cam gut health

Parasites that heal:

what our old friends
can do for us
In our third article examining the health implications of parasite infections, naturopath EMMA LANE
looks at some of the research around the positive effects of these fascinating hitchhikers.

hile there is no doubt that

parasites can cause serious
health problems, it is now
understood that as a result
of the hosts protective
response, some worms can actually help the
human immune system. The evidence for
this is so strong that over the past few years
a number of studies have tested worms for
clinical benefits.
During the past ten years, studies have
found that certain helminth infections protect
against the development of allergic diseases.
(A helminth is a parasitic worm.) Several
clinical trials investigated the effects of
deliberate exposure to parasites like porcine
whipworm (Trichuris suis) (Summers, 2003,
2005) or hookworm (Necator americanus)
to develop helminth therapies (Feary,
2010). They proved to be a safe option to
control aberrant inflammation. The goal of
researchers is now to identify the parasitederived immunomodulatory molecules
responsible for the protective effects.
One of the earliest insights was from
researcher John Turton, who in 1976 noted
the absence of his own normally pronounced
hay fever attacks during two summers in
which he was infected with hookworms;
he wrote a paper for The Lancet describing
his experience. He had deliberately infected
himself in order to rear larvae for his own
research (Turton, 1976).
A University of Nottingham study involving
parasites (Scrivener et al, 2001) focused
on hookworm and asthma; in America,
scientists have explored whipworms effects
on ulcerative colitis and Crohns disease
(Summers et al, 2005, 2003). At the University
of Cambridge, a study examined how the
tropical worm which causes the parasitic
disease bilharzia could modulate type 1
diabetes (Zaccone et al, 2010). All the studies

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showed positive outcomes and suggest that

worms and other organisms, through our
evolutionary history, have developed a role in
driving our immune systems.
Wilson and colleagues, in a 2005 study,
showed that worms in the gut can keep
allergies at bay. They found that mice infected
with the helminth H. polygyrus activated
regulatory T-cells in the gut. These T-reg cells
were dispatched to the lungs, where they
dampen the immune response to inhaled
allergens. The study reported significantly
reduced airway inflammation in the infected
mice (Wilson, 2005).
A 2007 study showed beneficial
immunomodulation in humans with multiple
sclerosis when they were infected with
helminths (Correale, 2007).

Effects on IBD

In 2010, scientists at the University of

California, San Francisco published a
comprehensive cellular and molecular
analysis of changes in the intestinal mucosa
of a patient with irritable bowel disease.
Active colitis was associated with T-helper
cells producing IL-17 and expression of
pro-inflammatory genes such as IL-17 and IL13RA2. However, during parasitic colonisation
with the human whipworm T. trichiura, the
colitis remitted and there was a decrease in
IL-17-producing cells and a dramatic increase
in IL-22-producing cells. They also saw a
relative reduction in pro-inflammatory gene
expression (Broadhurst, 2010).
Researchers are excited that parasites, and
their secreted products, could be used to treat
inflammatory diseases. Consequently, live
helminths are currently employed in at least
15 clinical trials in efforts to alleviate allergic
and autoimmune disorders. (See the 2013
review by Khan and Fallon in the International
Journal for Parasitology).

Bacteria and worms from healthy people

and animals have been transplanted to
stimulate a healing response in unhealthy
organisms especially in regards to
inflammatory diseases. A study published by
Duke University in April this year added new
insight into parasites and their potential. (Pi,
2015).
The researchers hypothesised that
enhancing biodiversity in laboratory rats,
including treating the rats with worms,
would suppress their immune systems. But
the results were the opposite. They found
enhanced, rather than suppressed, immune
function and increased biodiversity. The
findings add to the growing understanding of
the complex environment in the digestive tract
and its role in maintaining health.
Senior author William Parker, PhD, said the
study suggests that biome enrichment might
serve as an immune trainer to improve
immune function and overall health: In our
clean environment, rats and by extension
humans, are not doing well. We are potentially
seeing a decreased ability to respond to
dangerous antigens while, at the same time,
we respond to things that we shouldnt,
causing allergies and autoimmune problems.
This work demonstrates we all may really
need better biodiversity introduced back in
the system.
The hygiene hypothesis that our overclean environment is causing allergies has
been expanded. There are now good reasons
to think that a whole range of autoimmune
disorders are a result of our diminished
exposure to organisms like helminths.
Prof Graham Rook, from the Centre for
Clinical Microbiology, University College
London, developed the old friends version
of the hygiene hypothesis in 2003. He
said: The rise in allergies and inflammatory
diseases seems at least partly due to gradually

