Printer Friendly

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 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 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 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 whipworm that can colonize 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 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.


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.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:helminths, inflammatory bowel disease
Author:Zoler, Mitchel L.
Publication:Internal Medicine News
Geographic Code:1U7LA
Date:Jul 1, 2004
Previous Article:Smallpox vaccine myocarditis.
Next Article:Capsule endoscopy aids IBD assessment.

Related Articles
And So the Worm Turns.
Worm therapy: a new treatment for IBD? Worm therapy offers hope for patients suffering from painful and debilitating diseases such as Crohn's and...
Signs help distinguish ulcerative colitis, Crohn's.
Sargramostim Therapy Demonstrates Significant Improvements in Quality-of-Life for Patients with Crohn's Disease.
4SC AG Achieves Proof of Concept for Drug Candidate SC12267 for the Treatment of Chronic Inflammatory Bowel Diseases.
Biomarkers for inflammatory bowel disease.
We have come some way in understanding the aetiology of inflammatory bowel disease, which has allowed advances in its management.
MRI of inflammatory bowel disease.
Gut bug may hold key to inflammatory bowel disease treatment.

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters