Human Whipworms (trichuris trichiura) help Ulcerative Colitis

Many articles came out today about the case study of a man with ulcerative colitis who used human whipworms  (trichuris trichiura) as therapy for UC, with colonoscopy samples to supply information on inflammatory pathways and mucus secretion in relation to these helminths:

http://www.livescience.com/health/worm-therapy-stimulates-gut-mucus-101201.html

http://www.baltimoresun.com/health/la-heb-worm-healing-20101201,0,2645483.story

http://discussions.latimes.com/20/lanews/la-heb-worm-healing-20101201/10

From Scientific American: http://www.scientificamerican.com/article.cfm?id=helminthic-therapy-mucus

For the Good of the Gut: Can Parasitic Worms Treat Autoimmune Diseases?

Helminths could suppress immune disorders by promoting healthy mucus production in the intestine

By Ferris Jabr December 1, 2010

human-whipworm-eggs PROPITIOUS PARASITE: Human whipworm (Trichuris trichiura) eggs from a patient who deliberately infected himself with parasitic worms to treat his ulcerative colitis, an inflammatory bowel disease. The worms may have sent his sent his disease into remission. Image: Kimberley Evason, UCSF

In 2007, parasite immunologist P’ng Loke sat down for lunch at a University of California, San Francisco, cafeteria with an inquisitive man who had called him earlier that week. Their chosen topic of conversation would deprive many people of an appetite, but the scientist and his guest shared an intellectual hunger for a stomach-churning subject: gut worms—specifically, tiny worm-like parasitic organisms called helminths that live nestled in the gastrointestinal tracts of their hosts.

Loke was fully prepared to answer the man’s questions about the parasites he knew so well, but what he did not realize was that his companion had more than just questions—he had worms burrowed in his intestinal walls, worms he had deliberately swallowed. Together, Loke and the worm-wrangler embarked on a research project, the results of which appear today in the December 2010 issue of Science Translational Medicine.

The 35-year-old man who had lunch with Loke was quite healthy in 2007. But only a few years earlier he was in the throes of an inflammatory bowel disease known as ulcerative colitis. An autoimmune disease, ulcerative colitis inflames the colon and leaves it rife with open sores; patients experience intense abdominal pain, vomiting, diarrhea, rectal bleeding and weight loss. While searching for treatments, the man discovered the work of Joel Weinstock, a gastroenterologist, parasitologist and immunologist at Tufts University who has pioneered research on helminthic therapy—treating autoimmune diseases by deliberately infesting patients with parasitic worms, such as whipworm and hookworm.

The results of Loke’s new case study—the most recent of only five studies that investigate helminthic therapy in people instead of animals—suggest that helminths may ease the symptoms of autoimmune diseases by increasing mucus production.

“It’s a unique study—there’s nothing like it before,” says Weinstock, who was not involved in the new research. “In this case they had a very unique patient—one who was self-infecting with helminths.” Clinical trials on helminthic therapy are particularly difficult to arrange because helminths are live pathogens and have not been officially approved as therapeutic agents by any governmental agency, although the U.S. Food and Drug Administration has granted pig whipworm (Trichuris suis) the status of Investigational New Drug. In contrast to human whipworm (Trichuris trichiura), the porcine variety cannot survive inside the human gut for very long.

“The researchers noticed a specific pattern of behavior, cycling between remission and active disease depending on when the patient infected himself with helminths,” Weinstock adds. “This is not a double-blind study, but the pattern is highly suggestive that the worms helped this patient. The major point of this paper is the potential mechanism—mucus production—which has not been looked at properly before.”

The Might of Mucus

In the new study, Loke—who is now with New York University—analyzed the man’s medical records prior to 2007 and personally tracked the man’s health from 2007 onwards. In 2004 the man swallowed a vial of salty liquid brimming with 500 human whipworm eggs, which he obtained from a parasitologist in Thailand. Three months later, he slurped down another 1,000 eggs. The larvae hatched and matured within his gastrointestinal tract, burying their heads in the intestinal wall. By mid-2005, he was virtually symptom free and required no medical treatment for his colitis, except occasional anti-inflammatory drugs to suppress flare-ups. The nearly complete dismissal of colitis symptoms is especially striking because human whipworm infection can itself cause digestive problems, including diarrhea, abdominal pain, nausea, vomiting and, in extreme cases, rectal prolapse. Severe infections can also cause anemia and stunt the growth of children.

In 2008, the number of whipworm eggs in the man’s stool began to dwindle, dropping from more than 15,000 per gram to fewer than 7,000 per gram. As the eggs disappeared, the symptoms of colitis returned. So the man infected himself with another 2,000 whipworm eggs and, a few months later, his symptoms practically vanished once again. Repeated colonoscopies revealed that wherever worms colonized his colon, the symptoms of colitis were significantly reduced or nonexistent.