The rise in allergies and inflammatory diseases

seems at least partly due to gradually losing contact
with the range of microbes our immune systems
evolved with, way back in the Stone Age. Only now
are we seeing the consequences of this, doubtless
also driven by genetic predisposition and a range of
factors in our modern lifestyle - from different diets
and pollution to stress and inactivity. Prof Graham Rook,
Centre for Clinical Microbiology, University College London.
losing contact with the range of microbes our
immune systems evolved with, way back in
the Stone Age. Only now are we seeing the
consequences of this, doubtless also driven by
genetic predisposition and a range of factors
in our modern lifestyle from different diets
and pollution to stress and inactivity. It seems
that some people now have inadequately
regulated immune systems that are less able
to cope with these other factors.
Rook suggests that the old friends include
commensal organisms (the normal microbiota
of the skin, gut and respiratory tract of
humans) and some potentially pathogenic
organisms such as helminths (worms), which
can establish chronic infections. These latter
have to be tolerated, because attempts by the
immune system to eliminate infections that it
cannot remove only leads to pointless tissuedamaging inlammation.
Prof Rook said that it now looks more
and more likely that the development of
our regulatory immune system depends on
molecules that are encoded not in the genome
of the human, but in the genome of some other

organism we lived with throughout history.

(Rook GA. 2010).
Scientists are now suggesting that we
need constant exposure to a diverse range of
old friends, not just speciic microbes. The
most likely explanation of this need for daily
exposure to microbes, particularly in early life,
is because they interact with the regulatory
systems which keep our immune systems in
balance. Without this our immune systems
may overreact, react inappropriately, or fail to
switch off completely when no longer needed,
which is an underlying cause of these diseases.
Prof Jan Bradley, a parasitologist from the
University of Nottingham, said: If you dissect
any free-living organism it has worms. Its full
of them, in its blood, in its guts, everywhere.
Prof Bradley continues: It is only in the last
50 years in Britain that humans have been free
of worms. In the past we would have eaten
our own sewage through contaminated water
systems or spreading it on crops. Even getting
bitten a lot by insects would help to keep a
healthy amount of worms in our system. We
have evolved to have worms. Worms can have

unpleasant consequences but also maybe

theres a positive side that we can exploit in
new therapies for allergies.
In 2014, Prof Bill Gause, Rutgers New Jersey
Medical School, and colleagues showed that
intestinal helminth infection may indirectly
affect inlammation by inluencing the
composition of the intestinal microbiome.
Studies suggest that intestinal helminthinduced responses have potent systemic
effects on the immune system, raising the
possibility that whole parasites, or speciic
molecules produced by them, may be an
important resource for the development
of future immunotherapies to control
inlammatory diseases (Mishra, 2014).

Cross-talk with the microbiome

While it appears some worms can actually help

the immune system of their hosts, very little
was known about how worms interact with
the hosts immune system. However a new
study from the Ecole Polytechnique Fdrale
de Lausanne (EPFL) shows that these effects go
through the guts bacteria (Zaiss M, 2015).
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The EPFL laboratory has shown that
the anti-inflammatory activity of intestinal
helminths involves cross-talk with the
microbiome. The researchers looked at the
effects of helminths that infect pigs. After
chronic infection with the helminths, they
discovered that the animals metabolism had
been changed drastically: specifically, they
produced increased levels of short-chain
fatty acids. These SCFAs produced by the
microbiome can activate a family of receptors
that in turn influence the immune system.
The receptors are also known to contribute
to certain functions and malfunctions of the
colon, and are even involved in modulating
allergic airway disease.
The same results were found when they
monitored cells in the immune system of
mice that had been infected with a helminth.
Further testing showed that these acted on the
same receptors to influence specific immune
cells. In short, the researchers uncovered
a clear link between worm infection, the
microbiome and the immune system.
The work highlights the microbiome as a
new pathway through which helminths could
influence the immune function of the host.
Prof Nicola Harris of EPFL said: Its not the
whole story, but it opens up an additional,
intriguing way to explain, and perhaps exploit,
the strategy with which intestinal worms
communicate with the hosts immune system.
A review published in Nature showed
there is increasing evidence that intestinal
helminths can control harmful inflammatory
responses and promote homeostasis by
triggering systemic immune responses
(Maizels 2003). Induction of separable
components of immunity by helminths, which
includes type 2 and immune regulatory
responses, can both contribute toward
the reduction in harmful type 1 immune
responses that drive certain inflammatory
diseases. Despite inducing type 2 responses,
intestinal helminths may also down-regulate
harmful type 2 immune responses, including
allergic responses.

