Neurodegnerative and Neuropsychiatric Disorders: Prime Targets for Helminths

Within just a few weeks of each other, two papers have been published looking at the potential of using helminths to treat neurological conditions.  Not surprisingly, both focus on the powerful anti-inflammatory effect of helminths.

(For those of you new to helminths:  these are a kind of macrobiotic organism, intestinal worms, native to all mammals on this planet.  However, in the industrialized world, we have “de-wormed,” completely eradicating our native macrobiomes.  At this point, pinworms are the only one of these organisms that is still around in the westernized world, and when someone gets them, we instantly de-worm them (which is fair enough as they have nasty side effects).  However, there are benign helminths currently being used for “helminthic therapy” – using small, therapeutic doses of these organisms to modulate the inflammatory response.)

The first paper looks at helminths in neurodegenerative disorders like multiple sclerosis and Alzheimer’s disease.[i]  These authors believe that the upregulation (increase) in T regulatory cells (which produce anti-inflammatory cytokines, like IL-10) induced by helminths may play a pivotal role in treating these illnesses.

A few highlights from this paper:

1. “…until now, helminth infections have not been demonstrated as necessary for proper host immune maturation in either humans or in animal models, and co-evolution over millions of years involves a form of mutualism where both the host and the parasite derive some benefit from their relationship..”
2. I laughed when I read that sentence.  Isn’t it an oxymoron to say that a parasite is mutualistic?!  Maybe then they should call these therapeutic organisms mutualists, not parasites!
3. Clinical data, experiments and clinical trials all support the notion that “…helminths not only prevent but also reverse allergy and asthma and autoimmune diseases…”
4. Neurological inflammation is an important factor in the development of such illnesses as ALS, Parkinson’s, Alzheimer’s and multiple sclerosis. While the molecular mechanisms of brain damage in these diseases (as well as Lewy body dementia and frontotemperal dementia) are different, “the presence of neuroinflammation is a common feature of all these…”
5. To effectively treat neurodegenerative diseases, anti-inflammatory treatments must be considered, but at the same time, oversuppression of the inflammatory response – which would open the individual up to infection – must be avoided. The authors refer to this as “precise tuning of the immune responses.”  They go on to say, “It seems a promising use for this immunomodulation of the work of our ‘old friends’: gut microbiotic bacteria and parasitic organisms…”

The thrust of the 2^nd paper, which focuses on using helminths in the treatment of neuropsychiatric disorders (NPDs), is essentially the same.  They too state that helminths “…have shown to be protective against severe autoimmune and allergic disorders” and have been “…used for modulation of immune disturbances in different autoimmunity illnesses, such as Multiple Sclerosis (MS) and Inflammatory Bowled Disease (IBD).”[ii]

They go on to state that “…’helminthic therapy’ is able to ameliorate neuroinflammation of NPDs (neuropsychiatric disorders) through immunomodulation of inflammatory reactions and alteration of microbiota composition.”

A few high points of this one:

1. Immune disturbances are well documented in many NPDs. For example, significant elevations of inflammatory cytokines have been found in the blood of children with autism, as well as major depressive disorder and schizophrenia.
2. The link between autoimmune disease and NPDs is also well established. As just one example, those with inflammatory bowel diseases have nearly 6X the increased risk of anxiety issues.
3. Treating NPDs with anti-inflammatory agents has been shown to have therapeutic benefit.
4. Helminths not only directly modulate inflammation, but also, by positively altering the microbiome, have an indirect beneficial effect on the immune system.
5. The authors point out that there is “…a big opportunity for helminth therapy in NPDs” as few studies have been conducted…but based on what information is in the literature, this looks like an extremely promising treatment.

They summarize all this in their conclusion stating again that inflammation seems to be a driving force behind many neuropsychiatric disorders and helminths are perhaps the most potent natural modulator of the inflammatory response.  Thus, “…helminth therapy may be a promising and new therapeutic option for resolution of neuroinflammation in NPDs.”

Here’s a question for you to contemplate: if neurodegenerative and neuropsychiatric disorders are, at least in large part, caused by out-of-control inflammation…why wait for them the start before working on the unregulated immune system?  As Dr. Jamie Lorimer, of Oxford University says, “Humankind eventually needs to move beyond the idea that helminths are best used as a drug or a therapy. Rather, we need to embrace the view that helminths are a necessary component of the ecosystem of a healthy body, and that helminths should be cultivated for population-wide biota restoration…”[iii]

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[i] Donskow-Lysoniewska, K, Doligalska, M, Gasiorowski, K, Leszek, J. Parasitic worms for the treatment of neurodegeneration. Neuropsychiatry. 2019;9(2):2333-2346.

[ii] Abdoli, A and Ardakani,  HM. Potential application of helminth therapy for resolution of neuroinflammation in neuropsychiatric disorders. Metabolic Brain Disease. 2019. doi: 10.1007/s11011-019-00466-5

[iii] Lorimer, J. Hookworms Make Us Human: the Microbiome, Eco-immunology, and a Probiotic Turn in Western Health Care. Medical Anthropology Quarterly. 2018  Jul 13. doi: 10.1111/maq.12466