Helminths & Immune Regulation

Posted By Dr. Braverman || 25-Apr-2014

Dr. Braverman's patients are already aware of the role of inflammation in infertility. And they are likely aware that modern hygiene plays a role in the immune dysfunction responsible for much of this. Many realize that probiotics can be helpful in restoring the natural balance of the organisms in the gut. But few are probably aware of the role helminths play in normal immune regulation.

Helminths are multicellular organisms that normally exist in the human biome, the personal ecosystem that we each carry around with us. Just like the bacteria in our gut that protects us from harmful bacteria and produce vitamins, helminths also produce factors that are necessary for optimum health. However, because in large, unchecked numbers, some helminths can cause illness, we have largely eliminated them with hygiene and medication in the developed world. However, until quite recently in our evolutionary history, they have always been present in us - and they still are in the non-industrialized world. Where helminths still co-exist with humans, many of the chronic inflammatory diseases that plague our modern world effectively do not exist.

To quote Graham Rook, one of the leading researchers into the mutualistic relationship between helminths and humans, "Evolution turns the inevitable into the necessary."[i] Helminths were everywhere – in our soil, in our water – and avoiding them was an absolute impossibility. Thus, these millions of years of inevitable co-evolution have led to us now RELYING on our old friends for important immune regulatory function. Our body recognizes their presence, mounts an attack which is modulated by the helminths to make it not vigorous enough to hurt us or them – and ultimately, we end up with an immune system that is tuned just right.

Simply put, to fight off infections of any sort, our bodies have developed an immune response, which we refer to as pro-inflammatory. All kinds of pathogen-destroying immune cells are turned on to destroy whatever needs destroying. And once the battle is won, the off-switch should be thrown, in the guise of a family of chemicals called regulatory cytokines. (A cytokine is a chemical messenger of our immune system.) Although the pathways are not completely known, helminths induce regulatory (and other anti-inflammatory) cytokine production including IL-10 and TGF-beta. By dampening down the immune system's proinflammatory response, helminths, as invading organisms, create an environment that allows them to continue to exist. That is, in keeping our bodies from mounting an all-out-inflammatory-bombardment which would wipe them out, helminths lower the volume button. They MODULATE the inflammatory system. And due to these higher levels of anti-inflammatory factors, we have also come to tolerate other harmless substances and, like helminths, until recent history are unavoidable…like pollen and cat dander.

This ability of our immune system to recognize but not over react to harmless substances is crucial for maintaining pregnancy: tolerance of harmless substances includes paternal proteins that can erroneously be seen as harmful by the over-activated maternal immune system, thereby causing rejection of the implanting embryo.

There are many different helminths that can colonize the human gut. And there are many more which rarely, if ever, complete their lifecycle in us (as they are native to other animals). These "non-native-to-human" helminths can start to develop in us before being eliminated, thereby having a positive effect on our immune system without establishing a colony. The idea of biome restoration is to replace what has been depleted (to our detriment). This includes both the good bacteria that we are so often missing…and also, to choose our old friends, the helminth (or helminths), which have a positive effect on our immune systems, but which have as few undesirable side effects as possible.

Currently there are four helminths which are being self-administered by people interested in restoring the natural balance of their personal ecosystem: hookworm (Necator americanus), human whipworm (Trichuris trichiura), Pig whipworm (Trichuris suis), and HD (Hymenolepis diminuta). We, at Biome Restoration Ltd., believe that HD offers many advantages over the other three helminths currently being used.

Humans are not the natural host for HD, so colonization (that is, acquiring a lasting colony) is extremely rare. (HD normally completes its lifecycle in insects and rodents, most commonly mice and rats.) Hymenolepis diminuta cysticercoids (HDC, the "infective" stage of HD) come from grain beetles, like the mealy worms many of you have likely seen in a box of cereal from time to time. Even though we don't like to think about it, insect fragments are commonly found in our food. For nothing more than cosmetic purposes, the FDA regulates the amount of insect parts that are allowed in different foods and spices. As you can imagine, prior to modern sanitary practices and food processing, insects were commonly in our food. So HDC was very likely eaten regularly in the past. Indeed, they are likely very commonly eaten in less developed parts of the world today.

On the very rare occasion when human colonization is reported, it is usually found accidentally, by seeing the microscopic eggs in a stool sample. HDC colonization nearly always is asymptomatic. Nearly everyone who currently has taken HDC at home reports no side effects. (If in the rare instance the HDC mature in the human gut, time will usually eliminate them. Or, a single dose of a safe anti-helminth drug (called Prazaquantel) is all that is necessary if rapid elimination is desired.)

And finally, unlike the other three helminths, HD stays entirely in the lumen of the gut and does not obtain its nutrition from our blood or bodily fluids. It simply absorbs nutrients from the food we eat. It literally shares our lunch with us. In experimental colonization of lab rats, there are no visible signs of colonization on the inner surface of the gut. They simply live in the gut peacefully coexisting with their rodent hosts.

For 20 years or more, scientists have been studying the downstream effects of the loss of our old friends, as they are referred to in the medical literature. Dr. William Parker, of the Duke University School of Medicine, states, "Biome reconstitution includes the controlled and population-wide reintroduction (i.e. domestication) of selected species that have been all but eradicated from the human biome in industrialized society and holds great promise for the elimination of pandemics of allergic, inflammatory and autoimmune diseases." [ii]

In fact, helminths have now been used in clinical trials for a variety of inflammatory illnesses with great success. A couple of examples: a 4 ½ year long study of individuals with multiple sclerosis found no progression of the multiple sclerosis in those with helminths, as opposed to those without. Recently, a pilot study of individuals with autism was so successful that a full study will be started in the near future.

We believe that to stem the tide of this epidemic of inflammatory illnesses, biome restoration must begin as early as possible. The immune system does most of its development in the first two years of life. Our hope, our mission – which stemmed originally from our personal experiences with both chronic inflammatory illnesses – is to make biome reconstitution available for everyone and anyone who wants to bring their immune system back into balance.

- Don Donahue, MD, Marc Dellerba, PhD., Judith Chinitz, MS

[For more information on Biome Restoration Ltd., helminths and HDC, please visit our website at www.biomerestoration.com]

[i] Rook, G A E. Review series on helminths, immune modulation and the hygiene hypothesis: the broader implication s of the hygiene hypothesis. Immunology. 2009: 126(1):3-11.

[ii] Parker, W., and J. Ollerton. Evolutionary Biology and Anthropology Suggest Biome Reconstitituion as a Necessary Approach toward Dealing with Immune Disorders. Evolution, Medicine, and Public Health. 2013: 89-103.

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