They swallowed 3500 parasite eggs and spent $2300 just to treat baldness

“Are you nervous?” the doctor asked the patients sitting in the consulting room while preparing for the work.

“Do I look nervous?” The patient answered the question with a question.

The doctor shrugged nonchalantly, picked up an absorbent bandage stained with 30 hookworm larvae (filamentous larvae), and slapped it on the patient’s arm. 

Immediately after the initial chill, there was a burning sensation in the forearm—a local immune response triggered by the hookworm filamentous larvae shedding their outer cuticle like a sock and burrowing into the skin.

Different forms of hookworm filamentous larvae,Source: Screenshot of CDC’s official website

They swallowed 3500 parasite eggs and spent $2300 just to treat baldness

Afterwards, 30 hookworm filamentous larvae will go straight to the capillaries or lymphatic vessels.

With the blood circulation, they will pass through the right heart and pulmonary artery to the alveoli, causing the host to have symptoms such as throat itching, coughing, and fever.

After a while, they will crawl along the bronchi and trachea to the pharynx, pass through the esophagus and stomach to the small intestine with the swallowing action of the host, and settle here, grow, develop into adults, and mate and lay eggs here. 

They attach to the mucosa of the small intestine with hooked or plate teeth in the oral pouch and feed on the host’s blood, lymph, and sloughed intestinal epithelial cells.

The whole process will take about 5 to 7 weeks.

Spend $2,300 to treat hair loss with American hookworm

The patient’s name was Moises Velasquez-Manoff. He drove thousands of kilometers from San Diego, USA, all the way south, across the border to a clinic in Tijuana, Mexico, and paid as much as $2,300  just to get a special ” Drugs” – 30 American hookworms.

The disease Moises wanted to treat began when he was 11 years old.

That summer, his grandmother stumbled across a dime-sized patch of alopecia areata on the back of his head, and he was subsequently diagnosed with an autoimmune disease by doctors.

 Despite all the treatments he tried, Moises lost all his hair at 16 – having to hide himself in a hat throughout his adolescence .

In addition to hair loss, he suffered from severe asthma at an early age. Every spring, his lips and nails turn purple when he suffers a severe asthma attack, and he is rushed to the emergency room by his parents. 

He is also allergic to sesame, peanuts and eggs, and he has to be careful to avoid contact with these foods in his daily life.

For Moises, these misfortunes have become part of life. Until the birth of his daughter changed his mind.

Looking at his daughter’s lovely and fine hair, he couldn’t help worrying: Could such a lovely little girl also experience the pain of hair loss in the future? 

As a father, Moises decided to use himself as an experiment to explore the secrets of allergies and autoimmune diseases in the hope of finding a cure.

His choice was the parasite.

Hygiene Hypothesis: Unclean, No Sickness

The parasite, which has always been regarded as the enemy of human health, can actually become a “medicine”?

To many people’s surprise, parasites do have some rationale for treating allergies and autoimmune diseases.

In 1989, David Strachan, an epidemiologist from the United Kingdom, first proposed a new medical concept – the “Hygiene hypothesis”.

David Strohn, Source: Wikipedia

In a survey of children, David found that children with more siblings were less likely to suffer from hay fever and eczema than only children.

David believes that this is because non-only children have more exposure to other people from an early age, and are more likely to be exposed to a variety of pathogens such as microorganisms and parasites.

In the process, their immune systems have also been exercised , the probability of developing allergic diseases is also reduced.

From an immunological point of view, in infants and young children, the immune response is dominated by the pro-allergic Th2 type, while microbial infection can induce the development of a Th1-type immune response, promote the balance of Th1-Th2, and reduce the risk of allergic diseases. 

This also provides a certain immunological basis for the “hygiene hypothesis”.

In other words, it is “unclean, eat without disease” – properly infecting microorganisms in childhood can promote immune balance and reduce the occurrence of certain diseases in adulthood.

The “hygiene hypothesis” is not only reflected in families, but also in larger populations.

As early as the 1970s, epidemiologists discovered that there may be a link between the cleanliness of the living environment and allergic diseases.

In developed countries, the prevalence of infectious diseases such as parasitic diseases has dropped significantly due to vaccination, improved sanitation, and widespread use of antibiotics, which have reduced the number of people exposed to infectious pathogens . 

At the same time, however, the incidence of allergy and immune diseases has increased substantially. 

In China, from 2005 to 2011, the average prevalence of allergic rhinitis increased from 11.1% to 17.6% in major large and medium-sized cities. 

Between 2012 and 2015, one in twenty adults, or about 46 million people, had asthma.

Professor Chen Yuzhi from the Capital Institute of Pediatrics has done three epidemiological surveys on the incidence of childhood asthma. 

The results showed that in 1990, the average prevalence of asthma in children aged 0-14 years in China was 1.08%; in 2000, the figure was 1.97%; in 2010, the prevalence rate had reached 3.01%.

In addition, the incidence of ulcerative colitis and Crohn’s disease also increased between 1989 and 2007. 

In 2014, a survey of Crohn’s disease patients in Jiangsu Province found that the incidence of Crohn’s disease was proportional to the level of economic development in the region, and the incidence of Crohn’s disease was higher in the wealthy southern Jiangsu region.

Man’s “old friend”

Press the gourd to float the scoop, infectious diseases have decreased, but the trend of another kind of diseases has intensified. 

Realizing this, some people began to imagine whether it might be possible to re-expose humans to certain pathogens as a way to restore the balance of the immune system so that patients with allergies and immune diseases can return to health.

In 2003, microbiologist Graham Rook of the University of London proposed the “ Old friend hypothesis”.

