Note from SaneVax: The following letter was sent to the British Medical Journal by Lucija Tomljenovic, PhD. in reference to not only new studies linking autism to autoimmune dysfunctions and gut inflammation; but also a novel treatment that was approved by the FDA on a special use basis that actually reversed all three conditions.
I read a remarkable report published recently in The Scientist (Vol 25, Issue 2, Page 42) that shows how effective treatment of gut inflammation can reverse the most severe symptoms in autistic individuals. What is perhaps even more remarkable is that this new highly unorthodox treatment now has the stump of approval from the FDA. Why unorthodox? Because it involves feeding autistic patients with live ova of the nematode Trichuris suis, pig whipworm !
The idea for this came from Stewart Johnson (father of a child with autism) who discovered the work of researchers at the University of Iowa who had previously successfully treated patients with Crohn’s disease and ulcerative colitis with Trichuris suis ova (TSO) [1-2]. Both Chron’s and ulcerative colitis are autoimmune disorders in which the immune system attacks the intestinal walls. Stewart’s hypothesis was that parasitic worm infection would modulate his son’s immune system and calm the gut inflammation that was causing his disruptive behaviors. He came to this conclusion after reviewing the landmark study by Vargas et al.  which showed extensive glial activation and neuroinflammation in the brain of patients with autism. This led Stewart to conclude that indeed, there was a gut-brain connection in autism and that by fixing the gut problem the latter would be fixed as well.
He proposed this treatment to Dr. Eric Hollander from the Montefiore Medical Center University Hospital of the Albert Einstein College of Medicine.
After obtaining permission to administer the treatment from the US Food and Drug Administration (FDA) under “compassionate use” rules, Stewart and Hollander initiated the treatment.
Within 10 weeks of treatment (with 2,500 eggs given every two weeks), the boy’s symptoms did no just improve. They vanished. He stopped smashing his head against walls and gouging at his eyes. His psychotic behaviours stopped and the family was finally allowed to have a normal life.
The big question is: what is the mechanism by which TSO modulates the immune system to calm down autoimmune attacks and inflammation in autism ?
It was initially assumed that intestinal worms could activate a Th2-type response and as a consequence, suppress the Th1 response, which is usually implicated in autoimmune diseases. However, this hypothesis was later dismissed in favour of more recent research which showed that the mechanism involves direct modulation of regulatory T-cells (T-reg) by the worms. T-reg cells function to suppress activation of the immune system thereby preventing it from attacking the body’s own tissues. Research indicates that intestinal worms can induce T-reg cells initially in the gut and that this changes the inflammatory setting which finally results in less inflammation in the brain.
This is good news! Even better is that the FDA finally started thinking outside of the box!
1. R.W. Summers et al., “Trichuris suis therapy in Crohn’s disease,” Gut, 54:87-90, 2005.
2. R.W. Summers et al., “Trichuris suis therapy for active ulcerative colitis: a randomized controlled trial,” Gastroenterology, 128:825-832, 2005.
3. D.L. Vargas et al., “Neuroglial activation and neuroinflammation in the brain of patients with autism,” Annal Neurol, 57:67-81, 2005.