Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia.
College of Health Sciences, James Cook University, Cairns, QLD, Australia.
Nat Commun. 2023 Jul 26;14(1):4503. doi: 10.1038/s41467-023-40263-4.
The reduced prevalence of insulin resistance and type 2 diabetes in countries with endemic parasitic worm infections suggests a protective role for worms against metabolic disorders, however clinical evidence has been non-existent. This 2-year randomised, double-blinded clinical trial in Australia of hookworm infection in 40 male and female adults at risk of type 2 diabetes assessed the safety and potential metabolic benefits of treatment with either 20 (n = 14) or 40 (n = 13) Necator americanus larvae (L3) or Placebo (n = 13) (Registration ACTRN12617000818336). Primary outcome was safety defined by adverse events and completion rate. Homoeostatic model assessment of insulin resistance, fasting blood glucose and body mass were key secondary outcomes. Adverse events were more frequent in hookworm-treated participants, where 44% experienced expected gastrointestinal symptoms, but completion rates were comparable to Placebo. Fasting glucose and insulin resistance were lowered in both hookworm-treated groups at 1 year, and body mass was reduced after L3-20 treatment at 2 years. This study suggests hookworm infection is safe in people at risk of type 2 diabetes and associated with improved insulin resistance, warranting further exploration of the benefits of hookworms on metabolic health.
在寄生虫感染流行的国家，胰岛素抵抗和 2 型糖尿病的患病率降低，这表明蠕虫对代谢紊乱具有保护作用，但临床证据尚不存在。本研究在澳大利亚进行了为期 2 年的、针对有 2 型糖尿病风险的 40 名男性和女性成年人的钩虫感染的随机、双盲临床试验，评估了用 20（n=14）或 40（n=13）条美洲钩虫幼虫（L3）或安慰剂（n=13）治疗的安全性和潜在代谢益处（注册号：ACTRN12617000818336）。主要结局是通过不良事件和完成率来定义的安全性。稳态模型评估的胰岛素抵抗、空腹血糖和体重是关键次要结局。钩虫治疗组的不良事件更频繁，其中 44%的人出现了预期的胃肠道症状，但完成率与安慰剂组相当。在 1 年时，两种钩虫治疗组的空腹血糖和胰岛素抵抗均降低，在 2 年时，L3-20 治疗后体重减轻。本研究表明，在有 2 型糖尿病风险的人群中，钩虫感染是安全的，并与改善胰岛素抵抗相关，值得进一步探索钩虫对代谢健康的益处。
