Helminth Therapy: A Call to Action

An interesting opinion piece by Dr. William Parker, of Duke University, and colleagues at a couple of Czech Universities, just appeared in Trends in Parasitology.[i]  To summarize, the paper makes two key points:

A.  These scientists hold the belief that the interaction between human and helminth is so complex, that a drug isolated from a single helminth-derived metabolite will never have the same effect as using the whole, living organism.

B. Unfortunately, there is no research at all into what might be the optimal organism to use for helminth therapy. Currently, the 4 organisms currently available were selected because of they are not pathogenic in small doses.  But whether or not they are “the best,” we have no clue.

To share a few high points with you:

1. The authors emphasize that until recently, helminths were ubiquitous to all humans but now, are essentially entirely absent in developed countries.   And the loss of our native macrobiomes has had, “…dire consequences for human health.”
2. Epidemiological studies clearly show that the loss of a macrobiome in mammals inversely correlates with the global rise in chronic inflammation-associated diseases (CIADs).  These include allergies; autoimmune diseases like inflammatory bowel diseases, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, etc.; autism; and even many so-called “mental illnesses” like depression and anxiety.

(On a side note, this map is commonly used to illustrate point #2.  As you can see, wherever people still have a macrobiome (i.e. helminths on board), the incidence of autoimmune disease is low.  To read more about this, you might want to check out this post I wrote back in April 2017, about some fascinating research on this topic.)

3. More than 40 years ago, Dr. Turton demonstrated that he could reverse seasonal allergies by ingesting benign helminths, which over the years has led to a series of studies in humans and animals demonstrating, over and over, the health benefits of replacing this missing element from our body’s ecosystem.
4. The authors call helminths “master manipulators” of their host’s immunity, modulating the inflammatory response.
5. As I mentioned above, these scientists are of the belief that trying to isolate single metabolite from a helminth is in no way a replacement for the whole, living organism: “…we have argued that administration of purified factors cannot recapitulate complex biological relationships that have evolved over hundreds of millions of years.  For this reason, it is anticipated that the use of intact helminths for therapy has substantial and indeed insurmountable advantages over approaches using specific isolated HDecs [helminth derived compounds].”
6. We already have the ability to isolate and process living helminths under sterile, pharmaceutical-grade laboratory conditions, and regulatory agencies have already approved their use in trials. For example there have already been 14 clinical trials alone testing TSO (Trichuris suis ova, or porcine whip worms) registered with Clinical Trials.gov. There already exists a healthy body of literature on using other helminths in humans.
7. That said, no one has, as yet, looked at the possibilities of every helminth out there, or tested to see which might be optimal for use in helminth therapy. Like everything having to do with optimizing the human biome, we’ve barely scraped the surface!

From the conclusion of the paper:

“The loss of helminths from the human biome is one of a few key factors that underlie CIADs in modern society, and the necessity of dealing with the root causes of CIADs is increasing as the burden of these diseases rises.”

Take a good look at the graph I used above, to illustrate the rise in autoimmune and neurological diseases in the world, from the American Autoimmune and Related Diseases Association. A couple of weeks ago, I was in the UK giving a talk to the British Association of Naturopathic Practitioners.  These are some of the allergy statistics (from the American Academy of Allergy Asthma and Immunology) that I presented on just 1 slide:

• Worldwide, the rise in prevalence of allergic diseases has continued in the industrialized world for more than 50 years.
• Worldwide, allergic rhinitis affects between 10% and 30% of the population.
• Worldwide, sensitization (IgE antibodies) to foreign proteins in the environment is present in up to 40% of the population.
• Worldwide, sensitization rates to one or more common allergens among school children are currently approaching 40%-50%.

We in the industrialized world are in a health crisis of mammoth proportion.  Daily though I wonder why no one seems to care.

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[i] Sobotkova, K, et. al.  Helminth Therapy – From the Parasite Perspective.  Trends in Parasitiology. 2019.