During the 2008 relapse, the researchers found that immune cells in tissues with active colitis produced large quantities of an inflammatory signaling molecule named interluekin-17 (IL-17), but very little IL-22, the latter of which has been linked to wound healing and mucus production. When worms recolonized the colon, however, immune cells began manufacturing much more IL-22. Blood profiling and genetic analysis further revealed that tissues in which helminths thrived increased carbohydrate metabolism—a prerequisite for mucus production.

“Ulcerative colitis is often associated with decreased mucus production and the worms seem to somehow restore mucus production, possibly by inducing a population of immune cells that make IL-22,” Loke says. “It’s possible the mucus serves as a defensive barrier between bacteria and the gut that prevents bacteria from causing inflammation and crossing over into other tissues.” Autoimmune diseases generally occur when the immune system overreacts to benign—and even beneficial—organisms living within the body. In the case of colitis, researchers suspect the reaction is directed toward the bacteria in the gut. Loke thinks that the human body may boost mucus production when it detects helminths as a defense against the parasites; for a patient with ulcerative colitis, the extra mucus may also help calm an excessively aggressive immune system.

“We saw an association with remission and immune cells that make IL-22, but we don’t know for sure if these immune cells are actually induced by worms,” Loke says. “You can’t tell with a sample size of one,” which is especially susceptible to the placebo effect. Still, Loke adds, “the results seems quite compelling, especially when you consider the background—all the animal studies and clinical trials that show worms can suppress colitis and other autoimmune disorders.”

Mounting Evidence

In fact, in numerous animal studies, helminth infestation has protected rodents against colitis, asthma, rheumatoid arthritis, food allergies and type 1 diabetes.

Researchers have conducted few human studies, but most have shown promise. In a clinical trial published in 2005 in the journal Gut, Weinstock asked 29 participants with Crohn’s disease (another autoimmune inflammatory bowel condition) to ingest 2,500 pig whipworm eggs every three weeks for six months. Twenty-three patients (79.3 percent) improved significantly, and 21 (72.4 percent) experienced remission. Both the researchers and participants, however, knew exactly what treatment they were receiving, which makes excluding a placebo effect impossible.

In a controlled clinical trial published in 2005 in Gastroenterology, Weinstock and his colleagues gave 52 participants with colitis 2,500 pig whipworm eggs or a placebo every two weeks for three months. Thirteen of the 29 patients (44.8 percent) who received whipworm eggs improved, compared with only four of the 23 participants (17.4 percent) who received the placebo.

Weinstock and his collaborators point to these trials as experimental evidence that fits a global pattern: immune disorders are much rarer in less developed countries where helminthic infestation is widespread than in industrialized countries where much smaller populations host helminths. The “old friends hypothesis” proposes that the human immune system cannot learn to regulate itself without exposure to common pathogens like helminths that have coevolved with people and that modern hygienic practices deprive people of this necessary exposure, possibly explaining the relatively higher and more recent prevalence of immune diseases in industrialized countries like the U.S.

Loke plans to continue researching helminthic therapy in people and in monkeys. “We are talking about doing a small trial of, say, 10 people and basically doing colonoscopies on them before and after giving them pig whipworm,” he says. Loke also mentions that colitis plagues many juvenile monkeys in primate research centers and that he has received a pilot grant to treat diseased monkeys with human whipworm, an as-yet-unpublished experiment that is already returning promising results.

“When I first sat down to lunch with the guy who called me and he started telling me his story, I was really quite skeptical,” Loke recalls. “But now I am completely changing my mind about helminthic therapy.”

  1. admin’s avatar

    Yeehaw.

  2. Herbert Smith’s avatar

    OK, I need to meet up with Dr. Loke and have him do a case study on me as well. I also have various pathology reports, biopsies, endoscopy reports, etc.
    Doing a capsule endoscopy tomorrow – we’ll see how that goes.

  3. admin’s avatar

    Yes, we should all be case studies! Good luck with your pill cam! May they find lots of worms.

  4. rachel’s avatar

    I want to be part of this study. I have all reports of ulcerative colitis as well.

  5. admin’s avatar

    Rachel, contact Png Loke. He’s in NY, though, so I’m not sure if he’s recruiting case studies out of the NY area.

    http://parasitology.med.nyu.edu/people/faculty/png-loke

  6. Jodi’s avatar

    I would do anything to no feel like this all the time.

  7. Lisa’s avatar

    I have had Ulcertive Colitis for 15 years and would be very interested in being a part of this study, but am located in Raleigh, NC.

