As we have learned and discussed in class, Inflammatory Bowel Disease is considered by some researchers to be more prevalent in more developed countries in the Western World and less prevalent in developing countries that do not have access to adequate sanitation and clean water and food supplies. The article "Trichuris suis therapy in Crohn’s disease" is based on this idea. The researchers of the article believe that people living in more developed countries are not often exposed to bacteria and parasites so they do not carry parasites inside of them. Thus, they believe that people with IBD create an immune response to the natural flora normally present in the gut. The researchers believe that by feeding these people worms, specifically Trichuris suis, there will be a reduction in inflammation by down-regulating the host's immune response to natural gut flora.
The study was conducted at the University of Iowa over a time period of 24 weeks and involved 29 patients. There was a large diversity in ages of the patients, ranging from 18 to 72 years old. All of them were allowed to continue any medications they were taking at the time as long as they met the criteria for the clinical trial set by the researchers. The worms themselves were grown in vitro after they were isolated from the colon of a pathogen free pig the worm ova were fed to in the first place. Once the worms had matured, the patients were given a commercial drink filled with worms to drink every three weeks. Patients also kept diaries of the symptoms they experienced during the treatments.
Halfway through the clinical trial, 22 of the 29 patients enrolled had responded to the treatment and 19 of the 29 patients were considered to be in remission. By the end of the 24 weeks, 23 patients had responded to the therapy and 21 patients were considered to be in remission. It was also noted that patients that were using immunosuppressive drugs experienced greater improvement compared to patients that were not immunosuppressed.
Article Citation:
http://www.ncbi.nlm.nih.gov/pubmed/15591509
All of this parasite research is really interesting...and from everything we've read seems to be a very promising direction for Crohn's treatment research. I found another study which also had great results in improving the condition of the patients. My question though is...have you found any information about the long term effects of this treatment? I haven't been able to find too many reported adverse side effects but I have to wonder how these foreign parasites would affect the body long term, and if they would cause inflammation in other areas.
ReplyDeleteThat is a very interesting article. Sometimes I think it would be better if we lived in more primitive times since it seems to develop our immune systems more and prevent diseases that appear in our westernized lifestyles where we fear germs, parasites and anything “dirty.”
ReplyDeleteWhile living primitively seems to develop the immune system, there are many deaths related to lack of hygiene and sanitation in developing countries. According to the CDC 1.5 million deaths each year, many children, come from unclean water sources. A list of the illnesses caused by unclean drinking water can be found here.
ReplyDeletehttp://www.cdc.gov/healthywater/global/wash_diseases.html
I feel the better option would be to pursue alternative means of using microorganisms to mature the immune system as seen in the article we read in class that dealt with using helminth antigen to reduce the inflammation in IBD.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665684/?tool=pubmed
Ahh yes more parasites! I agree that parasite treatment is interesting but it all makes me wonder if people in the future will have worse immune systems under the assumption that the future is a more hygienic world. But then again is there a perfect level for parasites in our bodies? Also did people in the past have better immune systems?
ReplyDeleteIn addition to deadly diseases resulting from improper hygiene and sanitation practices, there is the possibility that parasite infestations could also trigger inflammation in the affected area by triggering a TH2 immune response. This is commonly seen in chronic parasitic infections and can cause serious damage, such as fibrosis of the GI tract. They can also make the person more vulnerable to other bacterial and viral diseases as well as other, deadly parasites by suppressing the TH1 immune response. More information on this can be found here.
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744001/?tool=pubmed