Smallwood et.al |
Helminthic Therapy; Could Worm Infections Help with Inflammatory
Diseases?
By Brenna Graber
Parasitic relationship with Social Constructs of Medicine
In the late 1980’s, researcher David
P Strachan proposed a theory that claimed personal cleanliness has gone too far
which has encouraged an increase in diagnosed allergies or inflammatory
diseases (Strachan 1989). Since then this concept has been repeatedly studied
and is now known as the “hygiene hypothesis”. One area where this hygiene
hypothesis is readily studied today would be how humans have a co-evolutionary
and beneficial relationship with small parasitic infections (Lorimer 2019).
Previously, parasites have resided in people for a long
periods of time with little to no
serious medical issues (Smallwood et. al 2017). In western medicinal practices
we have set a precedent that objectifies parasites to a strictly harmful and
invasive relationship when indeed human
relationships with certain parasites are mutualistic (Lorimer 2019). A mindset
like such, coupled with increased hygiene which reduces exposure to these organisms,
has led to an absence of an important contender to the human microbial
ecosystem.
Helminthic
Therapy: How it works.
Today some researchers are beginning
to discover that the administration of a small worm load of helminths can be
beneficial in combating multiple different
inflammatory diseases such as allergies and arthritis (Lorimer
2019). Helminths can stimulate immune responses that aid in inflammation.
Within the immune system, there are
two responses; (1) Th-1 and (2) Th-2. When the body gets infected with a
helminth, it ignites a Th-2 immune. While in the human body, helminths secrete
different materials that the body recognizes as non-self which then activates
cytokines IL-4,IL-5,Il-10,and IL-13 (Smallwood et. al).Cytokines are numerous
proteins that work together and communicate in order to activate an immune
response from the body. At the same time, regulatory T-cell development is
occurring which promotes a cloaking effect by releasing regulatory cytokines
like IL-10 and transforming growth factor (Beta). The body defending itself
against the helminth cloaks the inflammation process.
Helminths such as hookworms,
specifically propagate the activation of total immunoglobulin-E and activation
of the innate immune systems like mast cells basophils and eosinophils.
Immunoglobulins are antibodies found in the body that work to disarm whatever
is infecting the body, in this case it would be the hookworm. Meanwhile, both
basophils and eosinophils are white blood cells which increase in numbers
during an infection. All of these processes result in a decrease of inflammation by way of disease because the
immune system is distracted by the helminth’s presence (Smyth et. al 2017).
What
helminths are or have been used for treatment?
The phyla or different kinds
of helminths include roundworms, flatworms and flukes (trematodes). Most of the
helminths that are used to treat inflammatory diseases are the nematodes
(roundworms) and hook worms (Smallwood et. al). Specific hookworms have been
organized into a table per disease,
being treated (in people) by Smallwood et al. 2017:
Inflammatory bowel disease:
●
Schistosoma
mansoni
●
Heligmosomoides
polygyrus
●
S.
cercariae
●
Schistosoma
japonicum
●
S. mansoni
●
Anisakis
simplex
●
Acanthocheilonema
viteae
Multiple Sclerosis:
●
S.mansoni
●
T.spiralis
●
Fasciola
hepatica
●
S.
japonicum
Type 1 diabetes:
●
S.mansoni
Rheumatoid arthritis:
●
S.mansoni
●
S.japonicum
●
A.viteae
●
H.polygyrus
Systemic lupus erythematosus
●
A.viteae
From other
articles (Lorimer 2019):
Allergies:
●
A. caninum
●
N.americanus
●
H.diminuta
What’s Next
for Helminthic treatment?
Most recent research is working to
synthesize the reaction the human body has when interacting with helminths.
This would be administering a pill that contains synthetic molecules that
replicate helminth ability. The idea is to reduce the risks, discomfort and
chance of infection while still embracing the therapeutic benefit (Lorimer
2019).
Those
Opposed?
Other researchers argue that by
synthesizing this relationship, some benefits will be lost that are provided by
the whole helminth organism. These same researchers claim that synthetics like
pills could also lead to drug dependency and potentially resistance. Instead
they encourage the safety and naturally occurring benefits of helminthic
therapy through monitored and safe administration of the helminths (Lorimer
2019).
Conclusions
Helminths have, for a long time,
been seen as an invader, an organism to be exterminated. Due to this
relationship that has been created by western medicine coupled with the
increase of hygiene in a developed country, helminthic therapy is not an
accepted treatment by the Drug and Food Administration and therefore can’t be
clinically practiced (Lorimer 2019 &). This is because of shipping
regulations of the parasites when they are outside the body as well as lack of
research on this form of therapy (Lorimer 2019 and Smyth et al. 2017).
The future of helminthic therapy is
very open. More researchers are jumping on board with this practice. However,
changing the social standards of such a developed country will not be easy
(Lorimer 2019).
Literature
cited
Lorimer, Jamie. 2019. Hookworms Make us Human: The Microbiome,
Eco-Immunology, and a Probiotic Turn in Western Health Care. Medical
Anthropology Quarterly 33(1): 60-79.
Smallwood, T.B.,P.R. Giacomin, A.Loukas, J.P. Mulvenna, R. Clark,
and J.J. Miles. 2017. Helminth Immunomodulation in Autoimmune Disease.
Frontiers in Immunology 8:453.
Smyth, K., C. Morton, A. Mathew, S. Karuturi, C. Haley, M. Shang,
Z.E. Holzknecht, C. Swanson, S.S. Lin, and W. Parker. 2017. Production and Use
of Hyenolepis diminuta Cysticercoids
as Anti-Inflammatory Therapeutics. Journal of Clinical Medicine 6:98.
Strachan, David P.. 1989. Hay fever, hygiene, and household size.
Department of Epidemiology and Population Science, London School of Hygiene and
Tropical Medicine, London WC1E &HT.
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