A novel mechanism in maggot debridement therapy: Protease in excretion/secretion promotes hepatocyte growth factor production

Kenjiro Honda, Koji Okamoto, Yasuhiro Mochida, Kunihiro Ishioka, Machiko Oka, Kyoko Maesato, Ryota Ikee, Hidekazu Moriya, Sumi Hidaka, Takayasu Ohtake, Kent Doi, Toshiro Fujita, Shuzo Kobayashi, Eisei Noiri

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Maggot debridement therapy (MDT) is effective for treating intractable wounds, but its precise molecular mechanism, including the association between MDT and growth factors, remains unknown. We administered MDT to nine patients (66.3 ± 11.8 yr, 5 male and 4 female) with intractable wounds of lower extremities because they did not respond to conventional therapies. Significant increases of hepatocyte growth factor (HGF) levels were observed in femoral vein blood during 48 h of MDT (P < 0.05), but no significant change was found for vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor-α (TGF-β1), or tumor necrosis factor- α (TNF-α). We conducted NIH-3T3 cell stimulation assay to evaluate the relation between HGF and protease activity in excretion/ secretion (ES) derived from maggots. Compared with the control group, HGF was significantly higher in the 0.05 μg/ml ES group (P < 0.01). Furthermore, protease inhibitors suppressed the increase of HGF (P < 0.05). The HGF expression was increased in proportion to the ES protein concentration of 0.025 to 0.5 μg/ml. In fact, ES showed stronger capability of promoting HGF production and less cytotoxicity than chymotrypsin or bromelain. HGF is an important factor involved in cutaneous wound healing. Therefore, these results suggest that formation of healthy granulation tissue observed during MDT results from the increased HGF. Further investigation to identify molecules enhancing HGF expression by MDT will contribute greatly to drug target discovery for intractable wound healing therapy,

Original languageEnglish
Pages (from-to)C1423-C1430
JournalAmerican Journal of Physiology - Cell Physiology
Issue number6
Publication statusPublished - 2011 Dec


  • Critical limb ischemia
  • Intractable wounds
  • Wound healing


Dive into the research topics of 'A novel mechanism in maggot debridement therapy: Protease in excretion/secretion promotes hepatocyte growth factor production'. Together they form a unique fingerprint.

Cite this