Parasitic worms to treat human disease

Parasitic nematodes, particularly the pig whipworm, Trichuris suis, and the human hookworm, Necator americanus, are being used to treat humanautoimmune disease. Currently, these "treatments" are only available through research projects or as unregistered treatments. Eggs of whipworms for the treatment of inflammatory bowel disease were previously available commercially in USA with FDA approval, but not now.\ud \ud What is the evidence for the hypothesis that intestinal helminths can improve clinical outcomes in autoimmune disease? The initial stimulus was that epidemiological data indicated an inverse association between the prevalence of intestinal helminths and the prevalence of inflammatory bowel disease, asthma, allergic rhinitis and multiple sclerosis between countries and also within countries over time. The next step was prospective studies that demonstrated treating helminths in endemic countries rapidly increased the incidence of allergic responses. One serendipitous case study showed that 'treatment of enterobiasis caused loss of colonic wall T-reg cells and was followed by the development of ulcerative colitis.\ud \ud Trials on use of T. suis and N. americanus in humans with inflammatory bowel disease and allergic rhinitis marked the next intervention phase. Current research now seeks to understand host-parasite mechanisms and to isolate active compounds to bypass the use of live parasites