Helminths and a New Kind of Industrial Revolution

In August, 2017,  researchers gave TSO (porcine whip worm, Trichuris suis ova), to a man with psoriasis, who was otherwise healthy.  They then examined the effects of the helminth via colonoscopy and blood work, discovering that there were profound immunological changes in the area where the TSO live, limited changes in the other parts of the intestine. They also noted that the TSO did seem to colonize and mature enough to produce some eggs…and “Notably, the volunteer experiences a substantial improvement in psoriasis during the course of TSO treatment.”[i]

Dr. William Parker, at Duke University Medical School, and one of the leading researchers in the field of helminths and immunology, wrote a subsequent letter to the editor[ii], also published in the same journal, Immunology Letters, commenting on this study and he makes several excellent points that are worth sharing with you.

1. “…the presence of helminths in the ecosystem of the human body is probably necessary to ensure healthy immune function.”
2. “The working paradigm in the field is that helminths have the potential to alleviate on of the ultimate cause of inflammatory disease in Western society, biota depletion, defined as the loss of biodiversity from the ecosystem of the human body as a result of modern technology.”
3. He points out that the major hurdle facing helminthic therapy now is one of public relations (“…our imagination of infection with parasites provides fodder for nightmares and horror films alike”) I agree – it is a huge problem – with the media feeding these fears with headlines screaming of “eating worms” and the like.
4. His suggestion is that scientists start using correct terminology: “If an organism benefits its host without causing harm, it is by definition a mutualist, not a parasite.  By the same token, if it does not cause disease, then it is by definition colonization, not infection and not a burden.”
5. He makes the very interesting point that the host-helminth relationship is “contextual.” That is, the same helminth in a person living in an industrialized society versus in a person living in a “pre-industrial, overly crowded agrarian society” may cause vastly different immune response.
6. “The same society that once benefited from access to clean drinking water, effectively reducing the number of symbiotic helminths, may now desperately need to domestic the organism for controlled reintroduction.”

Dr. Parker concludes with pointing out that there are tremendous parallels between the current prevailing fear of helminths as the prior fear of bacteria: “…we learned that bacterial symbionts are not all pathogens out to kill us.  History is in the throes of repeating itself as we learn the same lesson with our larger intestinal symbionts.”

I really hope so.  We inflamed people of the industrialized world need another medical revolution and we need it now.

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[i] Williams, AR, Dige,A, Rasmussen, TK, Hvas,CL, Dahlerup, JF, Iversen,L, Stensvoid,CR, Agnholt, J, Nejsum, P.  Immune responses and parasitological observations induced during probiotic medicinal Trichuris suis ova in a healthy volunteer.  Immunology Letters. 2017 Aug;188:32-37.

 

[ii] Parker, W. Not infection with parasitic worms, but rather colonization with therapeutic helminths. [Letter to the Editor]. Immunology Letters. 2017. 192:104-105.