Clinical Reviews in Allergy & Immunology

, Volume 45, Issue 2, pp 211–216

The Hygiene Theory Harnessing Helminths and Their Ova to Treat Autoimmunity

  • Dana Ben-Ami Shor
  • Michal Harel
  • Rami Eliakim
  • Yehuda Shoenfeld
Article

DOI: 10.1007/s12016-012-8352-9

Cite this article as:
Ben-Ami Shor, D., Harel, M., Eliakim, R. et al. Clinic Rev Allerg Immunol (2013) 45: 211. doi:10.1007/s12016-012-8352-9

Abstract

The incidence of autoimmune diseases is increasing in Western countries, possibly due to the improved sanitary conditions and reduced exposure to infections in childhood (the hygiene hypothesis). There is an ongoing debate whether infection prevents or precipitates autoimmune diseases. Various helminths species used in several animal models were shown to limit inflammatory activity in a variety of diseases including inflammatory bowel disease, multiple sclerosis, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus. At present the scientific data is based mostly on experimental animal models; however, there is an increasing body of evidence in a number of clinical trials being conducted. Herein we review several clinical trials evaluating the anti-inflammatory effects of helminths and assessing their association with different autoimmune diseases, including inflammatory bowel disease, multiple sclerosis, and autoimmune liver diseases. We also describe the common pathways by which helminths induce immune modulation and the key changes observed in the host immune system following exposure to helminths. These common pathways include the inhibition of IFN-γ and IL-17 production, promotion of IL-4, IL-10 and TGF-β release, induction of CD4(+) T cell FoxP3+ expression, and generation of regulatory macrophages, dendritic cells, and B cells. Helminths products are becoming significant candidates for anti-inflammatory agents in this context. However, further research is needed for synthetic analogues of helminths' potent products that mimic the parasite-mediated immunomodulation effect.

Keywords

Helminth Hygiene Autoimmune Type 1 diabetes Inflammatory bowel disease Multiple sclerosis Autoimmune liver diseases 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Dana Ben-Ami Shor
    • 1
    • 2
  • Michal Harel
    • 3
  • Rami Eliakim
    • 2
  • Yehuda Shoenfeld
    • 4
  1. 1.Internal Medicine B, Sheba Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityRamat GanIsrael
  2. 2.Department of Gastroenterology, Sheba Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityRamat GanIsrael
  3. 3.Pediatric Department, Edmond and Lily Safra Children’s Hospital at Sheba Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityRamat GanIsrael
  4. 4.The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityRamat GanIsrael

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