Your Friendly Neighborhood Hookworms

Key takeaways

Hookworms, once considered solely parasites, may have therapeutic benefits for autoimmune and inflammatory diseases.
The decline of worms in modern hygiene and sanitation practices may have contributed to increased autoimmune conditions, supporting the hygiene hypothesis.
Controlled use of hookworms in clinical trials shows potential for reducing symptoms of diseases like type 2 diabetes, celiac disease, and multiple sclerosis.
Mainstream medical adoption is hindered by regulatory, safety, and perception barriers, but scientific advances aim to create safer, lab-made alternatives.
Our historical efforts to eradicate parasites may have had unintended health consequences, emphasizing the complexity of our relationship with these organisms.

Summary

Introduction to Hookworms and the Episode's Context

The hosts, Luttif Nasser and Molly Webster, revisit a 2009 episode about parasites, focusing on hookworms. They discuss the change in perception towards hookworms—from being regarded as a harmful pest to a potential medicinal tool—setting the stage for an exploration of recent research and updates on their role in human health, especially in autoimmune diseases.

Historical Perspective on Hookworms and Public Health

The episode narrates the history of hookworm eradication efforts in the early 20th century, notably involving Rockefeller's campaigns. The story illustrates how poor sanitation and barefoot defecation facilitated hookworm transmission. It highlights the unintended positive consequence of improved sanitation: the decline of parasites and feces-related diseases, linking public health advances with societal progress.

The Science of Hookworms and Immune Regulation

Jasper Lawrence's story illustrates the use of hookworms in experimental therapies. The worms' ability to modulate the immune system is discussed, particularly their role in calming autoimmune reactions. The podcast explains how hookworms might suppress overactive immune responses, potentially offering relief for conditions like allergies, Crohn’s disease, and MS, through a process of co-evolution with humans.

Current Research and Clinical Trials on Hookworms as Treatment

Recent studies and clinical trials are explored, focusing on how controlled hookworm infections are being tested for treating diseases such as type 2 diabetes, celiac disease, and autoimmune disorders. The research highlights include how worms are introduced via skin, their life cycle within humans, and their effects on health—reducing symptoms and improving quality of life in many cases.

Challenges and Future of Worm-Based Therapies

The episode discusses the hurdles in mainstreaming hookworm therapy, including regulatory issues, public perception, and practical difficulties in standardizing and sterilizing worm preparations. Scientists are working on developing lab-produced proteins from worms as safer alternatives. Despite setbacks, ongoing research suggests promise, with some patients opting to keep worms due to perceived benefits.

Show notes

For most of human history, people went about their daily lives with a worm or two (or fifty) in their guts. Only in the past century, with pharmaceuticals and sanitation practices, have we made significant strides towards deworming the whole of humanity. And that’s typically been thought of as a good thing, because having too many worms in your body can–quite literally–suck the life out of you.

But is it possible to have… too few worms? Science wonders if deworming ourselves has actually led to an increase in certain chronic diseases. On this episode, we dive into Necator americanus, a.k.a. the American Hookworm, and its mysterious relationship with each of us.

We trace the hookworm’s 118-year journey from a demonized economic depressant, to its use as a desperate D.I.Y. immunosuppressant, to its potential as a medical treatment for a number of chronic diseases, everything from asthma to MS.

We’re bringing back two stories from our 2009 episode Parasites plus new research on hookworms and autoimmune diseases, reported by Molly Webster

Special thanks to Ethan Hein for the use of his remix of Mozart's Piano Concerto No. 21. Plus, Doris Pierce, and Dan and Alice Hadley.

EPISODE CREDITS:

Reported by - Pat Walters and Molly Webster
with help from - {{wREPORTERS}}

Produced by - Matt Kielty

with help from - Rebecca Rand

Fact-checking by - Diane A. Kelly

and Edited by - Arianne Wack

EPISODE CITATIONS:

Articles -

Effect of experimental hookworm infection on insulin resistance in people at risk of type 2 diabetes (https://pubmed.ncbi.nlm.nih.gov/37495576/) by Giacomin PR et al. Nat Commun. 2023 Jul 26

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