helminth immunology

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Worm proteins injected intraperitoneally (shot in the abdomen) ameliorate colitis in mice.

http://www3.interscience.wiley.com/journal/121530207/abstract?CRETRY=1&SRETRY=0

“Conclusions: Treatment with proteins of S. mansoni and A. caninum ameliorated TNBS-induced colitis in mice. S. mansoni proteins increased mRNA expression of regulatory cytokines while suppressing expression of proinflammatory cytokines. Therefore, we suggest a therapeutic potential for helminth proteins in the treatment of IBD.”

This is probably the way helminth therapy will go. A shot every 2 weeks in the abdomen. No icky worms to think about. All sterile and in a nice box in the fridge. No worries about worm death…I wonder if it will hurt as much as Humira…

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One of the things those with Crohn’s disease ponder is the relationship between MAP (mycobacteria subspecies avian paratuberculosis) and helminths. MAP is one of the infections that some people think causes or contributes to Crohn’s, as it is abundant in our milk supply, survives pasturization and is very similar to Johne’s disease, which is basically Crohn’s in cattle.

The depressing thing about MAP, is like most mycobacteria, it is exceptionally hard to kill. Triple antibiotic therapy, usually for a course of many years, is required, and it is similar in leprosy in that one may never eliminate the infection, as it is even slower growing.

So how would helminths alter an existing infection? I was just reading Weinstock’s and Elliott’s patent on all use of helminths for all autoimmune diseases, and it mentions in the mouse model, that those mice infected with an existing mycobacterial infection, given helminths, have altered response to that infection:

“The immune response to helminthic parasites promotes Th2 responses to unrelated antigens. Infestation with helminthic parasites, which all induce Th2-type inflammation, can modulate the Th1 immune response to unrelated concomitant parasitic,
bacterial and viral infections (Kullberg et al., 1992, J. Immunol. 148:3264).

Animal experimentation supports this contention. Mice infected with Mycobacterium avium develop chronic Th1-type granulomatous inflammation in the lungs and liver. Splenocytes and granuloma cells from these infected animals normally produce
IgG2a and IFN-γ, and no IL-4 or IL-5. However, mice infected with S. mansoni after the establishment of Mycobacterium avium infection form mycobacterial granulomas containing eosinophils. Also, splenocytes and granuloma cells from co-infected
mice secrete more IgG1 and much less IgG2a. The cytokines released from these cells both constitutively or after mycobacterial antigen stimulation include IL-4 and IL-5, and much less than normal quantities of IFN-γ.

Th1 responses promote IgG2a production, whereas Th2 reactions enhance IgG1 and IgE. FIG. 3 shows that mice infected with M. avium have high serum IgG2a levels. Yet, co-infected animals have normal serum IgG2a concentrations, but increased IgG1
and IgE levels.

These data taken together show that a Th2 response to a helminthic infection can down-modulate the ongoing host response to even a strong Th1-inducing organism like M. avium.”

For those of us possibly infected with MAP, helminth infection should down-modulate the immune response. At least according to this patent.

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Always an American, too many choices.

Oh, the selection in the hookworm market! I can a) wait and get no more larvae; if I’m not better by X amount of months I can b) get more slowly – 2 or 3 every few weeks or c) get more quickly and possibly suffer the ill effects. I’m impatient. I want wellness now. But which method to choose? I deliberate constantly.

The choice of worm burden seems arbritrary. Throw up your hands and choose between 10 and 50 worms, with no idea of how many will remain, how many at a time will “stick”, how the body will react. Worm Russian Roulette.

This study showed that 2 already infected healthy men, who added 50 worms, ended up with an immune response that basically killed the new infection, or displaced some of the old ones, so that they ended up with the same worm burden they started with:

http://www.ncbi.nlm.nih.gov/pubmed/16890593

So how many to add? Who knows? I don’t want to go back to Mexico to get reinfected. I live in the same town as Jasper, so perhaps we could reinfect locally. I don’t think this therapy should be illegal in the US – if it is proven that we as human animals are meant to coexist with helminths, then we should be able to get free worms, or just pick up a prescription in the larval section of your favorite drug store. But that is probably never going to happen. Most people will have to wait decades for the drug derivative.

But I am a walking scientific experiment. Dr. Pritchard gets the deserved admiration for infecting himself with 50 larvae as part of the dose-ranging trials of hookworm. They define the necessary eggs per gram of stool for therapeutic effect as 50 eggs/gram. All doses; 10, 25 and 50 (the woman who got 100 had to terminate due to relentless vomiting and diarrhea) resulted in the necessary egg count. I should test to see where I’m at, but I don’t know how.

Yet I’m tired, still so tired. Will more worms boost me or simply add to the fatigue? The Crohn’s study is still recruiting, so no one knows yet if 10 worms will be enough. The average worm burden in New Guinea is 25 worms, and one assumes they are gotten in little doses, starting from childhood, not 10 or 20 all at once. Which is where “trickle therapy” comes in. In an interview, Dr. Pritchard said,

“The average worm burden of a person in Papua New Guinea is 25 worms. It’s this sort of level that we think is beneficial. Whether we can mimic this in a hospital in Nottingham is difficult to say, because we’ll be giving ten worms in one dose after the person has already developed allergy. So the trial may not work this time. We may have to go back to ‘trickle infections’ where we give small numbers over an increased length of time.”

So should I try the trickle infection now, for lack of better knowledge? So many choices, just one body to experiment on. What do I do?

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