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  • Jefferson Adams
    Jefferson Adams

    Could Hookworm Infections Help Cure Celiac Disease?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 11/16/2009 - Could unknown benefits from one of the oldest parasites of the human digestive tract hold the key to cure for celiac disease?

    Australian scientists think so. Encouraged by successful treatments of Crohn's and ulcerative colitis by American researchers using a pig whipworm (Trichuris sues), a team of Australian researchers is recruiting volunteers with celiac disease for trials using human hookworm (Necator americanus).

    The researchers have undertaken a similar preliminary study using a human hookworm in Crohn's patients.

    Researchers hypothesize that the disappearance of intestinal parasites from humans in developed countries may be responsible for the upsurge in many diseases including Celiac Disease, Crohn's, ulcerative colitis, asthma and hay fever.

    Using a small group of healthy people with celiac disease, the investigators will look to see if human hookworm interferes with the human immune reaction to gluten.

    Parasites survive partly by interfering with the host's immune response. The mechanisms they use to accomplish this are similar to those required by a person to regulate against the so-called autoimmune disorders, wherein the body begins to fight against itself.

    The investigators suspect that when parasites are excluded from the environment, some individuals become sufficiently self-reactive to develop an autoimmune disease.

    Using a small group of healthy people with celiac disease, the investigators will test if a human hookworm, Necator americanus, inhibits immune responsiveness to gluten.

    Specifically, they will examine whether hookworm infection will change the immune processes and suppress gluten sensitivity in people with celiac disease.

    Celiac disease is a good model for studying Crohn's disease because both involve similar immune changes. However, celiac patients are usually healthier overall, and, importantly, are not taking powerful immune suppressive drugs, and the provocative antigens (molecules that engage the immune system and provoke the disease) are well known and can be administered or cut out at will.

    In addition to directly benefitting celiac disease sufferers, this study may provide potential guidance in the use of hookworms to control inflammatory bowel disease.

    The study is open to people with proven celiac disease who reside in Brisbane, Australia. Those who enroll will be required to avoid gluten for six months.

    The blinded study will compare disease activity and immunity after a controlled break from the gluten-free diet in celiac patients, before and after hookworm infection.
    The team will use conventional and experimental methods to examine the disease severity and the immune system of celiac subjects before and after being inoculated with N. americanus.

    They will then compare immunity levels of the study subjects
    against those of matched, celiac control subjects (not infected with hookworm), before and after eating four pieces of standard white bread each day for three to five days.

    The initial study group will be small. The researchers will recruit ten subjects for each arm of the study, for a total of twenty.

    Initially, ten larvae will be placed on the skin under a light dressing for thirty minutes, followed by five more after twelve weeks.

    The researchers intend to asses whether the hookworm infection will change the immune processes and suppress gluten sensitivity in people with celiac disease. Outcomes to be measured will be those that reflect the activity of celiac disease.

    Stay tuned to see if hookworm therapy will be coming to a gastroenterologist near you! Tell us what you think. Would you sign up? Comment below.

    Source:
    ClinicalTrials.gov


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    Very interesting. I am all for finding a cure. However, as a mother of a 9 year old daughter who has been gluten free for almost 2 years now, I could never put her through the process as it was described in this article. Heck, I don't think I would do it - never mind her. That being said, I am very glad that others are willing to give it a try in hopes of finding a cure for everyone.

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    It will be most interesting to see the final results of this 'worm trial'. I guess most of us are not happy at the thought of some parasite wriggling around inside of us. But who knows - if it means that we can eat some REAL bread again - HOORAY!

    I was diagnosed as Coeliac in late 2006 and have been very careful to avoid gluten containing foods. I also believe that the longer a person is on a gluten-free diet the more sensitive they become if gluten is accidentally introduced into the diet. I have several other autoimmune diseases which specialists think are definitely connected to Coeliac Disease. Maybe they would improve or disappear with the 'worm treatment'

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    I myself live in the US and have had Crohn's for 10 years and am gluten sensitive (i.e. wheat/gluten triggers Crohn's flareups). I was inoculated with 25 hookworm (Necantor Americanus) this past June. Since that time, my Crohn's symptoms have been getting consistently better and now are a fraction as bad as they once were. Generalized inflammation is much less. However, as far as gluten sensitivity goes, it will get worse before it gets better with this therapy.

