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Porcine Whipworm Active Against Crohn's Disease: Presented at DDW
By Charlene Laino
NEW ORLEANS, LA -- May 20, 2004 -- The porcine whipworm Trichuris suis may be effective for the treatment of Crohn's disease, suggest the results of an open-label study.
Joel V. Weinstock, MD, Professor of Gastroenterology-Hepatology, and Director, Center for Digestive Diseases, University of Iowa College of Medicine, Iowa City, Iowa, presented the findings here on May 18th at the Digestive Disease Week Annual Meeting.
Worms "don't just sit around; they have beneficial effects," he added. Colonization with helminth, a parasitic worm, is associated with down-regulation of the immune response, and Crohn's disease appears to result from an inappropriate immune response to normal gut flora, Dr. Weinstock explained.
"Crohn's disease, like many other disorders, is a disease of the 20th century," he said. "We're the only people in history who have lived without [intestinal] worms. So we wanted to see if giving worms could be therapeutic."
To determine if use of T. suis – a genus of nematode worms comprising the whipworm – Dr. Weinstock and colleagues conducted a study of 29 patients with a score of 220-450 points on the 600-point Crohn's Disease Activity Index (CDAI) and had not responded to conventional treatments.
All the patients were administered 2,500 T. suis ova, dissolved in a popular beverage, every 3 weeks, and were evaluated for 24-weeks, Dr. Weinstock said. The researchers used pig whipworm, which colonize in humans for a short period of time he said.
By week 12, 62% of patients were in remission, defined as a CDAI of less than 150 points. Altogether, 76% of patients experienced a decrease in CDAI of more than 100 points or had a CDAI of less than 150 points.
There were no side effects or complications due to the therapy, although 4 patients dropped out of the study when their symptoms flared up and another withdrew due to pregnancy, Dr. Weinstock said.
Future research should include study of other helminths, which might be even more potent, he said, adding, "we might be able to isolate the compounds in worms that are responsible for the beneficial effect and use them to create new synthetic agents."
[Presentation title: "Trial of helminth ova in active Crohn's disease." Abstract 580]
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