  8. admin’s avatar

    There is no study for ulcerative colitis and trichuris trichuria right now. If you were to contact the above researcher he might be able to set you up as another case study if you’re willing to provide before and after colonoscopies. You’d have to procure the organism yourself, either by buying it from one of the two commercial companies, or finding it yourself and learning to work with it like the man in this study.
    http://opensourcehelminththerapy.org/mediawiki2/index.php?title=Providers for more info.

  9. Janice Wilkes’s avatar

    I would be interested in any clinical trials in the Richmond, VA area.

  10. Devin’s avatar

    I have 3 sons with crohn’s and 2 more who look like they will also be diagnosed I’m always looking for new info on cures or treatments, I find this one to be quit interesting and would like more info on trials being done. 2 of my sons have had part of there intestines removed already. thank you.

  11. Chuck Howell’s avatar

    My question if you take on the opportunity to self ingest the whipworms where do your get them and how much do they cost? Thanks for any help. Youngest son just diagonosed with UC.

  12. Brent Jefferson’s avatar

    How can I move in a better direction: For 17 years, I’ve battled with chronic Ulcerative Colitis.
    This illness has taken over my life, leaving me at its mercy. My family, including my wife and four sons, has been greatly affected by my UC. I have made many attempts to use traditional medicines to help improve my condition. I have spent many weeks in the hospital receiving intravenous steroids to get hold of the illness. I could never get a good hold on it, without being on steroids. In the past 2 years, I was in the hospital 5 times due to acquiring viruses after receiving intravenous medications that weakened my immune system. I have exhausted all viable options, with the exception of removing my colon, which I am not comfortable doing.
    I am very interested in helminth therapy and related clinical trials. The cost for Multi-stage therapy plus travel to a clinic is extremely high but I have read as much as I could about his procedure and believe it could be a success for me. Currently I am chemical free from UC drugs and daily life is very rough on me physically and emotionally. I am not able to continue this way.
    Thank you. –Brent

  13. admin’s avatar

    Right now, there are no trials for whipworms and UC. You have to buy them from one of the two commercial companies, wormtherapy.com and AIT. They charge several thousand dollars and you have to travel to Mexico in the case of wormtherapy if you live in the US, or with AIT, you have to know someone in Canada to get them (can’t ship to hotels anymore) or you need to fly to England. You can get more information in the “How to Get Worms ” link of this blog.

    You can buy pig whipworms and have them shipped to your door, but they are expensive too, since you have to drink them every 2 weeks. You can order them from ovamed.org, which links you to the Thailand site, and you just pay and they ship them to you.

    There also is a DIY movement happening, though it would require you to incubate the worms yourself. See:

    http://opensourcehelminththerapy.org/mediawiki2/index.php?title=Main_Page
    for more information.

    No trials currently for UC. I’ve read from Dr. Weinstock that there soon will be Crohn’s trials in Europe, but that won’t help you.

    Good luck!

  14. marilou appleton’s avatar

    my daughter was diagnosed 4 years ago with uc at age 7. we have found a holistic path with chinese acupuncture and herbs. along with a therapy called IMT you can go to their website http://www.centerIMT.com I recently saw on
    Dr. Oz about the whipworm therapy so you may want to check out his website too. http://www.droz.com good luck to anyone who may read this I do understand the agony you all are dealing with…I highly recommend alternative ways of dealing with any sickness that comes your way as much as possible!Doctors are a blessing in so many ways yet they don’t have all of the answers..that is for sure!peace on your path to optimum health and healing!

  15. Michele’s avatar

    I have been battling ulcerative colitis for 6 years now. My life has changed completely. I have tried everything to live a normal life. I feel my life is spinning out of control. I am in a vicious cycle…I need insurance in order to have my routine infusions, so I can work, thus have to work to have insurance and the cycle continues. I NEED an answer. I will do anything to stop this craziness. Even with routine infusions- I am still completely immobilized. I would welcome an opportunity to participate in a study. Count me in~ when the USA decides to allow us to do whatever it takes to get better.

  16. admin’s avatar

    I’m so sorry, Michele. IBD sucks! You can still try worms before the trials; click on my link of “how to get worms” and there are a few choices; TSO (trichuris suis ova) is legal to purchase and they ship to your door in the US; it’s just very expensive, but that would be an option. Also, AIT and wormtherapy are selling trichuris trichuria (human whipworms) but you have to travel to Mexico, Canada or England right now to get them. Also, the TT works for some, not everyone (same as TSO).

    And diet, if you haven’t considered it, SCD or Body Ecology Diet or paleo diet, probiotics. Good luck!

  17. Jane Ciresi’s avatar

    My 27 year old son is plagued with a severe case of UC. I myself have Crohs. I live in N. Y. and my son would be most interested in any study or help you can offer. It is really taking over his life and I hope he might receive some help. If there is any study in the future please let us know. thank you

  18. Joyce’s avatar

    I have colitis and I would like to be a part of the study.

