A person infected through the skin by the hookworm Necator americanus shows a spike in regulatory T-cells, specialized immune T-cells that work to limit inflammation, and a controlled infection by these generally safe worms may benefit some relapsing multiple sclerosis (MS) patients, research suggests.
“The findings of our study are encouraging. Whilst the results are modest in comparison to the current very potent and highly effective treatments available, some patients with milder disease or more inclined for natural treatments may consider this as an option,” Cris Constantinescu, a neurology professor at the School of Health Sciences, University of Nottingham and a study co-author, said in a press release.
The study, “Hookworm Treatment for Relapsing Multiple Sclerosis, A Randomized Double-Blinded Placebo-Controlled Trial,” was published in the journal JAMA Neurology.
In MS, a hyperactive immune system induces inflammation and demyelination — destruction of the myelin layer that protects nerves — leading to neuronal damage and loss. This also causes an unbalance between the pro- and anti-inflammatory molecules that control immune system activation.
Evidence suggests that MS is less prevalent in countries with a greater frequency of certain infections, like gut worms. This observation prompted researchers to speculate — in what they call the hygiene hypothesis — that certain parasitic infectious agents might protect against inflammatory diseases like MS.
These infectious agents are thought to induce a rise in the numbers of T-regulatory cells (Tregs), which are responsible for preventing the immune system from turning hyperactive.
Studies to date testing worm-based therapies in autoimmune diseases and MS have been of very short duration, with few patients, and without placebo controls. Still, the largest study conducted — which included 16 MS patients — showed moderately positive outcomes on MRI and immunological exams.
A team led by researchers at Nottingham conducted a large, placebo-controlled Phase 2 clinical trial in 71 MS patients, called WIRMS (NCT01470521), to assess whether exposure to a small number of hookworms would ease inflammation and disease activity.
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