2012. View at Publisher · View at Google Scholar