In 2008 a trial which involved reintroducing hookworms into patients with coeliac disease was commenced in Brisbane, Queensland. The first phase was completed in 2009. While 2010 has seen the trial roll over into a second extended phase. The results have been presented at several national and international meetings and publication of the results is pending.
The trial is based around the theory of the “hygiene hypothesis” which in brief, suggests that as we’ve become cleaner (or more hygienic) we have effectively removed parasites from our bowel. These are organisms with which humans have co-evolved with over tens of thousands of years, and to which our immune system may have developed a symbiotic dependent relationship – i.e. each helping the other to ensure their normal function and survival. By effectively removing these parasites we may have allowed our immune system to be overactive in certain areas which may have predisposed us to certain “autoimmune conditions” such as coeliac disease. This theory is supported by the observation that as we have improved our “cleanliness” and availed ourselves of better medical care we have not only seen a dramatic decrease in traditional infectious diseases such as rheumatic fever, hepatitis and tuberculosis, but over the same period of time we have witnessed a dramatic corresponding increase in “autoimmune diseases” such as Coeliac disease, Crohn’s disease, Multiple Sclerosis and Type I diabetes.
In this trial which was supported by the Broad Medical Research Program in Los Angeles, twenty people with coeliac disease in remission were enrolled. They were inoculated with either hookworm or placebo, and all underwent a gluten challenge consisting of four pieces of white bread twice a day for 5 days after twenty weeks. They all had gastroscopies pre and post gluten challenge. The results have been positive and suggest the possibility of modulating the immune system with parasites is possible. Those who initially received the placebo have now been inoculated with hookworms and will undergo a repeat gluten challenge with biopsies.
Pictures above: Dr James Daveson Inoculating the first participant in the hookworm in coeliac disease trial – Hugh Sheardown (President of the Queensland Coeliac Society) and (at left) the hookworm.






