A ‘Worm’ Pill Could Stop the Body From Hurting Itself

In 2009, New York writer Susannah Cahalan suffered a mysterious illness that sent her to the hospital for over a month while doctors labored to determine the cause of her brain illness. That same year, Meghan O’Rourke, another American writer, developed a vague and seemingly unrelated stream of symptoms that included overwhelming fatigue, swollen lymph nodes, a persistent low-grade fever, as well as an intermittent rash and swollen, painful joints. In both cases, physicians were initially puzzled and then challenged to find the origin of disease, which was ultimately autoimmune in nature.

Neither woman had before been ill and both suffered indiscriminately while their health failed for months while waiting for answers and possible solutions. And the symptoms for both women ran the gamut, further complicating potential diagnoses, as well as causing a great deal of fear as they both experienced disturbing cognitive symptoms, such as problems with memory, word recall, and reading comprehension — all significant digressions, especially in light of their careers.

Cahalan wrote about her experience — and ultimately her diagnosis — in the remarkable book, Brain on Fire: My Month of Madness, which quickly became a New York Times bestseller; O’Rourke did the same in a riveting article in the New Yorker in 2013. What both writers may not have realized at the time of their illness was that they were a part of a growing trend in Western societies: A significant uptick in autoimmune disease, which largely strikes women over men. (According to the Centers of Disease Control and Prevention [CDC], roughly eight percent of the U.S. population suffers from one or more autoimmune diseases, more than 78 percent of that number are women, which in current theory may be attributed to the presence of female sex hormones. Still that number is likely much higher as many autoimmune diseases go unchecked for decades.

What Is Autoimmune Disease?

An autoimmune disease is one where the body attacks itself because its immune system becomes overactive and can no longer discriminate between healthy cells and harmful antigens, such as bacteria, viruses, cancer cells, or toxins. As the body negatively reacts to antigens, its tissues become inflamed, similar to how it can be negatively triggered by an allergic reaction.

Autoimmune diseases mistakenly attack the body’s healthy cells, causing inflammation, irritation, and tissue destruction. Autoimmune disease can also cause changes in organ size or function. Mostly, autoimmune disease affects the body’s endocrine glands (thyroid and pancreas), its blood vessels, joints, connective tissues, skin and red blood cells. Although autoimmune diseases can be medically managed, they are not curable. Like allergies, symptoms of autoimmune disease may flare up or be triggered by environmental exposures and/or elevations in stress. According to the CDC, the group of disorders that fall into the category of autoimmune disease number more than 80 and affect millions of Americans. Common autoimmune diseases include lupus, Type I diabetes, multiple sclerosis, psoriasis, and rheumatoid arthritis as well as many rare subtypes; having one type of autoimmune disease also statistically makes it more likely that you will develop another.

Cleaner, Better, Sicker?

Put aside the gender issue for a moment and consider the rise of autoimmune disease in Western societies versus the lack of autoimmune disease in developing nations, such as those in Africa and South America. When scientists are presented with the question there are no clear answers, but one theory that is gaining traction is known as the “Hygiene Hypothesis.”

That theory suggests that as more developed industrialized nations wiped out many infectious diseases with better cleanliness, purer water, and mass-produced sterilized food that we have also wiped out necessary exposures to natural parasites that actually helped keep our internal systems in balance, particularly our immune system.

“That decline [in parasitic infection in Western society] is particularly clear [when considering the decline in cases of] hepatitis A, childhood diarrhea, and even more spectacular for parasitic diseases such as filariasis, onchocercosis, schistosomiasis, or other soil-transmitted helminthiasis,” explains a 2010 study published in Clinical and Experimental Immunology.

It continues, “In countries where good health standards do not exist, people are chronically infected by those various pathogens. In those countries, the prevalence of allergic diseases remains low. Interestingly, several countries that have eradicated those common infections see the emergence of allergic and autoimmune diseases.”

Treatment In A ‘Worm” Pill?

Even given the rise in acceptance of the hygiene hypothesis, researchers are still not entirely clear why there is such an increase in both autoimmune and allergic disease in the United States; but considering it, a new treatment idea has surfaced: A worm ‘pill’ that acts on the body in a controlled way in much the same way as a typical parasite would. In theory, introducing a parasite in this way would help balance the body’s immune system tasks, keeping it from attacking itself.

The proposed treatment actually suppresses the body’s immune system response. It is similar to helminthic therapy where a parasite like hookworm is intentionally released into the body; by synthesizing a common molecule from a similar parasite, scientists believe that creating a “worm” pill is a better, more controlled alternative treatment.

“The next step will be to see if we can develop this into a pill that could dampen the immune system in people with an autoimmune disease,” explains Dr. Sandeep Chhabra from Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia, and author of the ‘worm pill’ study that appeared this month in the Journal of the Federation of American Societies for Experimental Biology.