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Helminth/Parasite Treatment of Multiple Sclerosis

  • MULTIPLE SCLEROSIS AND RELATED DISORDERS (PN RISKIND, SECTION EDITOR)
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Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

Epidemiological studies suggest that autoimmune diseases, such as multiple sclerosis (MS), are less frequent in individuals who are helminth carriers. This observation has been tested in murine models of colitis, MS, type 1 diabetes and asthma. In each case, mice colonized with helminths show protection from disease. This apparent down-modulation of inflammatory response resulting from helminth infection has triggered interest in exploring the potential clinical efficacy of controlled helminth infection in patients suffering from autoimmune diseases. To date, clinical trials using helminth therapy (Trichura suis ova [TSO] or Necator americanus larvae) in MS have been small, safety-oriented trials of short duration, attempting to reproduce and confirm epidemiological and experimental data. Thus far, no adverse events related to therapeutic helminth infection have been observed. Nonetheless, there is a clear need for caution when considering such approaches. Some preliminary clinical, magnetic resonance imaging and immunological outcomes using TSO have been encouraging. Nevertheless, results should be interpreted with caution as the number of individuals studied was small and duration of follow up limited. Longer studies, monitoring safety and objective outcome measures are necessary to assess this novel therapeutic strategy in a more definitive fashion. An alternative approach to use of live helminth infections might arise from identification of helminth-derived immunomodulatory molecules mimicking the protective effects of parasite infection, i.e. capable of altering immune responses and, therefore, the course of autoimmune diseases. Although positive results from administering parasite products in mouse models of autoimmunity have been reported, much remains to be explored before the field can move from experimental animal models to application in clinical practice. To the best of my knowledge, parasite-derived molecules have not yet been administered as treatment for any autoimmune disease in humans. At this time, it is strongly recommended that live helminth or ova parasites be administered only to individuals participating in strictly monitored, controlled clinical trials.

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Conflict of Interest

Jorge Correale is a board member of Merck-Serono Argentina, Merck-Serono LATAM, and Novartis Argentina. He has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, TEVA-Tuteur Argentina, and Novartis LATAM, as well as professional travel/accommodations stipends.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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  1. Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Montañeses 2325, 1428, Buenos Aires, Argentina

    Jorge Correale MD

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This article is part of the Topical Collection on Multiple Sclerosis and Related Disorders

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Correale, J. Helminth/Parasite Treatment of Multiple Sclerosis. Curr Treat Options Neurol 16, 296 (2014). https://doi.org/10.1007/s11940-014-0296-3

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