Paper Examination: Advances in the use of Parasitic Worms Against Inflammatory Bowel Diseases and its Challenges

This is the first part of a series where we will be examining scientific papers studying helminthic therapy.  I have had a lot of anxiety lately about whether or not helminthic therapy is going to work for me.  I have found that looking into the scientific research of helminthic therapy and IBD has really helped calm my anxieties.  

First up is one of the first papers that I ever read on helminthic therapy for IBD.  Helminth Therapy: Advances in the use of Parasitic Worms Against Inflammatory Bowel Diseases and its Challenges.  Published in 2018 by Maruszewska-Cheruiyot, Donskow-Lysonieska, and Doligalska.  

Please read the entire paper here to gather your own knowledge about helminthic therapy for IBD.

We will examine, 

• What the paper is about
• Quotes from the paper
• Highlights of the paper

 

What Advances in the use of Parasitic Worms is About

There are many topics covered in Advances in the use of Parasitic Worms.  Including the general rise of autoimmune conditions in the 20th and 21st Centuries.  And how this closely aligns with the rise of mass hygiene; hence the hygiene hypothesis.

The authors discuss the effectiveness of helminthic therapy for IBD.  Although it has been only demonstrated in limited clinical trials; the results are promising.

The researchers admit that one of the largest hindrances of helminthic therapy is that its “mechanisms are still unclear.”  We are not exactly sure how the helminths change or modulate the immune system, which helps autoimmune disorders.

There has been more research into helminthic therapy with animals than humans.  And those exciting results are also discussed in relation to IBD.

 

Quotes from the Paper

Advances in the use of Parasitic Worms starts out strong.  Saying that, “Cure with helminths seems to be the most effective therapy of IBD currently proposed.”  While I do have slight issue with the word “cure” their point is made clearly:

Helminthic therapy needs to be considered as a viable alternative treatment for IBD.

Below is a list of quotes that I took from the paper, to summarize the research.  I have included some thoughts below the quotes.

 

• “Absence of effective treatment [for IBD] in standard therapies effects the search for alternative opportunities.”
  • There are lots of desperate people out there with IBD, who are willing to try alternative therapies like helminthic therapy, that’s why I tried it
• “Helminths have co-evolved with their hosts over millions of years to arrive at a form of mutualism where both the host and the parasite derive some benefit from their relationship.” 
  • Helminths are not new.  We are re-introducing them in our gut biome after we have cleaned them out
• “In United States schoolchildren, the prevalence of hookworm fell from 65 % in 1910 to fewer than 2 % in 1980.”
• “The most promising group of intestinal parasites seems to be the nematodes.  The most common genera of nematodes distributed in human digestive track are Ascaris, Trichuris (whipworm), Necator and Ancylostoma (hookworms). Two species of which, Trichuris suis and Necator americanus, have been investigated in clinical examinations of UC and CD patients.”  
  • I am currently taking necator americanus (NAs) for Crohn’s disease
• “A group of UC and CD patients received a single oral dose of 2500 live T. suis eggs, and were then monitored every 14 days for 12 weeks. A second group of patients received the same administered dosage every 21 days for 28 weeks. After accurate monitoring, no side effects were noticed and a further repeated dosage resulted in the improvement of all medicated patients (Summers et al., 2003). Similarly, in a second clinical trial, a repeated dose of 2500 viable T. suis eggs was given to 29 of CD patients every 21 days for 24 weeks, and no adverse reaction was observed. After 24 weeks of therapy, 79.3 % of patients responded to treatment and 72.4 % were in remission, as evaluated based on Crohn’s disease activity index”
  • These results are exciting.  And are helping me stay positive.  Other research shows even higher rates of remission past 24 weeks.

 

Highlights of the Paper

Advances in the use of Parasitic Worms is one of the only papers I have read that has percentage statistics on how likely helminthic therapy is to work on IBD patients.  Other researchers have obviously studied this topic.  But this paper displays its results in such convincing statistics that it can’t be overlooked.

Table 2 is another exciting feature of this paper.  It summarizes the results from 5 different clinical trials on helminthic therapy for IBD.  The table summarizes the scheme (timeline of the trial, and helminth used) as well as the results.  

By displaying the results in chronological order based on trial length.  You can clearly see that the longer you stay on helminth therapy.  The more likely you are to see benefits, and even reach remission.  To the point where by 28 weeks (the longest clinical trial studied), the very small trial group (7 people) had all reached remission.  

The paper discusses the possibility of isolating certain helminth antigens that have this desired effects on the immune system.  This way the benefits of helminths could be sold and used, without taking the helminths.

But with further research this seems more and more impossible.  It is becoming clear that the helminths produce a multitude of different secretions that may all play unique roles in altering the human immune system.  So for now taking live helminths is the only way to receive their benefits.

 

Rereading Advances in the use of Parasitic Worms made me feel a lot more confident in helminthic therapy.  This was one of the papers that I originally read which convinced me to try helminthic therapy.  It summarizes the high likelihood that I will at least see some improvement, and the very low likelihood that I will have long term side effects.  

I think that once you begin to study the science of helminthic therapy, it makes not only complete logical sense.  But there are a growing number of clinical studies that prove that it works.