Ulcerative colitis is most common in Western industrialized countries.
Inflammatory bowel disease is uncommon in developing countries where helminths are frequent.
People with helminths have an altered immunological response to antigens.
In animal models, helminths prevent or improve colitis by the induction of regulatory T cells and modulatory cytokines.
Dr Summers and colleagues conducted a study to determine the efficacy and safety of the helminth Trichuris suis in therapy of ulcerative colitis.
The researchers designed a randomized, double blind, placebo-controlled trial conducted at the University of Iowa and select private practices.
| After 12 weeks of ova therapy, improvement according to the intent-to-treat principle occurred in 43% compared with 17% in placebo|
The team obtained Trichuris suis ova from the US Department of Agriculture.
The investigators included 54 patients with active colitis, defined by an Ulcerative Colitis Disease Activity Index of equal to or more than 4.
The team recruited patients from physician participants and were randomly assigned to receive placebo or ova treatment.
Patients received 2500 Trichuris suis ova or placebo orally at 2 week intervals for 12 weeks.
The primary efficacy variable was improvement of the Disease Activity Index to equal to or more than 4.
The researchers found that after 12 weeks of therapy, improvement according to the intent-to-treat principle occurred in 43% with ova treatment compared with 17% of patients given placebo.
The team also reported that improvement with the Simple Index was significant by week 6 and that the difference in the proportion of patients who achieved an Ulcerative Colitis Disease Activity Index of 0 to 1 was not significant.
In addition, the research team found that the treatment induced no side effects.
Dr Summers concludes, “Ova therapy seems safe and effective in patients with active colitis.”