From Helminthic Therapy Wiki
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Dedicated to the idea that Helminthic Therapy (hookworm & whipworm therapy) need not be exotic, expensive or rare.
Helminthic therapy is the use of hookworm, whipworm or other helminths (parasitic worms) to modulate the immune system. It is an experimental therapy that has not been approved by any governmental body for the treatment or prevention of disease. Medical authorities of many countries have however, approved research that has yielded very promising results in the treatment of autoimmune diseases with helminths. Successful studies have encouraged further research, and the field appears to be gaining ground quickly. You may review many of these studies on the Studies and Papers page. We are actively seeking all papers or studies in the medical literature relating to helminthic therapy, so please post links to material that is not listed on the site.
The information on this website is an attempt to aggregate the research, the current providers, and the state of this therapy in general. All medical therapies carry some risk. Untreated autoimmune conditions also carry very serious risks. The current medications for autoimmune disease all carry risks, some of them very serious. In the opinion of the website authors, medical providers in the United States, where this website is based, often do an inadequate job of informing patients of the documented side effects, and risks of the procedures and medications that they provide. This website will do its best to point out risks and benefits of this therapy, but at this point it is up to users of helminthic therapy to research the known and possible medical risks.
Wikis work by contributors making changes, anyone who registers on this site can edit pages here. The idea behind Wikipedia and the Wikis like it that deal with single subjects, is that the community of users who grow up around it and contribute to the site will through a process of debate and collaborative contributions produce well written, accurate and referenced content. The quality of the results depend on the size of the contributing community, their abilities and intelligence, and their willingness to research and to reference what is written. Both by themselves and others.
Inherent in the concept of the Wiki is the idea that good information will drive out bad, and that the user or readers of the Wiki should think critically about what they read, evaluating it against other information sources and what they know, until they establish an appropriate level of trust for the particular wiki they are reading. Just because it is written on a wiki does not mean necessarily that the information is accurate, complete or good. Nor, conversely, does it imply that it is poor information, incomplete or unreliable as an information source.
One way to evaluate a Wiki is to use the "history" tab at the top of each page, which allows the user to compare different versions of the page through time. For instance you can use the history tab on this page to compare the first version of this page to the current one, or any two versions. The system even shows what areas have been changed and how. This is a great tool for evaluating the frequency of contributions and updates, the more frequent and active a Wiki is the better, and to compare, using the discussion tab at the same time, to see how debates about contentious issues have been resolved.
At this point in time, none of the website authors are doctors, although we actively seek review and critique of the site by the medical community. The whole website is also set up as a wiki and we enthusiastically encourage participation from anyone who wishes to add links or create content on this website. Potential contributors without experience in editing wikis should either jump in and learn (better) or just post material to the forum, which can then be added by others.
Website Mission Statement
- Helminthic Therapy appears to be an effective therapy for several diseases involving immune dysregulation, of which autoimmune diseases (see Wikipedia definition of autoimmunity here: http://en.wikipedia.org/wiki/Autoimmunity) form a subset.
This website seeks to document the scientific evidence for the efficacy of Helminthic Therapy.
- Helminthic Therapy may be simple enough to be practiced by careful and conscientious individuals, specifically individuals directing their own therapy. This website is an experiment in exploring that idea.
- The medical community should be engaged to the greatest extent possible in exploring Helminthic Therapy. This does not mean interested individuals need wait until Helminthic Therapy becomes fully accepted by the mainstream medical establishment, which may take some time. This website may be viewed as an attempt to aid and further the acceptance of Helminthic Therapy by the medical community. This website especially values commentary, information, and opinion, of any type, from medical practitioners.
- Helminths (hookworms and whipworms) have a long history of involvement with humans and helminth's life-cycles and possible detrimental effects in humans are well understood. This pre-established history of human testing makes Helminthic Therapy somewhat unique in emerging medical therapies.
- The website is dedicated to best practices in Helminthic Therapy and will not be connected to any one therapy provider or practitioner. This website is also completely dedicated to the open exchange of information and the propagation of Helminthic Therapy.
