Can Hookworm Infection Cure Celiac?

Several companies are looking for a celiac disease treatment in the pharmaceutical realm, but one Australian group is experimenting with something a bit more unusual: human hookworm infection.

In a paper published earlier this week in the International Journal for Parasitology, the group reported on trials in which they purposely infected celiac disease patients with the hookworm Necator americanus. The results were intriguing, to say the least.

The experiment, conducted in Australia, involved volunteers with celiac disease who agreed to be infected with the hookworms and then undergo a gluten challenge to measure their responses. Half of the people were infected with hookworms, and the remainder served as the control group.

The researchers found that hookworm infection did alter the volunteers' responses to gluten: part of the inflammatory response in the small intestine was suppressed during the gluten challenge, but other measures of an inflammatory response appeared to rise following the challenge.

Nonetheless, villous atrophy developed in the volunteers following the gluten challenge regardless of whether they had been infected with hookworms or not, indicating the hookworms didn't prevent the intestinal damage associated with celiac disease.

However, the researchers still believe they may be onto something: it's possible, writes study author Dr. John Croese, that the study didn't use enough hookworms to make a difference. It's also possible, he says, that the gluten challenge (four slices of bread for five consecutive days -- yikes!) was too abrupt and intense. These potential problems could have obscured any effects of hookworm infection on celiac disease, the researchers conclude.

Therefore, the Australian research team has begun another trial involving more hookworms and much less gluten per patient, in an effort to see if it's possible to induce a better immune system response.

This all probably seems far-fetched, but Dr. Croese and his colleagues explain that autoimmune disease (remember, celiac disease is autoimmune) has increased as sanitation and overall infectious disease prevention have improved. This is known as the "hygiene hypothesis," which holds that our immune system tends to overreact when we remove most of the parasites from our environment (and our intestines).

Therefore, as the theory goes, intentionally reintroducing the hookworm into the small intestine of people who have an immune system response to gluten might alter that response, leading to a potential treatment or cure.

However, hookworm infection is not without its own risks. The little beasts can cause gastrointestinal symptoms on their own, especially in people who haven't been infected with them before, and in severe cases cause anemia and protein loss. Nonetheless, it will be interesting to see if the human hookworm provides a potential treatment or cure for celiac disease.

• Learn more about other potential treatments: Celiac Disease Drugs in Development

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Photo courtesy of the Centers for Disease Control and Prevention