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Intestinal worms may resolve Crohn's, IBD.



NEW ORLEANS -- Industrialized society has allowed people to purge themselves of intestinal worms, but this may have opened the door to inflammatory bowel disease inflammatory bowel disease
n. Abbr. IBD
Any of several incurable and debilitating diseases of the gastrointestinal tract characterized by inflammation and obstruction of parts of the intestine.
 and other autoimmune disorders. Results from pilot clinical studies show that putting a harmless worm parasite back in the gut may be an effective way to treat Crohn's disease and ulcerative colitis.

In a study of 29 patients with Crohn's disease, ingesting a dose of helminth helminth /hel·minth/ (hel´minth) a parasitic worm.

hel·minth
n.
A worm, especially a parasitic roundworm or tapeworm.


Helminth
A type of parasitic worm.
 eggs every 3 weeks led to a 72% remission rate after 24 weeks, Dr. Robert W. Summers reported at the annual Digestive Disease Week. And in a second study with 54 patients, dosing with the same type of worm eggs every 2 weeks led to a 48% response rate during 12 weeks of treatment, said Dr. Summers, the James A. Clifton professor and director of clinical programs for the gastroenterology division at the University of Iowa Not to be confused with Iowa State University.
The first faculty offered instruction at the University in March 1855 to students in the Old Mechanics Building, situated where Seashore Hall is now. In September 1855, the student body numbered 124, of which, 41 were women.
 in Iowa City.

"Helminths have a unique property of causing long-lasting modulation of the immune system," commented Dr. Joel V. Weinstock, professor and director of gastroenterology-hepatology at the university and a coinvestigator on these studies. "Inflammatory bowel disease and other common immune diseases in industrialized countries seem to be diseases of the 20th century that are very rare in less developed countries. I predict that helminths may also be a factor in asthma, multiple sclerosis, and other immunologic diseases."

The helminth selected for initial clinical study was Trichuris suis, a porcine porcine /por·cine/ (por´sin) pertaining to swine.

porcine

pertaining to pig. See also hog (1), swine.


porcine circovirus 1
a nonpathogenic virus.
 whipworm that can colonize col·o·nize  
v. col·o·nized, col·o·niz·ing, col·o·niz·es

v.tr.
1. To form or establish a colony or colonies in.

2. To migrate to and settle in; occupy as a colony.

3.
 for several weeks in humans but cannot multiply, because it is not a natural human parasite. It is not directly transmissible from one person to another. So far, this treatment has been developed with support from the University of Iowa, the National Institutes of Health, and charitable foundations. Helminth treatment has not yet been commercialized.

In the Crohn's disease study, 29 patients with a Crohn's disease activity index The Crohn's Disease Activity Index or CDAI is a research tool used to quantify the symptoms of patients with Crohn's disease. This is of importance in research studies done on medications used to treat Crohn's disease; most major studies on newer medications use the CDAI in  score of 220-450 were enrolled, and 25 finished the study. In this open-label study, each patient ingested 2,500 T. suis ova every 3 weeks for 24 weeks. After 12 weeks, the response rate was 75.9% and the remission rate was 62.1%. After 24 weeks, these rates had risen to 79.3% and 72.4%, respectively, said Dr. Summers. There were no adverse effects or complications from therapy.

The ulcerative colitis study involved 54 patients with a disease activity score of at least 4. Patients were treated with either 2,500 T. suis ova or placebo every 2 weeks for 12 weeks, then the two study groups were crossed over and the patients took the new regimens for another 12 weeks.

Combined data from both 12-week treatment groups showed that the 47.8% response rate among patients treated with helminths was significantly better than the 15.4% response rate during placebo treatment, Dr. Summers reported in a separate presentation at the meeting.

In this initial clinical study, the dosing regimens, as well as the type of helminth administered, were not yet optimized, Dr. Summers added.

"This is a prototype," Dr. Weinstock said. "It likely works by a novel mechanism. It has the potential to give us real insight into the causes of inflammatory bowel disease and perhaps new insights into how to treat and prevent inflammatory bowel disease," he said.

BY MITCHEL L. ZOLER

Philadelphia Bureau
COPYRIGHT 2004 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004 Gale, Cengage Learning. All rights reserved.

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Title Annotation:helminths, inflammatory bowel disease
Author:Zoler, Mitchel L.
Publication:Internal Medicine News
Geographic Code:1U7LA
Date:Jul 1, 2004
Words:547
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