Hookworm infection with live parasites can begin full-scale trials for inflammatory bowel diseases (IBD), according to a new pilot study. Focusing on patients with ulcerative colitis, it’s the first study of its kind to deploy hookworms in a controlled setting and investigate how they are tolerated as a potential therapy for the condition.
Hookworms target the intestines of their animal hosts, including humans, but it’s a long journey from their point of entry to the gut. Larvae typically enter through the skin, most often via the feet, where they enter the bloodstream and wind up in the lungs. Journeying up the respiratory tract, they’re eventually coughed up and swallowed, finally arriving at their ultimate destination: the intestines.
Once inside the intestines, larval hookworms are able to complete the next stage of the lifecycle in becoming adults so that they can mate, sustaining their trysts with blood taken from the intestinal wall. The eggs follow feces out of the body, and the cycle begins all over again.
In case you’re wondering how it’s possible a group of intestine-targeting worms could benefit a form of IBD like ulcerative colitis, the physiological perks of some parasites have been established in several areas of medicine. Some studies have found that infection with helminth parasites like hookworms, flukes, and tapeworms has merit not just for the management of IBD, but also asthma, eczema, multiple sclerosis, rheumatoid arthritis, and diabetes.
Belief in the worms is so strong that some IBD patients are already running with it, despite not yet having the medical data to back it up.
“Patients with ulcerative colitis already use medically unsupervised hookworm therapy, suggesting it may be of benefit, but the evidence base is lacking,” wrote the authors of a new study exploring if hookworms can be tolerated as a potential treatment for ulcerative colitis.
The pilot, double-blind, randomized controlled trial took a small sample to look at how hookworm parasitization influenced a patient’s chances of remaining in remission from an ulcerative colitis flare-up. It took 20 patients in disease remission and gave them either 30 hookworm larvae or a placebo, and then monitored their progress for up to 52 weeks to see if they had another flare.
Using just 20 participants means the results can’t be generalized, but the main aim of the research wasn’t to glean insights into hookworm therapy so much as to explore if it can be tolerated in research. If it could, the study design could be scaled up to include more patients, creating a larger body of data that could be used to investigate the therapeutic effects of hookworm infection.
A “double-blind” trial is one that requires both the investigators and the participants to be unaware of who is receiving the treatment and who is receiving the placebo. In the case of hookworms, keeping the placebo group unaware proved easy but detectable eggs in the feces of the hookworm group meant most of these participants clocked on to what they’d been given.
However, adverse events associated with hookworm infection were mild, and blood results showed that while all participants in this group developed eosinophilia, their quality of life wasn’t statistically different from that of the placebo group.
“This pilot study is the first controlled evidence in the use of hookworm as a therapy in ulcerative colitis,” concluded the study authors. “It has shown hookworm therapy to be well-tolerated and safe, and a full-scale [randomized controlled trial] is feasible.”
“Hookworm therapy could provide an alternative therapeutic option to conventional medications and improve adherence by removing the need to take daily medication. This study is a step towards proving whether it is efficacious in ulcerative colitis.”
The study is published in Inflammatory Bowel Diseases.
[H/T: Medical Xpress]
Source Link: Getting Infected With Hookworms Could Become A Legit Treatment For Ulcerative Colitis
