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Matrix is the main substance of the connective tissue surrounding blood vessels and inner organs. It fulfills a number of functions which can be classified as protective. At first it is matrix that controls the supply of nutrients and oxygen from capillaries and other vessels to other organ cells. The transportation function of the cardio-vascular system is of primary significance, so matrix work on taking substances from blood flow and removing new metabolites is the most important task for the connective tissue surrounding capillaries.
Blood is normally rich in functionally saturated proteins such as albumin and globulins. There are so many proteins that they cause the diffusion of the connective tissue fluid that flows into vessels. This is the way how the exchange via capillary walls occurs. The fluid pressure difference in venous and artery vessels of small size creates the filtration pressure inside them, which regulates the flow process of tissue fluid into capillaries and back.
Pathological changes in capillary permeability induced by shock due to traumatic or inflammatory lesions of the vascular system lead to violating metabolic processes in tissues, including those expressed in edemas, when the fluid actively moves from capillaries into tissues and accumulates there.
The next task of the protective layer is to block foreign biological agents (foreign proteins, viral particles, bacteria) penetrating into the blood flow, as they can cause allergic reactions, inflammations of infections. If foreign protein molecules and microbes were not destroyed in the blood flow in time, they would freely move around the body and damage cell walls inducing their irritation an intoxication.
Thanks to the matrix microbes and other agents remain in the blood stream, where the human immune system neutralizes them: they are gradually eaten by huge protective cells (leukocytes from the group of phagocytes) or bound by specific proteins called antibodies. The protective system of the blood flow is supported by the biological activity of particular globulins saturating blood. These substances are called immunoglobulins.
As some recent research has revealed the effect of leech saliva enzymes extends much further than the vascular endothelium. These substances deeply penetrate into the layer of connective tissue fibres lining the outside of capillaries, venules and arterioles. Orgelaza is to be considered one of the most significant among such enzymes, it has been discovered quite recently, and it can liquefy the matrix.
Orgelaza increases the wall permeability of small blood vessels, firstly, that of capillaries. The presence of the substance with such properties in the leech saliva can be explained very simply. It is another "cunning invention" of evolution. Parasites tried to support the high efficiency of their saliva secretion due to the influence not only and not so much on the local vascular system, but also on the distant adjacent branching capillaries, venules and arterioles.
It would allow worms to successfully control blood nutritional quality. But the further saliva enzymes moved, the more body tissues blocked them. That is why parasites needed a fundamentally new saliva component which would change properties of tissues adjacent to the blood flow and the ones making up vessels.
The enzyme hits human body cells responsible for metabolism between blood and other tissues. As a result, a leech prepares the human blood in our own body to be digested. Orgelaza promotes the active spread of leech anticoagulants in the blood flow, turning our body into a big jar with huge supplies of high-quality blood.
This most powerful hit of the enzyme, if we could efficiently dose its introducing into the organism using the hirudotherapy techniques, won’t turn out to be disruptive. The medical enzyme effect stabilizes substance transfer, open access to cells for biologically active compounds, intensifies blood micro-circulation around the damaged organ. The latter is implemented in a triple way.
At first, as it has been told, orgelaza together with other leech enzymes liquefy blood and increases its flow speed along capillaries. Secondly, this substance activates a great number of closed capillaries. These closed capillaries present an amazing phenomenon in the human physiology. Mostly, the body doesn’t use its possibilities in full. This reserve is employed only in emergency. Otherwise, our body will be worn too soon. Blood can flow much faster along capillaries than it usually does.
The living tissue circulation drastically increases when we do sport or physical work, when it is necessary to quickly supply muscles with oxygen and nutrients as well as clean the body of intensively accumulated metabolites (metabolism products). It Is natural that this load increase requires to enlarge the vascular system capacity.
Partly, it can be achieved through the temporary size increase of capillaries, venules and arterioles. But mainly the body enlarges the system capacity due to opening precapillary sphincters of closed, “extra” capillaries. While in rest, most of our vessels are always closed, these are reserve ways of blood transfer. Only 10% of capillaries off their total number constantly work.
We can see that the body has a tremendous reserve. It is necessary to increase the blood flow speed at some diseases when stagnant symptoms ate noted in the circulatory system. This is where we need these closed reserve capillaries. Orgelaza promotes their opening. At last, the third way of intensifying blood circulation by this enzyme has been recently discovered: there is a high probability that orgelaza invokes the growth of new small vessels, that is, the blood system capacity grows due to the appearance of new ducts – capillaries, though many specialists are very careful when talking about this fact.
Thus, physiological consequences of introducing orgelaza into the connective tissue matrix are the disappearance of edemas, recovery of fluid balance, inflammation removal, normalization of blood microcirculation in organs, stabilization of plasma protein fraction concentration, partial structural renewal of tissues, providing the substance transportation and so on.
When considering the range of enzyme activities produced by a medicine leech, it is easy to make a conclusion that doctors use this hirudotherapy technique specifically. The main indication for employing leeches is thrombosis, thrombophlebitis and similar diseases connected with the increased blood clotting and massive formation of clots in the blood flow.
Also, leeches help at such inflammatory processes when capillaries are seriously damaged, which leads to the violation of blood microcirculation in organs and tissues. Finally, raising blood fluidity and improving capillary wall structures, leech saliva substances promote eliminating stagnation in the blood system. Therefore, hirudotherapy is of use at such diseases where the leading pathogenesis factors are clotting, vessel damage, inflammation, blood and lymph stagnation.
Hirudotherapist do not always recommends using leeches, because it is easy to take drugs prepared on the basis of the enzyme mixture from leech saliva.
The first pharmacological preparation made from the leech saliva extract was hirudin. Its mass production as a raw form from head ends of a regular medicine leech was established in the 1920s, and at the beginning of the 1960-s the protein was obtained in a purified form. Nowadays it is used to substitute heparin. Recently a number of new and efficient means made in a similar way have appeared.
First of all, they are hirulogs and hirogens. These compounds possess man properties of hirudin, but chemically they are short synthetic segments of this enzyme. There are produced on our country and some other countries when the demand for the anticoagulant went up. The traditional production of raw hirudin out of leech extract did not meet medicine needs anymore.
Genetically engineered hirudin works both as anticoagulant and helps at heart diseases, but it is too expensive. Though being very useful, only few customers can afford it. Only the material artificially synthesized in big quantities “in vitro” can be cheap. The above-mentioned molecule segments of real hirudin can be such a primitive substance which is relatively easy to produce.
About 15 years ago the biology department of MSU started developing a new preparation out of leech saliva extract. At the moment the work has been generally finished. The preparation has been recently allowed to be used in clinics after passing all the necessary tests, so soon it will appear in medical practice.
This preparation is a complex of various active substances and produces thrombolytic, anti-thrombolytic and anti-inflammatory effects. “Piyavit” is designated for treating surface veins, but it may be employed in some other cases. Its full range of properties is still under investigation. Besides, some unfinished studies of several promising preparations have been recently performed, and they are expected to appear on slae in the nearest future.