Hookworm trial offers new hope to MS patients

Date:
June 18, 2020
Source:
University of Nottingham
Summary:
Parasitic worms could offer a new treatment hope for patients
suffering from the autoimmune disease multiple sclerosis, according
to experts.



FULL STORY ========================================================================== Parasitic worms could offer a new treatment hope for patients suffering
from the autoimmune disease multiple sclerosis, according to experts
from the University of Nottingham.


==========================================================================
The findings of the research, published in the journal JAMA Neurology,
show that infecting MS patients with a safe dose of the hookworm parasite Necator americanus induces immunoregulatory responses and boosts the
number of cells which help keep the immune system under control.

The research was led by Cris Constantinescu, Professor of Neurology in
the University's School of Clinical Sciences and a leading MS expert,
and David Idris Pritchard, Professor of Parasite Immunology in the
University's School of Pharmacy, who has spent decades studying the
biology of the hookworm. The study was funded by the Multiple Sclerosis Society.

MS is a condition that can affect the brain and spinal cord, causing a
wide range of potential symptoms, including problems with vision, arm
or leg movement, sensation or balance. Whilst treatments are available,
there is currently no cure.

The study aimed to show that the presence of hookworms in the body
switches off the mechanism by which the body's immune system becomes
overactive -- the main cause of MS -- reducing both the severity of
symptoms and the number of relapses experienced by the patients.

71 patients were recruited for a controlled clinical trial who suffer
from the most common type of the disease, relapsing remitting MS (RRMS).



========================================================================== Symptoms in patients such as vision problems, dizziness and fatigue,
appear and then fade away either partially or completely, and secondary progressive MS with superimposed relapses.

Half of the patients on the trial, received a low dose of the hookworms
-- 25 of the microscopic larvae -- on a plaster applied to the arm,
while the other half received a placebo plaster.

At the beginning of the trial, the participants underwent an MRI scan
to record the scarring or lesions on the brain which are present in MS patients. Over the course of nine months, all the patients were scanned
on a regular basis for new or worsening lesions which can be a tell-tale
sign of relapse.

The results at the end of the trial showed that the total number of
new MRI lesions did not differ significantly between patients receiving hookworm and those receiving placebo. However, more than half the patients
on hookworm had no new lesions at all.

In addition, the scientists found an increase in the percentage of
regulatory T cells found within patients who received the hookworm. These
cells help to keep the immune system under control, and are deficient
in MS patients. The results showed that the hookworm increases this type
of cell which could be beneficial in the treatment of MS.

Professor Constantinescu said: "The findings of our study are encouraging.

Whilst the results are modest in comparison to the current very potent and highly effective treatments available, some patients with milder disease
or more inclined for natural treatments may consider this as an option.

"On the more biological level, it is worth harnessing immunoregulatory mechanisms, for example increasing regulatory T cells in MS (and possibly
other autoimmune diseases). Further studies are now needed to establish
whether different protocols can enhance this benefit. For instance, would
a booster infection in around nine months enhance the regulatory T cells responses and enhance the clinical/radiological benefit?" Professor
Pritchard is equally encouraged by the results of the trial. He said:
"In essence, we were able to safely and easily deliver a living drug to
humans, an organism which has long lasting modulatory effects on the
immune system, given the time the adult parasite is resident in the
small intestine (years).

Clearly, this study has set the scene for follow up trials, where I
would envisage booster infections being given to enhance the immune
modulation already recorded. The dosage used in the current study (25
larvae) was the maximum permitted under regulatory guidelines, therefore boosting with this dose would be preferable to increasing the level of
primary exposure."

========================================================================== Story Source: Materials provided by University_of_Nottingham. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Radu Tanasescu, Christopher R. Tench, Cris S. Constantinescu, Gary
Telford, Sonika Singh, Nanci Frakich, David Onion, Dorothee P. Auer,
Bruno Gran, Nikos Evangelou, Yasser Falah, Colin Ranshaw, Cinzia
Cantacessi, Timothy P. Jenkins, David I. Pritchard. Hookworm
Treatment for Relapsing Multiple Sclerosis. JAMA Neurology, 2020;
DOI: 10.1001/ jamaneurol.2020.1118 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200618150223.htm

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