In conclusion

In conclusion, it seems that our declining

exposure to helminths and increasing
bacterial dysbiosis, alongside the overuse of
antibiotics and poor dietary choices, have all
contributed to the rising incidence of immune
and metabolic inflammatory disorders in
industrialised countries.
Parasites can be friends or foes; however
what is very clear is that we need to make
better lifestyle choices on a daily basis in
order to create a more desirable balance in
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Whipworm and autism: one

boys symptoms disappear
Stuart Johnson, an American father of a
severely autistic child, has made a significant
connection between the eggs of the
whipworm and autism.
His son, Lawrence, displayed many typical
autistic behaviours, such as no interaction
with other children, fixations, poor impulse
control and self-abusive behaviour. As he
matured, his agitation, anxiety and selfabusive behaviours became more severe,
and he also had a number of severe allergies.
Stuart observed that the autistic behaviours
improved when his son had a fever or cold.
Equally, his behaviours would become more
severe when his seasonal allergies were at
their worst.
The tipping point came when his son went
to summer camp. Instead of having to collect
him after a day or two, the boys behaviour
improved to such an extent that he was able
to stay for the whole week. When he collected
Lawrence, he found his sons legs were
covered in Chigger bites, which cause a very
powerful immune response in humans. His
autistic behaviour was significantly reduced,
but returned once the bites healed.

our health and environment. It may also be wise

to show respect towards parasites. We are only
at the very beginning of our understanding of
their potential benefits for humans, however
when there is a parasitic overgrowth that is
causing negative symptoms for the individual it
must be addressed appropriately.
In the next and last article in the series
we will take a close look at when and how to
appropriately address parasites when they are
causing challenges to a persons health and
wellbeing. cam
References online at www.cam-mag.com/references.

This set Stuart on a path of research

that led to a number of studies relating to
ulcerative colitis and Crohns disease, all of
which involved introducing helminths in the
form of porcine whipworm eggs (Trichuris
suis ova, or TSO) to patients.
Researchers thought that TSO could
down-regulate the human immune
response, which Stuart felt was the reason
why his sons behaviour changed with the
Chigger bites and when he was unwell with
fevers.
After discussion with Dr Eric Hollander,
Director of the Seaver and New York Autism
Center of Excellence and Chair of the
Department of Psychiatry at Mount Sinai
Medical Center in New York, Lawrence was
treated with TSO ova. After eight weeks
on a dose of 2500 ova bi-weekly, they saw
significant improvements in Lawrences
behaviour. After ten weeks the symptoms had
disappeared. The treatment has continued,
with no re-occurrence of symptoms.
Additionally Lawrences nut allergy and
seasonal allergies have disappeared.
http://autismtso.com.

About the author

Emma LanE, ND, Dip NT, CMTA, C.H.E.K IV,
HLC3, PEA, RSA, has more than 25 years
experience in the industry, working as a
naturopath, naturopathic nutritionist and
functional medicine practitioner. Emma has two busy
practices in the north of England and central London,
and is also the founder and director of Integrative Health
Education and PCI Europe. Emma regularly lectures
around the world and is passionate about sharing her
knowledge with other practitioners. She works closely
with Dr Omar Amin, a world-renowned professor of
parasitology. For more information about parasite testing
go to www.parasitetesting.co.uk. The World of Parasites,
Fungus and Bacteria course taught by Emma Lane: www.
integrativehealtheducation.co.uk.