In fact, parasites infect humans as early as the Paleolithic period. In the long time of fighting with humans, the parasites gradually discovered that killing the host was completely “more than the gain”.

American hookworm, Source: Screenshot of YouTube video

Therefore, in the process of co-evolution, they managed to become the manipulators of the human immune system, and humans “evolved” tolerance to some common parasites, so that later, normal human immune development and function even Some rely on regulation by parasites and microbes . This is the “old friend hypothesis”.

After the parasite invades the human body, it may inhibit the host’s immune response by activating the Th2-type immune response and forming soluble immune complexes. It also reduces the inflammatory response and promotes tissue repair by imaging the host’s cytokine secretion.

By holding down the “turbulent” immune system so that it no longer attacks its own tissues or harmless foreign objects for no reason, it also reduces the occurrence of autoimmune diseases and allergies.

But so far, it has only stayed in theory. Is it really reliable in practice to treat parasites?

clinical trials worldwide

Since 2003, there have been 19 phase I/II trials in parasitic diseases worldwide, and the treatment scope covers a variety of allergic and autoimmune diseases, including Crohn’s disease, ulcerative colitis, asthma , allergic rhinitis, rheumatoid arthritis, psoriasis rosea, multiple sclerosis and celiac disease.

The parasites selected for these studies were mainly Trichuris suis and the American hookworm or American Necator .

The reason why it is favored is because the safety of these two parasites is relatively better: the adult Trichuris suis parasites in the cecum of the host, and the adult lifespan is about 4 to 5 months, and mild infection generally has no obvious symptoms; The “flat-toothed” H. americana is less pathogenic than the four-toothed human H. duodenum.

Some experiments even showed good results.

Six clinical trials have been completed in the use of oral Trichuris suis eggs (TSO) for the treatment of inflammatory bowel disease (IBD). 

In an early phase I clinical trial, IBD patients who were treated with TSO for 12 weeks experienced significant improvement in symptoms compared with placebo.

However, hope may be temporary. In the subsequent series of open, randomized, double-blind clinical controlled trials, no strong evidence has emerged to confirm the effectiveness of parasitic treatment.

In 2013, the first large study (NCT01576471) of oral Trichuris suis eggs for the treatment of Crohn’s disease did not meet the primary endpoint of improving disease activity index or remission rate, and only found non-significant improvement in severely ill patients. 

A phase II study in 240 patients with Crohn’s disease (NCT01279577) was also stopped shortly after due to “lack of efficacy.” Neither study released further data.

In the treatment of allergic rhinitis or asthma, three relatively large clinical trials have shown that neither Trichuris suis nor N. americana has been found to significantly improve respiratory responsiveness or control asthma.

In September 2020, a study of hookworm americanus in the treatment of multiple sclerosis was published in a JAMA sub-journal. 

The double-blind controlled trial neither met the primary clinical endpoint nor reduced the number of lesions on MRI despite increased levels of regulatory T cells, interleukin-4, and interleukin-10 after active infection with N. americana in 71 patients.

To this end, the editors of JAMA also wrote an editorial, titled “Keep the Worms in the Mud” (Keep the Worms in the Mud).

Image source: JAMA screenshot

Fantasy and reality

In 2009, the US FDA stipulated that parasites are biological products and must undergo rigorous clinical trials before they can be used to treat diseases.

But despite this, some people are still plagued by disease and choose to go to areas such as Mexico and Thailand that currently lack supervision to receive parasite therapy.

The New York Times once reported on a young American named Vik who suffered from ulcerative colitis for many years. 

Although the medical experts around him had persuaded him not to try parasite treatments lightly, he decided to fly to Bangkok and buy a bottle of liquid containing Trichuris suis eggs from an 11-year-old Thai girl. stool.

whipworm, Source: Wikipedia

After swallowing 1,500 eggs, Vik’s condition was greatly relieved for a period of time. But three years later, his condition relapsed and he had to swallow another 2,000 eggs.

However, according to Vik, the parasites did not cause any discomfort in his stomach.

But not everyone is as lucky as Vik. At the beginning of the article, Moises, who tried to treat baldness with parasites, only grew a little fluff-like hair after “inoculating” 30 American hookworms. “For a fluff like the surface of a peach, if I used 0 to 10 to express the process from baldness to denseness, I should have been 0.05 at the time.”

Even more unfortunate, the American hookworm triggered a strong reaction in his body: in the third week after the vaccination, his abdomen began to cramp, accompanied by mild dizziness; later, the abdominal pain became more severe, accompanied by severe diarrhea, intestinal The tossing made him almost collapse. “I feel like I’m taming a horse.”

Fortunately, “it’s easy to send bugs and it’s hard to invite bugs.” In the end, Moises chose to take anti-parasitic drugs to bid farewell to these “old friends” he paid a lot of money to.

“But I still don’t regret experimenting on myself, because I felt it firsthand. But I won’t do it again.”

“If someone asks for my advice, I have only one answer,” Moises said. “Hell no .” 

References:

[1] The disappearance of microorganisms and the eternal battle of the immune system (An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases) Li Li/Ding Lisong: 2019-10

eLife 2021;10:e65180 DOI: 10.7554/eLife.65180

[2] JAMA Neurol. 2020;77(9):1089-1098. doi:10.1001/jamaneurol.2020.1118

[3] https://www.nature.com/articles/s41590-020-0753-y

[4] https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-019-3561-1

[5] doi: 10.1164/rccm.200603-331OC. Epub 2006 Jun 15.

[6] DOI: 10.16066/j.1672-7002.2019.08.004

[7] doi: 10.1186/s12865-015-0074-3

[8] doi: 10.1016/S0140-6736(19)31147-X. Epub 2019 Jun 20.