Do worms protect against the metabolic syndrome? A systematic review and meta-analysis

Tracey, Ella F.; McDermott, Robyn; McDonald, Malcolm

doi:10.1016/j.diabres.2016.08.014

Cited by 52 publications

(63 citation statements)

References 37 publications

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“…It may therefore be reasonable to employ a regimen where cohorts of children are screened and treated as part of health screening procedures as they reach adulthood. Furthermore, as noted above, there is increasing evidence that pre-existing helminth infections may have beneficial effects on metabolic parameters in later life, and this potential effect may need to be taken into consideration when considering treatment in populations where type 2 diabetes mellitus is extremely prevalent [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Control of chronic Strongyloides stercoralis infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study

2017

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ObjectivesTo assess the effect of treatment with ivermectin on the prevalence of S. stercoralis infection in an Australian Aboriginal population over a three year period, and to assess the validity of using a lower ELISA cut-off in diagnosis.MethodsA three-year cohort study of 259 adult Australian Aboriginals living in a remote community in northern Australia. S stercoralis infection was diagnosed using commercial ELISA testing, and employed a lower threshold for treatment than that recommended. Follow up was conducted at 6 months and 3 years following ivermectin treatment.FindingsTreatment with ivermectin was highly effective and resulted in a sustained fall in the prevalence of infection in the study group (Initial prevalence 35.3%, 3 year prevalence 5.8%, McNemar’s chi2 = 56.5, p<0.001). Results of treatment suggested use of a lower ELISA threshold for treatment was valid in this setting. Follow up identified a small group of subjects with persistently positive ELISA serology despite repeated treatment.InterpretationControl of S. stercoralis infection in this cohort appears to be feasible using pharmacological treatment alone.

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Section: Discussionmentioning

confidence: 99%

Control of chronic Strongyloides stercoralis infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study

2017

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“…A meta-analysis of papers concerning helminth infection and metabolic syndrome found that individuals with a previous or current helminth were 50% less likely to have an endpoint metabolic dysfunction comparted to uninfected individuals [37]. In addition, there is evidence that the human intestinal microbiomes (here including parasitic worms) influence who develops allergy, atopy and autoimmune disease and who does not.…”

Section: Essential Learning Objectivesmentioning

confidence: 99%

Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training

Graves

Reiber

Thanukos

et al. 2016

EMPH

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Evolutionary science is indispensable for understanding biological processes. Effective medical treatment must be anchored in sound biology. However, currently the insights available from evolutionary science are not adequately incorporated in either pre-medical or medical school curricula. To illuminate how evolution may be helpful in these areas, examples in which the insights of evolutionary science are already improving medical treatment and ways in which evolutionary reasoning can be practiced in the context of medicine are provided. To facilitate the learning of evolutionary principles, concepts derived from evolutionary science that medical students and professionals should understand are outlined. These concepts are designed to be authoritative and at the same time easily accessible for anyone with the general biological knowledge of a first-year medical student. Thus, we conclude that medical practice informed by evolutionary principles will be more effective and lead to better patient outcomes. Furthermore, it is argued that evolutionary medicine complements general medical training because it provides an additional means by which medical students can practice the critical thinking skills that will be important in their future practice. We argue that core concepts from evolutionary science have the potential to improve critical thinking and facilitate more effective learning in medical training.

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“…In contrast, the prevalence of inflammatory metabolic diseases, such as Type 2 diabetes mellitus (T2DM) is high in high-income countries. The absence of exposure to helminth infections has been postulated as one mechanism to explain this markedly increased prevalence of T2DM [2][3][4][5][6]. Recent observational studies in India, Indonesia, China and Australia have reported that the prevalence of helminth infections was significantly lower in T2DM individuals compared to non-diabetic controls [4,5,7,8], thus confirming a protective effect of helminths against T2DM pathogenesis.…”

Section: Introductionmentioning

confidence: 98%

Helminth infection modulates systemic pro-inflammatory cytokines and chemokines implicated in type 2 diabetes mellitus pathogenesis

et al. 2020

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Background The prevalence of helminth infections exhibits an inverse association with the prevalence of Type 2 diabetes mellitus (T2DM), and helminths are postulated to mediate a protective effect against T2DM. However, the biological mechanism behind this effect is not known. Aims/Methods We postulated that helminth infections act by modulating the pro-inflammatory cytokine and chemokine milieu that is characteristic of T2DM. To examine the association of cytokines and chemokines in helminth-diabetes co-morbidity, we measured the plasma levels of a panel of pro-inflammatory cytokines and chemokines in individuals with Strongyloides stercoralis infection (Ss+) and T2DM at the time of Ss diagnosis and then 6 months after definitive anthelmintic treatment along with uninfected control individuals with T2DM alone (Ss-). Principal findings Ss+ individuals exhibited significantly diminished levels of the pro-inflammatory cytokines-IL-1α, IL-1β, IL-6, IL-12, IL-18, IL-23, IL-27, G-CSF and GM-CSF and chemokines-CCL1, CCL2, CCL3, CCL11, CXCL1, CXCL2, CXCL8, CXCL9, CXCL10 and CXCL11. In contrast, Ss+ individuals exhibited significantly elevated levels of IL-1Ra. Anthelmintic treatment resulted in increased levels of all of the cytokines and chemokines. Conclusions Thus, helminth infections alleviate and anthelmintic therapy partially restores the plasma cytokine and chemokine levels in helminth-diabetes co-morbidity. Our data therefore offer a plausible biological mechanism for the protective effect of helminth infections against T2DM.

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Do worms protect against the metabolic syndrome? A systematic review and meta-analysis

Abstract: This review has shown that helminth infections can be associated with improved metabolic outcomes. Understanding of the mechanisms underlying this relationship could facilitate the development of novel strategies to prevent or delay T2DM.

Cited by 52 publications

References 37 publications

Control of chronic Strongyloides stercoralis infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study

Control of chronic Strongyloides stercoralis infection in an endemic community may be possible by pharmacological means alone: Results of a three-year cohort study

Evolutionary science as a method to facilitate higher level thinking and reasoning in medical training

Helminth infection modulates systemic pro-inflammatory cytokines and chemokines implicated in type 2 diabetes mellitus pathogenesis

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