Investigators at the University of Wisconsin, Madison, are planning a small,
novel study using the eggs of a harmless parasitic worm - called a helminth - to
treat people with MS. The concept is based on the as yet unproven "hygiene
hypothesis," which states that MS is less common in underdeveloped regions
because early exposure to common infectious agents may stimulate the immune
response in a positive way and help offset the attack on the brain and spinal
cord in MS. John Fleming, MD, and colleagues are funded by a research grant from
the National MS Society to conduct a small clinical trial to determine whether
the treatment can reduce relapses. The team expects to begin recruiting
participants for this study within weeks, which will involve up to 20
people.
Scientists have noted that autoimmune diseases and allergies are
less common in underdeveloped regions. Some researchers have noted that early
exposure to common infectious agents, such as occurs to people in regions with
poor sanitation, may stimulate immune regulation in a positive way and aid
healthy immune responses. Because MS is more prevalent in regions with high
standards of hygiene, researchers have been testing the hygiene hypothesis - the
idea that lack of exposure to common innocuous agents at an early age may cause
the immune system to over-react and cause MS.
Studies in MS-like disease
in lab rodents and preliminary clinical trials in Crohn's disease, an autoimmune
disease of the bowel, suggest that drinking a concoction containing eggs from
the helminth might alter immune attacks and improve these
conditions.
Based on these and other studies, Dr. Fleming's team is
conducting a small clinical trial to test the potential of oral helminth eggs
for improving relapsing-remitting MS.* In the first phase, five participants who
have declined to take medications approved to treat MS (and who meet other study
criteria) will be given a solution containing the tiny eggs of the helminth. The
eggs will hatch and mature inside the body, reaching about the size of an
eyelash. When they reach the large intestine, the larvae interact with the
immune system and are then killed. The ingestion of the eggs is not expected to
cause intestinal problems.
Participants will be followed for seven months
with MRI and clinical measures to evaluate safety and effectiveness. The primary
outcome being measured is how treatment affects the number of new, active
lesions (areas of myelin damage) as observed on MRI. If the first phase
demonstrates safety and effectiveness, the team will enroll 15 people for a
year-long study. If treatment shows effectiveness, a longer-term goal is to
determine the exact mechanism of action so that patients could reap the
potential benefits using a pill.
This cutting-edge research should
provide important information as to whether this unique therapy has the
potential to benefit those with MS.
*Relapsing-Remitting MS is a course
of MS characterized by clearly defined flare-ups followed by partial or complete
recovery periods (remissions) free of disease progression.
National MS
Society
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