Date: 09.12.2021

Return of the Worms

Immunologists and parasitologists are working to revive the idea that helminths, and more specifically the molecules they secrete, could help treat allergies and autoimmune disease.

In the middle of 2020, Alex Loukas deliberately infected himself with intestinal worms. The procedure was pretty straightforward: he used a Band-Aid to press a few larvae of the New World hookworm (Necator americanus) gently onto his forearm, and waited for the microscopic critters to burrow on in. Although it wasn’t painful, exactly, he describes a tingly feeling like “little tiny electric shocks as these guys go through your skin,” he says. “It’s intensely itchy for a number of days and then that resolves.” Some people who undergo this process experience stomach discomfort when the worms arrive in the gut, where they will grow up to 1 cm long, but many “will then never have any other clue that they’re infected.”

There were several reasons that Loukas wanted the parasitic worms, or helminths, on board. For one thing, his research at James Cook University in Australia focuses on multiple aspects of N. americanus biology, and as obligate human parasites, these intestinal worms just don’t grow very well outside of people. Rearing a few in his own gut and then collecting eggs via a bathroom visit would be a lot simpler than trying to maintain a population in the lab, Loukas explains. (Judging by how many eggs he’s currently shedding—he estimates it’s around 20,000 per day—his worms seem to be doing just fine.)

Loukas has also, in the course of his research, developed the view that infection with N. americanus and other intestinal helminths, which together are thought to inhabit at least 2 billion people worldwide, isn’t always harmful. In fact, he argues, work by his group and others indicates that there could be some unique benefits to controlled, low-level infection with certain worm species, particularly for combating so-called Western diseases, including allergies, autoimmune disorders, and various other inflammation-related conditions. As an advocate for exploring helminth infection as a potential therapy against such conditions, Loukas realized he had to give it a go. “I’m sitting there telling the world how great this is,” he recalls thinking. “I should probably experience it for myself.”

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Biology Centre CAS
Institute of Parasitology
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370 05 České Budějovice

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