Tuesday, 15 March 2016

Helminth Worms for MS..Is this the future

Peón AN, Terrazas LI. Immune-regulatory mechanisms of classical and experimental multiple sclerosis drugs: a special focus on helminth-derived treatments. Curr Med Chem. 2016 Mar 10. [Epub ahead of print]

Multiple sclerosis (MS) is the most prevalent autoimmune disease affecting the central nervous system (CNS). Its pathophysiology is centered on neuron myelin sheath destruction in a manner largely dependent upon CD4+/CD8+ T-cell autoreactivity against myelin antigens, inducing Th1/Th17 pathogenic responses with the resulting production of free radicals and soluble mediators that exhibit the effector mechanisms of neurodegeneration. The immune response responsible for this disease is complex and challenges modern medicine. Consequently, many experimental therapies have been proposed in addition to the classical array of immunoregulatory/immunosuppressive drugs that are normally used to treat MS....Special emphasis is placed on helminth-derived immunoregulators, as some of them have shown promising results. Additionally, we will compare the mechanisms of action of both the MS drugs and the helminth-derived treatments to discuss the potential importance of some signaling pathways in the control of MS.



It seemed like years ago when infection with worms was considered to be a useul approach to treat MS. This is based on the idea from animals that Th1=BAD and Th2 =  GOOD. As a Th2 response (Types of T helper cells than make cytokines that stimulate B cells and are involved in Allergy) can block a Th1 response (Types of helper T cells than make cytokines that stimulate autoimmunity). Fuelled by some anecdote....people were requested to volunteer to become environmental polutants (infected Pooh?) and be infected with worms. They would be imaged to see if lesion load is reduced and then the worms will be killed.
What has happened to the trials? There are a few going n in the world.

TheWorms for Immune Regulation of Multiple Sclerosis (WIRMS)
has completed in January 2016.

The trial started in January 2011 and it has taken until January 2016 to get 72 people to do a year long study according to clinical tials.gov. NCT01470521. Pharma would have lost interest if their phase II took 5 years, but its shows how long it can take academics to do trials, because recruitment at single/few centres is not easy. How long would a phase III take?

Maybe the original idea was made by people so young, or older people with selective memory loss, that they are woking with very clean animals, which animal houses now are. 

However, before the 1980s University animal houses were fizzing with infections (e.g. pinworm and viruses) and I can remember counting the number of live worms coming from the pooh of the animals. Did that stop animals getting EAE....well no. Did those woms not make a TH2 response. (I have heard Protagonists re-write history saying that in the bad old days you could not get EAE to work in worm-infected animals). Will the TH2 switch stop MS..Let's see, I may have to eat it. However I personally think Th1= BAD and Th2 = BAD, you don't want either.

If the original study from Argentina repeats itself then the trial will show that there are less MRI lesions in people given hookworms (will 25 be enough), but will it be 90% reduction seen with pharmaceutical DMT. If it isn't will this be seen as being positive. Surely we will find out at ECTRIMS2016 or before....

P.S. Has the rate of Hookworm infection increased in the Nottingham area:-)

10 comments:

  1. Hookworms were on the BBC website a few days ago about developing a hookworm vaccine. They also are looking to engineer the worms as medicine for different conditions.
    http://www.bbc.co.uk/news/health-35779112

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    1. Maybe the people of Nottingham have been spreading eggs:-)

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  2. Had a break from the computer for a few days, came back to find more DMT stuff and some worms. I'll go back to the gardening. (I prefer earthworms.)

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    1. Sorry not aware of earthworm use in MS..next time you come back it may eb the movectro road show so more good stuff. deja vu?

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  3. You are not "given hookworm egs". The biology of the hookworm, nectar americanus, is such that the egs develop into larvae in the dropped stool on the ground, the larvae then enter the skin on the host when stepped, on migrate via the veins to the lungs where they are coughed up, swallowed and get to the lower intestines where they lay egs and the proces continues.

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    1. They are given 25 larvae were they sterilised I will have to look up if not you get adults you get eggs?

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    2. ps I was never any good on parasite life cycles...
      I was asked what is life cycle of tse tse fly... eggs lava pupae adult eggs..easy ? live birth apparently:-(

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  4. If Th2 stimulates B cells, certainly will not be anything good ...

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  5. http://multiple-sclerosis-research.blogspot.com/2015/02/parasite-eggs-not-much-use-in.html

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