The Malaghan Institute has initiated a clinical programme, funded by the Health Research Council, to explore the therapeutic potential of human hookworms. Our aim is to ultimately find better treatment options for a range of inflammatory and autoimmune diseases, including coeliac, asthma, allergy, MS and inflammatory bowel disease.
The Malaghan Institute is collaborating with the University of Otago to undergo a benchmark clinical study of human hookworms in healthy individuals. The programme, which has met strict regulatory and safety requirements, aims to investigate how these worms alter the human immune system and whether this has potential therapeutic benefit.
In 2019, the Malaghan Institute began a clinical study to explore the therapeutic potential of human hookworms. The study seeks to understand the effects human hookworms have on a healthy individual’s immune system, gut bacteria composition and function.
This research was extended in September 2020 to investigate the feasibility of using human hookworms as a medication-free maintenance therapy for ulcerative colitis, an inflammatory bowel disease. Similar trials for perennial allergic rhinitis (hayfever) and eosinophilic esophagitis – a chronic, allergic inflammatory disease of the oesophagus – are in development.
As part of this research, the Institute has also been developing techniques for sorting, harvesting and storing hookworm, to ultimately establish a safe, reliable and consistent GMP (good manufacturing practice) grade hookworm product that can be used safely for ongoing trials and ultimately in some form as an approved therapeutic product.
Why are we interested in hookworms?
Our interest in hookworms is twofold – we study the mechanisms that parasitic worms use to subdue the immune system because of their potential to dampen harmful inflammatory immune responses. We’re also working to develop vaccines to target parasitic disease in developing nations, to prevent re-infection and break the cycle of disease.
It is thought that the loss of gut parasites such as hookworms from humans may be partially to blame for the increase in inflammatory and autoimmune diseases. People who come from developed, Westernised countries experience less parasitic diseases (ie hookworm infection) but have higher rates of inflammatory and autoimmune disease.
Hookworms alter the immune system of their human host to help them persist in the body, dampening down the immune system to evade detection and expulsion. They do this by producing compounds that interact directly with immune cells in the body. This allows the hookworm to be tolerated by the human host yet leaves the immune system strong enough to be able to protect the human host against other diseases.
Because of this effect, it is thought that hookworms could be used to treat several inflammatory and autoimmune diseases. These diseases are characterised by an overactive immune system, so it is thought that dampening this immune response may impart some therapeutic benefit to patients.