Helminthic Therapy or Helminth Therapy?
This website will use the term "Helminthic Therapy" because the term is consistent with the therapy involving deliberately infecting patients with helminths, and is referred to widely on the web and in scientific literature on the subject using this term.
The therapy concerned with eradicating helminth infections acquired inadvertently, is variously referred to in medical literature as anthelminthic, and anti-helminthic, but also as "helminth therapy", so the terminology can be quite confusing to new comers.
One reason for this is that the concept of helminthic therapy, as used on this website, is quite new and still emerging. References older than the last 7-10 years in the medical literature, regardless of terminology used, almost always refer to therapy intended to eradicate helminth infections.
What Is Helminthic Therapy?
Wikipedia pages aren't always the most clearly written or concise documents due to the group dynamic involved, but the wikipedia page helminthic therapy page is a notably well-written collaborative effort and the best general overview of the field we have seen. From the wikipedia page:
Helminthic therapy, a type of immunotherapy, is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth or with the ova of a helminth. Helminths are parasitic worms such as hookworms and whipworms. Helminthic therapy is currently being studied as a treatment for several (non-viral) auto-immune diseases including celiac disease, Crohn's disease, multiple sclerosis, asthma, and ulcerative colitis. Autoimmune liver disease has also been demonstrated to be modulated by active helminth infections.
The entire wikipedia page is actually a very nice overview of Helminth Therapy, with many citations from medical literature.
Helminth characteristics required for use in therapy
Also from the wikipedia page:
For use as a therapeutic agent, the specific helminth should meet all the following minimum requirements:
- should not have the potential to cause disease in man at therapeutic doses
- should not be able to reproduce in a host, thus allowing control of dose
- should not be a potential vector for other parasites, viruses, or bacteria
- should not be easily transmissible from the host to other people
- should be compatible with a patient's existing medication
- should have a significant period of residence in the host
- must be easily eradicated from the host, if required
A slightly longer list, from a review of helminth-related research1
Ideal characteristics for a therapeutic helminth
- Has little or no pathogenic potential
- Does not multiply in the host
- Cannot be directly spread to close contacts
- Produces a self-limited colonisation in humans
- Produces an asymptomatic colonisation in humans
- Does not alter behaviour in patients with depressed immunity
- Is not affected by most commonly used medications
- Can be eradicated with an anti-helminthic drug
- Can be isolated free of other potential pathogens
- Can be isolated or produced in large numbers
- Can be made stable for transport and storage
- Is easy to administer
Necator americanus (hookworm), Trichuris trichiura (human whipworm) and Hymenolepis diminuta (rat tapeworm) meet these requirements. None of these are known to cause any specific disease in man, although allergic reactions have been reported with T. suis, and anemia has been reported in individuals hosting very large numbers of N. americanus. N. americanus, the species of hookworm used therapeutically, takes on average 0.03 ml (less than one drop) of blood per day from the host, so anemia is only observed in malnourished individuals with very large numbers of hookworms; this scenario has traditionally been a problem with children and some adults in developing countries. Neither helminth is known to be a vector for the infection of the host with other parasites, viruses or bacterium.
In addition, neither helminth reproduces in the host; in both cases, the reproductive cycle requires a period outside the host, with these worms requiring several weeks' incubation in moist soil. As a result, the therapeutic dose can be tightly controlled. The complexity of these helminths' life cycles also means that cross-infestation, even with people living in very close proximity to the host, is highly improbable. The main difference between N. americanus and T. suis is residency time: T. suis has a lifespan of only 2–3 weeks in humans, while N. americanus has an average life span of 5 years. Frequency of dose corresponds directly to lifespan. Both helminths have been demonstrated to have beneficial effects when used in conjunction with existing (conventional) therapies. If eradication of helminths from the host is required at any point, they respond to either albendazole or mebendazole. H. Diminuta responds to praziquantel and niclosamide.
1 Helminths as governors of immune-mediated inflammation David E. Elliott, Robert W. Summers aand Joel V. Weinstock International Journal for Parasitology 37 (2007) 457–464