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Comment by BugsJustFindMe | Hacker News Reader

So I keep reading reports about how hookworms are like a super cure for autoimmune disorders from allergies to Crohn's disease. Does anyone know why we can't just inject, ingest, or apply whatever it is that they emit? Like...why is there not a treatment for eczema yet better than steroid creams?

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The three things that come to mind are

A) it's extremely time-consuming and difficult to capture the mechanism for how organisms act in the middle of the human body in the middle of their lifecycle when we're not even sure what we're looking for, so it's just not been found yet.

B) it might just be safe and cost-effective enough to give people worms temporarily as a treatment instead for now. (I don't know if this is the case, but if they're doing it for a study, the risk profile can't be that bad...)

C) even if we isolate whatever mechanism they have (and can synthesize it readily), it's still an immune modulator, so all the same caveats for steroid creams might apply at any significant dose.

> even if we isolate whatever mechanism they have (and can synthesize it readily), it's still an immune modulator, so all the same caveats for steroid creams might apply at any significant dose.

Sure, but it wouldn't be an infection you could spread to other people. It also wouldn't be an infection that could grow, of its own accord, to undesirable levels within you. That's a huge improvement.

I suspect any final form for a “live” treatment, would probably be a two part sort of thing. “Take worms/eggs day 1, day 2, 3 or 4 you take the anti worming drug to prevent the worms getting much of a foothold”

The pig whipworm eggs used previously for this purpose can hatch in the human body but they cannot survive, so no foothold therapy is needed. Instead, they're just enough to attract the attention of a perhaps overly-excitable immune system.

> The pig whipworm eggs used previously for this purpose can hatch in the human body but they cannot survive

If this became a routine treatment, it seems pretty likely that they'd start being able to survive.

That doesn't really follow.

For something to evolve like that you need to re-introduce the mutated strains back to the source.

If there is no re-introduction (which there wouldn't be, because the worms would be bred in an isolated environment and not the sewer system), then there isn't really anything to worry about. There is no selection pressure at the point where breeding and distribution occurs.

even if the 'gradually-evolving' process isn't provided, isn't there some genetic chance? (be it really small -- like lottery?)

The mutation would have to happen in the lab and not in the wild, since the pills would come from the lab.

I imagine if such a thing did occur, they would just kill the batch they were breeding and start over from a known strain.

(Not a microbiologist, so who knows though)

Why would you need to reintroduce the mutated strains back to the source? They already have a plan for migrating from one host to another host; they don't need to migrate from their host back to a lab so their laboratory-bred eggs can be intentionally introduced into another host.

You might end up with strains that could survive in humans, but those wouldn't be the strains being prescribed to people.

Be warned that parasites are generally pests, and in normal circumstances don't typically cause serious problems for a host.

However when crossing hosts signals can get crossed and they can cause serious health problems like eating your retina, brain, hearts, etc. Be very careful with parasites that aren't evolved for humans.

They don't usually cause serious problems for hosts they coevolved with.

Necator Americanus was always specialized to infect humans. But it evolved to infect Africans, who brought it to the new world. For blacks, it doesn't pose much of a problem. For whites, it does.

https://en.wikipedia.org/wiki/Helminthic_therapy

Helminthic therapy is a real thing for people with severe autoimmune issues. There are folks in the US right now walking around with relatively mild hookworm infections and substantially fewer autoimmune symptoms :)

Thank you for this. I have an autoimmune disease and welcome any and all alternative therapy options (to discuss with my doctor).

There was an episode of NPR's "This American Life" podcast in 2010 that included the story of someone who had terrible allergy problems and ended up curing that via deliberate hookworm introduction.

https://www.thisamericanlife.org/404/enemy-camp-2010/act-thr...

Because scientists don’t know exactly what the mechanism is yet. But yes, they could potentially identify the mechanism and skip the worms.

That said, Coronado Biosciences ran a pork hookworm clinical trial in the treatment of inflammatory bowel syndrome and it failed. More work needed.

Apparently you can buy "pig whipworm" (Trichuris suis) eggs and ingest them. It seems they can't survive for long in your gut (so there's no danger of an infestation), but it's long enough to trigger whatever cure / autoimmune reset it is that you're looking for.

This is just anecdotal (I know someone who did this and says that it worked) -- but please do your own research and consult a healthcare professional!!!

From what I read on the internet, in order to have benefits a human being would need to get infected with worms in childhood.

The adult in this article said his allergies went away.

This is a bit old but ... https://web.archive.org/web/20060701163959/http://www.kuro5h... (2006, kuro5hin)

Have an autoimmune condition. Medication works well but side effects are brutal.

This is huge gross factor, but if it would give me a normal life I could tolerate it.

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