HELMINTHIC THERAPY IN CROHN'S DISEASE: A REVIEW

The incidence of the Crohn's disease (CD), an inflammatory bowel disease is markedly increased in industrialized countries during the last decades. Different pharmacological agents are currently used in several combinations to control the inflammatory process, including helminthes. There is a lot of scientific data in animal models and human host that favors an immunoregulatory role of helminth infection in Crohn's Disease. Recently, the hygiene hypothesis of the development of immunological diseases was proposed, stating that raising children in extremely hygienic environments with less exposure to parasite infections may negatively affect the development of the immune system, predisposing them to immunologic diseases such as CD. Thus lack of exposure to parasites may critically contribute to the risk of CD. This hypothesis is supported by experimental data showing that helminthic parasites protect against T helper (TH) type 1 cell-mediated gastrointestinal inflammation in Crohn's disease. Both TH-2 cells and regulatory T-cells may be involved in this immunomodulatory mechanism. Helminth infection may activate goblet cells and mast cell which increases mucus and water secretion into the gut lumen. Adult worms live in the host small intestine for an average of five years. Infection can be easily terminated with an anthelminthic. No severe adverse effects have been reported thus far. Inoculation proved safe, even in immune suppressed patients. This review highlights the clinical use of helminthes like Trichuris suis and other for Crohn's disease (CD), a new perspective of therapy for CD.