Opening A New Can of Worms... to Treat Inflammatory Bowel Disease

Abstract

Abstract There are no effective long-term treatments for Inflammatory Bowel Disease (IBD), more specifically Crohn’s disease and Colitis. According to the hygiene hypothesis, the incidence of autoimmune disease is higher due to the loss of exposure to helminths. In the field of helminth therapy, worms and their derived products are administered to restore the disrupted immune balance in IBD. The aim of this study is to compare Schistosoma japonicum and Schistosoma mansoni and their experimental effect on reducing inflammation in IBD using TH17 immunological outcomes and to comparatively evaluate these two worms as candidates for helminth therapy. A meta- analysis was conducted using the databases Pubmed, Web of Science, Scopus, and the software R metaDigitise to extract data in figures. The data extracted was control and experimental means, standard error, and sample size for three TH17 immunological outcomes (mRNA producing IL17, CD4+ TH17 Cells, IL17 cytokine concentration). The Hedges' g standardized mean differences and the 95 percent confidence intervals were then calculated and compared between worms. Published studies were found to show that S. japonicum is the better therapeutic worm compared to S. mansoni and that emulsified, secreted egg proteins are a likely effective treatment method. For patients who do not respond well to current IBD therapies, there is a potential future where helminth therapy could be used as an alternative treatment. If Schistosome worms were to be used in future experiments, S. japonicum and its egg proteins should be further researched and investigated.