Peptides derived from exocrine secretions of venomous animals used as traditional Chinese “worm” medicines

The term “worm medicines” (Chong Yao) in Traditional Chinese Medicine encompasses a diverse category of small animal-derived therapeutics, including arthropods, amphibians, and reptiles, rather than strictly vermiform organisms. Many of these animals, such as scorpions, centipedes, toads, and horseflies, are toxic, and have been employed in clinical practice for centuries, despite limited understanding of their active compounds and underlying modes of action. Among the bioactive constituents extracted from these taxa, peptides represent a particularly promising class, with over 2 000 identified to date. These peptides are primarily secreted from specialized exocrine glands, including venom, salivary, and cutaneous glands, and are characterized by high structural diversity and target specificity. Their potent modulatory effects on the nervous, cardiovascular, and immune systems make them excellent candidates for drug discovery and development. This review examines peptide-based compounds derived from the exocrine secretions of venomous and poisonous taxa historically employed in traditional Chinese “worm” medicines. Emphasis is placed on their biological origins, structural features, and pharmacological activities, highlighting their significant potential as a rich and largely untapped resource for modern therapeutic discovery.