For several years, scientists have suspected that our hyper-hygienic world of vaccinations, antibacterial soap and bottled water actually might be making some people sick by bewildering their immune systems and causing them to turn on their bodies.

Now, doctors at the University of Wisconsin-Madison are about to carry that theory to the ickiest extreme.

They soon will begin serving up liquid concoctions of microscopic worm eggs to people with multiple sclerosis in the hope that the parasites will tone down the immune systems of the patients and relieve their symptoms.

The experiment is based in part on observations first made more than 40 years ago that high levels of sanitation in a child’s environment are associated with an increased risk of developing MS.

MS is believed to be a so-called autoimmune disease in which the body’s immune system launches an attack against its own tissue, specifically the substance myelin, which insulates nerve cells.

Some researchers say the trick to halting the attack might lie in the tiny helminth whipworm, an organism that long has infected humans, usually without harm, especially in undeveloped countries.

UW doctors plan to give helminth eggs to five MS patients over the course of several months. If the experiment proves safe and shows promise, more patients will be enrolled.

More than 2,000 of the football-shaped eggs, which are produced by the German company OvaMed, can fit onto a space that’s smaller than the head of a pin.

Once inside the body, the eggs will hatch and the worms grow to about the size of an eyelash. It is hoped that the presence of the worms will redirect the immune systems of the patients and slow down the damage to the myelin coating on their nerve cells.

“We don’t want to go back to the dark ages,” said lead researcher John Fleming, a professor of neurology at the UW School of Medicine and Public Health. “We want to give an innocuous organism to stimulate the immune system to make up for the sterile environment we live in.”

It’s an approach that already has been tried with some success on a small scale with Crohn’s disease and ulcerative colitis, both autoimmune diseases of the gastrointestinal system.

It’s also being contemplated with disorders such as Type 1 diabetes, allergies and hay fever, said Joel Weinstock, senior author of papers on both the Crohn’s and colitis clinical trials, which also used helminth eggs to treat the disorders.

“We assume that all this hygiene is great, but it could have negative consequences,” said Weinstock, an immunologist and professor of medicine at Tufts University. “We evolved to live close to the soil. People didn’t bathe regularly. They didn’t drink water that was particularly clean.”

He noted that MS, allergies and other autoimmune diseases were relatively uncommon in the 19th century compared with today.

“The gunslingers weren’t rubbing their noses when they were about to draw,” said Weinstock, who also serves as chief of the division of gastroenterology and hepatology at Tufts New England Medical Center.

The first direct evidence of a link between intestinal parasites and MS came from a 2007 study in Argentina.

The study, published in the Annals of Neurology, found that over the course of 4 1/2 years, 12 MS patients who had been naturally infected with intestinal parasites had dramatically fewer relapses, less disability and fewer lesions found on MRI scans than 12 matched MS patients who had not been infected with parasites.

UW’s Fleming wrote an editorial that accompanied the study in which he acknowledged that intentionally treating people with live parasites “may appear odd or repulsive.”

But a little over a year later, he now is preparing to do just that.

“Every really new idea seems like a crackpot idea to start with, because most of them are,” Fleming said. But “we have some pretty strong reasons to think it is going to help.”

And safety is not likely to be an issue, he said. In most people, the worms don’t produce symptoms, and if symptoms do occur, anti-parasitic drugs can be given, he said.

Not everyone is convinced that the research will lead to major treatments for MS.

MS is a complex disease that likely has several contributing factors, not just whether someone has been infected by intestinal parasites, said Bhupendra Khatri, director of the regional MS center at Aurora St. Luke’s Medical Center in Milwaukee.

Genes likely play a strong role determining who gets the disease, as well as factors such as sunlight exposure and vitamin D levels early in life, Khatri said.

The worm study “may help our understanding of why some people get MS and why some people don’t,” he said. “Will it help the MS patients? We’ll just have to wait and see.”


The study, approved by the U.S. Food and Drug Administration, is being funded by a grant from the National Multiple Sclerosis Society.

The trial is one of about 400 grants being funded by the society and possibly the most unusual, said John Richert, the society’s executive vice president for research and clinical programs.

“Even though it’s very unorthodox. . . it has the potential for being very beneficial and very safe,” he said.

To measure whether the worm eggs are having an effect, doctors will take MRI scans before and during treatment to look for lesions on nerve cells.

The study will be blinded so the radiologists and neurologists examining the scans will not know when the images were taken.

The researchers also will look for changes in symptoms.

The treatment period will last three months. Once every two weeks during that time, the patients will ingest about a teaspoon of clear liquid containing about 2,500 helminth eggs.

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(c) 2008, Milwaukee Journal Sentinel.

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