Case study: A patient counters worms to treat colitis
Because of their capacity to alter the immune system, certain parasitic worms have become medically interesting. We pore through science publications every week to investigate a perplexing medical topic. By choosing an unconventional treatment for his developing ulcerative colitis, a 36-year-old California man wormed his way into medical history.
1,500 parasitic worm eggs!
Short on choices for his terrible ailment — and facing the prospect of having his colon removed — the guy sought the help of a parasitologist in Thailand, who advised him to eat 1,500 parasitic worm eggs, according to LiveScience. Surprisingly, as reported in the man’s case study published in the journal Science Translational Medicine in 2010, there was (some) method to the madness.
Because of their ability to alter how the body’s immune system responds to specific threats, parasitic worms, also known as helminths, have been a growing source of interest. Because ulcerative colitis induces inflammation in the colon, which kills good cells and leaves painful ulcers in their wake, the worms were hoped to suppress the man’s immune system and alleviate his misery.
Pay attention before you order plates of worms!
Researchers revealed the man’s inflammatory bowel illness had improved to the point that therapy was no longer needed a year after he ate the slimy snack. But, before everyone begins ordering plates of plump parasitic eggs, the researchers point out that, while the worms had the desired impact , it was for a different cause than first thought .
A modulated response rather than a widespread decrease!
How helminth exposure impacts autoimmune and inflammatory illnesses has sparked a lot of interest, said Mara Broadhurst, one of the case’s researchers and (at the time) a PhD student in immunology at the University of California, San Francisco. What we saw was a modulated response rather than a widespread decrease of inflammation.
Helminths can actually aggravate inflammation
Researchers believe that as the man’s body attempted to remove the microscopic intruders, it also created a thick mucus that covered the lining of his colon, offering temporary relief from symptoms. Despite the fact that the treatment had the anticipated results, Broadhurst advised against it. I don’t believe we’re at the point where we can make this a blanket recommendation, she said. We certainly aren’t at the point where we know which patient subgroups will benefit. Exposure to helminths can actually aggravate inflammation in certain circumstances, with specific defects.
Worm treatment is not a successful method.
Because ulcerative colitis goes into remission on its own, this might have been the case, according to Hotez. The main line for me is that treating with worms is not a long-term successful method for IBD, and it is potentially highly dangerous because you are effectively generating a severe kind of IBD by delivering the worms.
A second round of the same phenomenon
Broadhurst said he ate another 2,000 eggs to restore the parasite supply in his body after the man’s symptoms resurfaced in 2008, four years after his trip to Thailand. As the worms neared the end of their lives, the inflammation returned, and we were able to see a second round of the same phenomenon, she explained. Broadhurst believes that future study in this area should focus on treating patients by removing whatever helpful ingredient — if any — is present within the worms before swallowing thousands of their eggs. Finding a means to boost the body’s ability to produce mucus in the colon would also be a worthwhile research topic.
Producing new medications
This holds a lot of promise in terms of designing medications that target those signaling pathways, she said. Ideally, patients who desire to pursue this sort of treatment would not need to introduce a live parasite.