GastroIntestinal (GI) System

Discussion in 'Men's Health Forum' started by Michael Scally MD, Dec 2, 2010.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Eat Your Worms: The Upside Of Parasites
    Eat Your Worms: The Upside Of Parasites : NPR

    December 2, 2010

    For years evidence has been mounting that intestinal parasites can actually be a good thing for people with inflammatory bowel disease because certain parasitic worms seem to help the intestine heal.

    Now scientists think they've found at least one reason why this is so, thanks to a man who has spent years treating his own bowel disease with worms. Years ago, that man placed a call to P'ng Loke, a parasitologist who was then working at the University of California, San Francisco.

    "He had moved into the Bay Area and basically was looking for someone who works on worms, and so he called me and convinced me to have lunch with him," Loke recalls.

    Over lunch, the man told Loke a remarkable story about how he'd recovered from ulcerative colitis, a bowel disease in which the immune system appears to attack the lining of the colon, causing devastating ulcers. And for this man, Loke says, the usual treatments, including steroids, hadn't helped.

    "So he was being faced with the options of really severe immune suppressants or a colectomy," the removal of his colon, Loke says.

    But this man was a young entrepreneur with his own ideas. He'd run across the work of scientist Joel Weinstock who is now at Tufts Medical Center in Boston. Weinstock had done something that seemed bizarre: He had started using parasitic worms to treat people with ulcerative colitis.

    "So people would swallow microscopic eggs, and the eggs then hatch within the GI tract, and that living agent that comes out is capable to interact with the host's immune system," Weinstock says.

    Weinstock thought these parasites might help because in places where they are common, inflammatory bowel disease is rare. His hunch turned out to be correct: The people in his study got better.

    Worms A Key Factor In Healing

    Loke says that was good enough for the entrepreneur in San Francisco, who started looking for his own source of parasitic worm eggs.

    "He managed to find a parasitologist in Thailand who was willing to help him obtain these eggs, and then he infected himself," Loke says.

    And he too got better and was feeling fine by the time he had lunch with Loke. But he wanted scientists to figure out why the cure had worked. So he offered to let researchers study his intestine over the next few years.

    During that time, the worms began to die off and the man's disease came back. So he took another dose of worm eggs and got better again. Through it all, Loke and his colleagues were collecting blood and tissue samples from the man.

    A diagram of the life cycle of the Trichuris trichiura parasite. Enlarge the image for a more detailed description.

    "What we found was that after worm infection, the regions of the colon that were previously not making mucus, were now making mucus again," he says.

    That's a key factor in healing, and it looked like the mucus came back because the worms were causing the body to produce a substance called IL-22.

    Weinstock says that makes sense.

    "This is a molecule that promotes epithelial growth and healing and perhaps does other things to the immune system that would be potentially beneficial," he says. Weinstock says other studies suggest parasites can regulate the immune system in ways that prevent it from going wild and attacking healthy tissue, and he says it's likely that human evolution took that into account.

    "Humans have had parasites ever since we evolved from living in caves or swinging from trees or however it used to be, and disrupting these relationships probably had consequences," he says.

    Weinstock says drug companies are now trying to create parasites that would actually be approved by the FDA for treating inflammatory bowel disease. The research appears in the journal Science Translational Medicine.

    Broadhurst MJ, Leung JM, Kashyap V, et al. IL-22+ CD4+ T Cells Are Associated with Therapeutic Trichuris trichiura Infection in an Ulcerative Colitis Patient. Science Translational Medicine 2010;2(60):60ra88. IL-22+ CD4+ T Cells Are Associated with Therapeutic Trichuris trichiura Infection in an Ulcerative Colitis Patient — Sci TM

    Ulcerative colitis, a type of inflammatory bowel disease, is less common in countries endemic for helminth infections, suggesting that helminth colonization may have the potential to regulate intestinal inflammation in inflammatory bowel diseases. Indeed, therapeutic effects of experimental helminth infection have been reported in both animal models and clinical trials. Here, we provide a comprehensive cellular and molecular portrait of dynamic changes in the intestinal mucosa of an individual who infected himself with Trichuris trichiura to treat his symptoms of ulcerative colitis. Tissue with active colitis had a prominent population of mucosal T helper (TH) cells that produced the inflammatory cytokine interleukin-17 (IL-17) but not IL-22, a cytokine involved in mucosal healing. After helminth exposure, the disease went into remission, and IL-22 “producing TH cells accumulated in the mucosa. Genes involved in carbohydrate and lipid metabolism were up-regulated in helminth-colonized tissue, whereas tissues with active colitis showed up-regulation of proinflammatory genes such as IL-17, IL-13RA2, and CHI3L1. Therefore, T. trichiura colonization of the intestine may reduce symptomatic colitis by promoting goblet cell hyperplasia and mucus production through TH2 cytokines and IL-22. Improved understanding of the physiological effects of helminth infection may lead to new therapies for inflammatory bowel diseases.


    Elliott DE, Weinstock JV. Helminthic therapy: using worms to treat immune-mediated disease. Adv Exp Med Biol 2009;666:157-66.

    There is an epidemic of immune-mediated disease in highly-developed industrialized countries. Such diseases, like inflammatory bowel disease, multiple sclerosis and asthma increase in prevalence as populations adopt modern hygienic practices. These practices prevent exposure to parasitic worms (helminths). Epidemiologic studies suggest that people who carry helminths have less immune-mediated disease. Mice colonized with helminths are protected from disease in models of colitis, encephalitis, Type 1 diabetes and asthma. Clinical trials show that exposure to helminths reduce disease activity in patients with ulcerative colitis or Crohn's disease. This chapter reviews some of the work showing that colonization with helminths alters immune responses, against dysregulated inflammation. These helminth-host immune interactions have potentially important implications for the treatment of immune-mediated diseases.

    Weinstock JV, Elliott DE. Helminths and the IBD hygiene hypothesis. Inflammatory Bowel Diseases 2009;15(1):128-33.

    Helminths are parasitic animals that have evolved over 100,000,000 years to live in the intestinal track or other locations of their hosts. Colonization of humans with these organisms was nearly universal until the early 20th century. More than 1,000,000,000 people in less developed countries carry helminths even today. Helminths must quell their host's immune system to successfully colonize. It is likely that helminths sense hostile changes in the local host environment and take action to control such responses. Inflammatory bowel disease (IBD) probably results from an inappropriately vigorous immune response to contents of the intestinal lumen. Environmental factors strongly affect the risk for IBD. People living in less developed countries are protected from IBD. The “IBD hygiene hypothesis” states that raising children in extremely hygienic environments negatively affects immune development, which predisposes them to immunological diseases like IBD later in life. Modern day absence of exposure to intestinal helminths appears to be an important environmental factor contributing to development of these illnesses. Helminths interact with both host innate and adoptive immunity to stimulate immune regulatory circuitry and to dampen effector pathways that drive aberrant inflammation. The first prototype worm therapies directed against immunological diseases are now under study in the United States and various countries around the world. Additional studies are in the advanced planning stage. (Inflamm Bowel Dis 2008)

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  2. NeedsHRT

    NeedsHRT Junior Member

    This is very interesting. My chinese doctor believes that the body will get rid of the worms if it is strong enough and keep them if it is weak.
  3. ickyrica

    ickyrica Member Supporter

    @Michael Scally MD

    If you can recall, are there any threads that deal with GI related issues? I'm missing it/them if so.
    Thank you for the time dude.
  4. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    I do not recall any off hand. Try search for "Crohns".
    ickyrica likes this.
  5. ickyrica

    ickyrica Member Supporter

    Much appreciated. It put me in the right direction.