The subtext of this article is, “We got white people problems!“. Humor aside, it has not escaped the notice of the medical community that autoimmune disorders (including Crohn’s) are almost entirely exclusive to first world, developed countries. Visit places less developed, and you will find something interesting. Rather, you WON’T find something interesting… you won’t find asthma, IBD, MS, psoriasis, eczema, food allergies, or any of the other non-contagious autoimmune diseases that one finds here. That’s not to say they don’t exist there, but they exist in numbers that, at one time, were more closely reflected in our own culture. Crohn’s occurs in something like 1 in 10,000 people, as opposed to first world countries, which are seeing rates closer to 1 in 250.
While most researchers are asking questions like, “What’s changed that’s causing increased rates of autoimmune disorders?”, or “How can we better manage symptoms of autoimmune disorders?”, there are a few out there that are asking a different question…. “What’s occurring in the developing and undeveloped countries that’s *preventing* this increased incidence?”. This is a fundamentally different approach.
More than one researcher has concluded that one of the primary factors that is now missing in our developed world is the prevalence of parasites, in particular, gut-residing worms. Helminths are a class of parasitic worm that includes hookworms and whipworms. Some helminths are incredibly dangerous and can lead to anemia, malnutrition, even death. Others are more innocuous, however.
Helminths generally invade during the larval stage by burrowing through the host’s skin (they are quite small… microsopic, even). From there, they make their way into the gut and take up residence, where they feed on whatever the host eats. Their eggs or larva are evacuated along with the host’s poo, and there they wait until either another host come along or they die.
“How the heck”, you might ask, “does this help to reduce instances of Crohn’s??”. After all, if Crohn’s is the result of an over-active immune system, wouldn’t adding a parasite to the mix only aggravate the immune system more? That’s a totally reasonable conclusion, and according to these researchers, totally wrong. Think about it… how tough would life be as a parasite if you had to deal with being attacked by the immune system all the time? The thought is that helminths have developed a mechanism for actually *calming* the immune system, thereby making the host more hospitable.
Another part of the theory behind helminthic therapy is the learning nature of the immune system. The human immune system is a learning system that develops proper response as a result of stimulation. Medical sciences in the industrialized nations (and the easy access to medical care) has resulted in an environment where our immune system is exposed to relatively few stimuli. As such, it is never properly ‘calibrated’. The introduction of helminths gives the immune system something to work with, and helps to teach the immune system proper response.
As a theory, it’s all well and good, but there has actually been some clinical research into the effectiveness of helminthic therapy, specifically targeting Crohn’s. In that study, fully 75% of the patients went into full remission, apparently as a result of the introduction of pig whipworm into their gut. More info here: Wormy Cocktail Fights Crohn’s Disease
Obviously, there are some pretty serious hurdles to introducing helminthic therapy as a mainstream treatment for Crohn’s. There’s the obvious ‘icky’ factor at play… as a culture, we have not only excised most parasites from our physical existence, but we’ve imbued them with a powerful ‘wrongness’. But aside from that, there are serious issues with regulation, quality of production, distribution, etc.
Personally, I think I’d have some difficulty following this therapy unless I’d exhausted a few other options first. It’s certainly less undesirable than, say, corticosteroids. But the aforementioned ick factor would definitely be a hurdle. What about you? Have you considered it? Would you?