  19. Mark’s avatar

    I have Ulcerative Colits in Florida Tampa Bay , by Bucks Stadium, Dr. Ashwin Mehta gave me prednisone improperly causing failure of remission and massive stretch marks which he said will vanish once prednisone is stopped.

    My colitis got well under a different doctor on its own but Ashtma developed and skin flaking etc.

    So will pig whip-worms help cure these other things that are actually extra-intestinal manifestations of colitis?

  20. Mike’s avatar

    Will a person with Ulcerative Colits that has been so severe that USF GI doctors wanted to do a colonectomy, but then patient refused took Pro-Biotics that Dr.Oz recommended and now the Colitis is so so better as long as I pop the Pro-Biotics pills – way easier then poping Asacol pills that do nothing to help. But one big problem the super expensive ASACOL pills are almost free under Medicaire Part D.

    But the way cheaper Pro-Biotics are not covered by any insurance – humm – this is how USA wastes money and hurts patients.

    Anyhow I now developed Minimal Change Disease or Nephritis.

    Will Pig Whip Worms help cure Minimal Change Disease?

  21. admin’s avatar

    Just to emphasize, THERE ARE NO STUDIES WITH WHIPWORMS AND UC. You have to get the organism yourself, either through the two commercial companies selling them (wormtherapy or AIT) or find them yourself.

  22. admin’s avatar

    @Mike, yeah, my insurance only covers probiotics if you’ve lost your colon. They won’t cover it to PREVENT losing your colon. So I pay hundreds a month for VSL knowing there is a prescription for double strength that my stupid insurance won’t pay.

    (They also won’t pay for the ambulence ride from the emergency room to the hospital at 3 AM. They claim it was non-emergency. So how the hell would I have gotten to the hospital, which doesn’t have an emergency room to be treated? So now I have to spend precious hours of my time fighting for this.)

    The hell we go through is enough, fighting with the insurance companies or our doctors to give us alternatives to colectomies should not be so hard.

  23. admin’s avatar

    Mike,

    I don’t know if whipworms will solve all your problems. The case study guy above still suffers from allergies.

    Hookworms seem to be helpful for allergies and other diseases. Whipworms seem to help colonic disease the most. But it’s a fine line between help and harm. Too many whipworms cause colitis and rectal prolapse. Not enough won’t alter your immune response. What’s the right number? Don’t know, since almost no one is doing egg counts or colonoscopies to assess their population.

    AIT is experimenting with adding hookworms to whipworms after a period of time on the second. The first UC’ers who tried hookworms alone got worse, but wormtherapy has a patient with UC who has gone into remission on hookworms alone, so it’s really unknown at this time who will benefit from what worm, and in what quantity.

    I would call the two providers, ask a billion questions, see if they can tell you their success rate or not, hope they are honest, and go from there.

    AIT has more experience, but wormtherapy is far easier to work with. Jasper denied me worms several times when he got mad at something I said or wrote about. So I really can’t recommend working with him, although many of patients have done well, and they provide excellent service to most. If you do go with them, try to work with Marc only.

  24. Laura Martin’s avatar

    My son suffers from this disease as well. He would love to be a part of this whipworm study. He is 15 and we live in Clovis, CA. Our only other options are remicade or a colectomy. Please help!

  25. mom of three’s avatar

    wow…did lots of research today and found AIT and emailed with Marc, sent in my info form. Appears there is no clinical trials at this point I could find online. Checked w/Tufts Univ. and Dr. Weinstock but still no trials.

    Found the thailand site but unsure of what qty of whipworms to buy, I think they are the pig whipworms…for crohns’ that seems like the better one than the TT or human whipworms. If you go to the site, make sure you calculate the currency right…it’s not in Thailand dollars, it seems to be the Euro currency symbol…after I figured that out and did a conversion I realized shipping is about $90 USD and one bottle of the least count of pig whipworms would run about $280 with s/h. Still a far cry less than AIT with $2900 and I am not interested if they are using human or TT.

    My crohns story, if anyone still cares or has any input…sorry long day and kinda cranky…had this since 16, had 3 surgeries. Have most of my small intestine but in Feb. the surgeon removed all but my sigmoid down to the rectum. Better chance of ice in Hades than me having a formed poop ever again. That being said and livin on Immodium was manageable…amazing what we live with isn’t it..but then my rectovaginal abcesses came back along with fistulas and I basically pooped my freakin panties today b/c I couldn’t make it to the bathroom. So, try Humira and depress my immune system or try whipworms? Choices, choices….

  26. aniko’s avatar

    UC is taking everything i love and hold dear. i amconfined to my bathroom and in pain constsantly. I wish to be part of the study if there is one right now.

  27. nootropics’s avatar

    I enjoyed your wonderful post. awesome stuff. I hope you release many. I will carry on watching

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