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Sir, For centuries, larval therapy has been recognized as an aid in wound healing. During the 1930s and 1940s, before the antibiotic era, larval therapy was commonly used by surgeons in the USA and Europe when treating various soft-tissue and bone infections. The most commonly used larval species is Lucilia sericata (LS). From a clinical point of view, the two major effects of larval therapy have been ascribed to their antibacterial and debriding mechanisms (1 – 4). In regard to the latter function it has been speculated that the larvae, when introduced into the wound, secrete proteolytic enzymes that enable them to degrade and ingest necrotic tissue. Here, we address this question and demonstrate that these larvae secrete a group of serine proteases when cultured in vitro. Furthermore, these serine proteases were detected in the wound fluid of a patient with a chronic leg ulcer treated with larvae. The data suggest that serine proteases of LS are released during treatment.

Detection of Serine Proteases Secreted by Lucilia sericata In vitro and During Treatment of a Chronic Leg Ulcer