Liu J, Morey R A, Wilson J K, Parker W
Department of Surgery,Duke University Medical Center,Durham, NC 27710,USA.
Department of Psychiatry and Behavioral Sciences,Duke University Medical Center,Durham, NC 27710,USA.
J Helminthol. 2017 May;91(3):267-277. doi: 10.1017/S0022149X16000316. Epub 2016 May 31.
The successful use of helminths as therapeutic agents to resolve inflammatory disease was first recorded 40 years ago. Subsequent work in animal models and in humans has demonstrated that the organisms might effectively treat a wide range of inflammatory diseases, including allergies, autoimmune disorders and inflammation-associated neuropsychiatric disorders. However, available information regarding the therapeutic uses and effects of helminths in humans is limited. This study probes the practices and experiences of individuals 'self-treating' with helminths through the eyes of their physicians. Five physicians monitoring more than 700 self-treating patients were interviewed. The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug. Further, exposure to helminths apparently did not affect the impaired comprehension of social situations that is the hallmark of autism. These observations point toward potential starting points for clinical trials, and provide further support for the importance of such trials and for concerted efforts aimed at probing the potential of helminths, and perhaps other biologicals, for therapeutic use.
40年前首次有记录表明成功使用蠕虫作为治疗炎症性疾病的药物。随后在动物模型和人类身上开展的研究表明，这些生物可能有效治疗多种炎症性疾病，包括过敏、自身免疫性疾病以及与炎症相关的神经精神疾病。然而，关于蠕虫在人类治疗用途和效果的现有信息有限。本研究通过医生视角探究了个人使用蠕虫“自我治疗”的做法和经历。采访了5名监测700多名自我治疗患者的医生。结果有力地支持了先前的迹象，即蠕虫疗法可有效治疗多种过敏、自身免疫性疾病和神经精神疾病，如重度抑郁症和焦虑症。在该研究中，医生观察到的自我治疗患者中约57%患有自闭症。医生报告称，大多数患有自闭症和炎症相关合并症的患者对自我治疗者目前使用的两种最常见生物——微小膜壳绦虫和猪鞭虫中的任何一种治疗反应良好。然而，约1%的儿科患者在使用微小膜壳绦虫时出现严重的胃肠道疼痛，不过症状通过抗蠕虫药物得以缓解。此外，接触蠕虫显然并未影响自闭症标志性的对社交情境理解受损的情况。这些观察结果指出了临床试验的潜在起点，并为这类试验的重要性以及为探究蠕虫乃至其他生物制剂治疗潜力的协同努力提供了进一步支持。
