Socio-medical studies of individuals self-treating with helminths provide insight into clinical trial design for assessing helminth therapy

Venkatakrishnan, Aarushi; Sarafian, Joshua T; Jirků-Pomajbíková, Kateřina; Parker, William F.

doi:10.1016/j.parint.2021.102488

Cited by 7 publications

(3 citation statements)

References 57 publications

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“…Evaluation of potential solutions to the adverse consequences of biota alteration involves systematic evaluation of benign symbiotic organisms for their effect on disease, with a view of optimizing the benefit-to-cost ratio of the therapy. Unfortunately, as with other efforts to address environmental mismatch, incentives to proceed with available solutions are insufficient at the present time [ 37 ]. As highlighted above, data showing that complex eukaryotic symbionts profoundly benefit allergic and autoimmune disorders are now more than half a century old [ 7 , 32 - 34 ], suggesting that the consequences of biota alteration are as entrenched in the population as the consequences of other environmental mismatches.…”

Section: Discussionmentioning

confidence: 99%

“…Another decade passed before the late Joel Weinstock attempted to reconstitute the human biota with helminths in an effort to treat inflammatory bowel disease. Despite dramatic early successes prior to 2005 at the University of Iowa, the effort to bring biota reconstitution to the clinic eventually failed, likely due in part to a lack of understanding regarding the production of helminths by pharmaceutical manufacturers [ 37 ]. Subsequently, thousands of individuals began self-treating with helminths [ 37 , 38 ], but the practice has not yet reached mainstream clinical use.…”

Section: Overcoming the Mismatch Of Biota Alteration: Another Example...mentioning

confidence: 99%

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Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities

Parker,

Jirků,

Patel

et al. 2024

Yale J Biol Med

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Section: Discussionmentioning

confidence: 99%

Section: Overcoming the Mismatch Of Biota Alteration: Another Example...mentioning

confidence: 99%

Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities

Parker,

Jirků,

Patel

et al. 2024

Yale J Biol Med

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“…The result of this is the aberrant activation of inflammatory pathways, thereby increasing the incidence of immune-mediated diseases, such as T1D and T2D. Given these observations, live helminth infection, or the administration of their ES products, are being actively investigated for therapeutic potential ( 82 – 84 ).…”

Section: Using the Immune Regulatory Mechanisms Of Helminths To Posit...mentioning

confidence: 99%

How do parasitic worms prevent diabetes? An exploration of their influence on macrophage and β-cell crosstalk

Camaya¹,

O’Brien²,

Donnelly³

2023

Front. Endocrinol.

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Diabetes is the fastest growing chronic disease globally, with prevalence increasing at a faster rate than heart disease and cancer. While the disease presents clinically as chronic hyperglycaemia, two distinct subtypes have been recognised. Type 1 diabetes (T1D) is characterised as an autoimmune disease in which the insulin-producing pancreatic β-cells are destroyed, and type 2 diabetes (T2D) arises due to metabolic insufficiency, in which inadequate amounts of insulin are produced, and/or the actions of insulin are diminished. It is now apparent that pro-inflammatory responses cause a loss of functional β-cell mass, and this is the common underlying mechanism of both T1D and T2D. Macrophages are the central immune cells in the pathogenesis of both diseases and play a major role in the initiation and perpetuation of the proinflammatory responses that compromise β-cell function. Furthermore, it is the crosstalk between macrophages and β-cells that orchestrates the inflammatory response and ensuing β-cell dysfunction/destruction. Conversely, this crosstalk can induce immune tolerance and preservation of β-cell mass and function. Thus, specifically targeting the intercellular communication between macrophages and β-cells offers a unique strategy to prevent/halt the islet inflammatory events underpinning T1D and T2D. Due to their potent ability to regulate mammalian immune responses, parasitic worms (helminths), and their excretory/secretory products, have been examined for their potential as therapeutic agents for both T1D and T2D. This research has yielded positive results in disease prevention, both clinically and in animal models. However, the focus of research has been on the modulation of immune cells and their effectors. This approach has ignored the direct effects of helminths and their products on β-cells, and the modulation of signal exchange between macrophages and β-cells. This review explores how the alterations to macrophages induced by helminths, and their products, influence the crosstalk with β-cells to promote their function and survival. In addition, the evidence that parasite-derived products interact directly with endocrine cells to influence their communication with macrophages to prevent β-cell death and enhance function is discussed. This new paradigm of two-way metabolic conversations between endocrine cells and macrophages opens new avenues for the treatment of immune-mediated metabolic disease.

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Health‐promoting worms? Prospects and pitfalls of helminth therapy

Lamminpää,

Boem,

Amedei

2024

BioEssays

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In this manuscript, we explore the potential therapeutic use of helminths. After analyzing helminths’ role in connection with human health from the perspective of their symbiotic and evolutionary relationship, we critically examine some studies on their therapeutic applications. In doing so, we focus on some prominent mechanisms of action and potential benefits, but also on the exaggerations and theoretical and methodological difficulties of such proposals. We conclude that further studies are needed to fully explore the potential benefits of this perspective, and we encourage the scientific community in doing so.

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Socio-medical studies of individuals self-treating with helminths provide insight into clinical trial design for assessing helminth therapy

Cited by 7 publications

References 57 publications

Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities

Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities

How do parasitic worms prevent diabetes? An exploration of their influence on macrophage and β-cell crosstalk

Health‐promoting worms? Prospects and pitfalls of helminth therapy

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