Medical Science Peeks Around The Blinders
Date: Mon, 10 Jul 95 17:16:00 PDT
From: Peter Langston <psl>
Subject: Medical Science Peeks Around The Blinders
Forwarded-by: bostic@CS.Berkeley.EDU (Keith Bostic)
OXFORD, England (AP) - In a dank, fly-infested basement lab, David Rogers
proudly displayed the fruit of his labors: a bite-size chunk of liver
smothered with thousands of slimy, squirming maggots.
Enough maggots, Rogers estimated, to help heal the wounds of 10 patients
- figuring 10 maggots per square centimeter of open sore.
Rogers, an Oxford University entomologist, is a pioneer in the fledgling
field of maggot therapy.
The notion is that maggots devour dead tissue and bacteria lurking in
the wound but avoid healthy skin and muscle. In an age of increasing
antibiotic resistance, the maggots may do a better job than medicine,
``It's got global appeal. It's ludicrously cost-effective and low-tech,''
said Dr. John Church, an orthopedic surgeon. He, along with Rogers and
fellow entomologist Paul Embden, aim to launch maggot therapy here. It is
already up and running in one U.S. hospital.
``We just have to get past, what I call, the Yuck Factor,'' said Church.
``It's this immediate reaction of disgust.''
The Oxford team has a fertile family of flies, capable of producing
hundreds of thousands of offspring every few weeks.
``We can produce phenomenal quantities, the biggest problem is
overproduction,'' said Embden, swatting flies buzzing around the scientists
and a visitor.
Now they just need the go-ahead from nurses, squeamish about changing
bug-ridden bandages, and hospital managers, antsy about condoning infested
Church said he has treated one patient successfully, but he would not
reveal the patient's details.
For at least three centuries, observant doctors had noted that patients
with maggot-infested wounds healed faster than those without fly eggs, said
Church. But only recently have a few clinicians sought to bring nature's
remedy to hospital wards.
Dr. Ronald Sherman, entomologist-turned-doctor at the University of
California, Irvine, completed one of the first studies comparing maggots to
medicine. He has been breeding and treating patients at the Veterans Affairs
Medical Center in Long Beach for about five years.
The findings, based on 10 patients and published in the April issue of
The Journal of Spinal Cord Medicine, indicated that the bugs could heal
wounds that defied medicine. Patients got maggots after medicine failed.
The maggots, said Sherman, shrunk the wounds by about 20 percent to 25
percent a week. All the patients healed completely within about a month,
Maggots thrive off dead meat and bacteria, and can ``get into the nooks
and crannies that antibiotics can't reach,'' Church explained.
Within about five days, maggots mature into pupa, a hardened cocoon-like
stage in which the full-grown fly develops. Bandages must be changed before
the flies fly away, said Church.
Most patients require at least three batches of maggots.
Both Shermans and Church's teams breed green-bottle flies, a common
housefly formally known as Lucilia sericata. They suspect that other species
are just as effective but caution that it is also possible that other types
of maggots could invade healthy tissue.
In other words: Don't try this without medical assistance. Besides
treating patients, the scientists seek to unravel the mysteries of
maggot's inherent anti-bacterial traits. Such findings may yield clues to
design more effective antibiotics.
Sherman has a hunch the mechanism may be too complex to replicate. Then,
again, if you have the real thing, why settle for an imitation?
``As an entomologist,'' said Sherman, ``I don't see why anybody wouldn't
be just as happy with the maggot. But I'm sure if we could come up with a
different delivery system without live critters, it would be more acceptable
to most people.''
© 1995 Peter Langston