Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
Institute of Parasitology, Biology Centre, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic; Faculty of Science, University of South Bohemia, 370 05 České Budějovice, Czech Republic.
Parasitol Int. 2022 Apr;87:102488. doi: 10.1016/j.parint.2021.102488. Epub 2021 Nov 1.
The virtually complete loss of intestinal worms, known as helminths, from Western society has resulted in elimination of a range of helminth-induced morbidities. Unfortunately, that loss has also led to inflammation-associated deficiencies in immune function, ultimately contributing to widespread pandemics of allergies, autoimmunity, and neuropsychiatric disorders. Several socio-medical studies have examined the effects of intentional reworming, or self-treatment with helminths, on a variety of inflammation-related disorders. In this study, the latest results from ongoing socio-medical studies are described. The results point toward two important factors that appear to be overlooked in some if not most clinical trials. Specifically, (a) the method of preparation of the helminth can have a profound effect on its therapeutic efficacy, and (b) variation between individuals in the effective therapeutic dosage apparently covers a 10-fold range, regardless of the helminth used. These results highlight current limits in our understanding of the biology of both hosts and helminths, and suggest that information from self-treatment may be critical for clinical evaluation of the benefits and limits of helminth therapy.
西方社会中肠道蠕虫（俗称寄生虫）几乎完全消失，导致一系列寄生虫引起的疾病得到消除。不幸的是，这种消失也导致了与炎症相关的免疫功能缺陷，最终导致过敏、自身免疫和神经精神疾病的广泛流行。一些社会医学研究已经研究了故意驱虫（即使用寄生虫进行自我治疗）对各种炎症相关疾病的影响。在这项研究中，描述了正在进行的社会医学研究的最新结果。这些结果表明，在一些（如果不是大多数）临床试验中，似乎被忽视了两个重要因素。具体来说：（a）寄生虫的制备方法对其治疗效果有深远影响；（b）个体之间有效的治疗剂量差异显然在 10 倍范围内，无论使用何种寄生虫。这些结果突出了我们目前对宿主和寄生虫生物学的理解的局限性，并表明来自自我治疗的信息对于评估寄生虫治疗的益处和局限性的临床评估可能至关重要。