     

    This is because the hookworm actually cause the body change anatomically and flatten its villi out (in an attempt to flush the worm out). Even people that historically have no problem with gluten will oftentimes become gluten sensitive at this time due to this for a period of months. After this change completes, the hope with me is that the gluten sensitivity symptoms largely reside, since the worms also promote the creation of peripheral T suppressor cells.

     

    The therapy does not have a linear path of improvement and is long term (the brunt of benefits begin after 4-6 MONTHS, and it will take 1 to 1.5 YEARS to see the full effect) but I have been amazed with my progress so far due to a little worm. Fingers crossed.

     

    BTW, there is a wealth of published literature out there about hookworm and autoimmune diseases. I reviewed all of that, talked to my GI doctor and family, and took the plunge.

    I am amazed at what "rbd" had to say about voluntarily being infected with hookworms. A brave person, although I'm considering it myself. I'd love to hear more about his/her progress. Wonder if it's possible to easily kill those little blood suckers if things went south?

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    I would definitely do this! I actually thought about asking my doc, but then realized since it isn't even through the study phase yet, it would probably be difficult for her to get a hold of some hookworms....I would love to be cured of this!!!

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    I searched this topic after reading about other beneficial effects of hookworm in auto-immune conditions and was very excited to see that it's already being researched! I wouldn't hesitate to participate in clinical trials if any are available in my area, (Northern California).

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    I'm very skeptical about this working. I was recently diagnosed with Hashimoto's Thyroiditis, celiac disease AND a hookworm infestation. I've already got hookworms and they didn't stop me from getting an autoimmune illness or from having autoimmune responses to gluten, casein and soy.

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    well, well, well.....how interesting to read all the above comments. I am one of those participants residing in Brisbane Australia and was fortunate enough to be one of the 'guinea pigs' mentioned. I have been inoculated for over a year now and at the end of the trial, I chose to keep my new buddies (to answer one blog - a single dose of worming tablets will see an end to our friendship!).

     

    I chose to keep my new found friends as they are a naturally occurring parasite and I have felt no side effects - in fact I feel that the effects of incidental 'poisoning' from eating out has been reduced (based on pre-inoculation experiences). I agree with some comments that I had to give it a go with a hope to find assistance in dealing with and hopefully recovering from this condition.

     

    The first stage is over and my understanding is that the consenting control group are also being inoculated after which time, the initial inoculated group will be offered to rejoin the longitudinal study. It is reported that the initial findings are favorable, hence the continuance of the study. To answer Laurie, it may depend on the type of hookworm you have and I guess you can't measure the difference you may feel if you didn't haven't any hookworm - can't have it both ways. Keep on eye on this one!

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    I find this interesting. After 11 years of many unrelated symptoms, 2 naturopaths suspected gluten but blood work was always negative. My own research led me to the possibility of parasites. (puppies, kitties, gardening etc.) After a 3 month parasite cleanse/ diet changes with some positive results it then seemed like a Violent shove into gluten and dairy intolerance. Fasting was the only thing that brought relief. (gastro, muscles, extreme fatigue and many more) Then gluten and dairy free continued the relief of many non classic gluten sensitivity symptoms. I had always thought the parasite cleanse was the link. As with many gluten sensitive people, doctors have been of little help. Even the celiac specialist that sent me my genetic test showing DQ 2.5 with the letter stating I have NO celiac risk, since my endoscopy was normal. Thank You to everyone in this study, blessed health to you all.

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    I think it's important to note hookworms most commonly found in humans are not native to North America but are believed to have arrived during slavery. Hookworm disease is known to cause anemia and iron deficiencies depending on the bodies current state of health. Sufferers symptoms include protein deficiency, mental dullness, heart failure among others, but intestinal absorption is not a feature of this disease. For all that are considering the infection, I would ask if further stressing the body's ability to fight off symptoms of foreign agents is worth simply avoiding an gluten? I don't and I would choose health and listening to my body's natural indicators.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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