Randomized crossover feasibility trial of helminthic Trichuris suis ova versus placebo for repetitive behaviors in adult autism spectrum disorder

Abstract

This proof-of-concept study demonstrates the feasibility of TSO for the treatment of ASD, including a favourable safety profile, and moderate to large effect sizes for reducing repetitive behaviours and irritability. Clinicaltrials.gov: NCT01040221.

Immune System Investigation Using Parasitic Helminths

“…This will advance the translational potential of worms and their secreted products and facilitate cutting-edge immunological analyses in carefully controlled clinical settings (Figure 2). Pilot studies (143,144) Helminth therapy for allergic rhinitis (210), ulcerative colitis (122), Crohn's disease (122,131), multiple sclerosis (123), and autism spectrum disorder (155) No currently active trials…”

“…Nonetheless, these studies highlight an unchartered frontier: the use of helminths and/or their ES products for therapeutic interventions that operate through endogenous immunoregulatory mechanisms. Some recent progress has been made with a proof-of-concept TSO trial for autism, a related inflammatory condition of the nervous system (155). In future studies, researchers should consider exploring the potential benefit of helminths for neuropsychiatric disorders with an immunological basis, such as depression, anxiety, and schizophrenia, where systemic low-grade type 1 inflammatory responses are implicated in disease progression (156).…”

Between Dysbiosis, Maternal Immune Activation and Autism: Is There a Common Pathway?

“…To examine the potential therapeutic effects of helminth a pilot study on ASD adults was conducted and the results show improvements in repetitive and restricted behavior. Although further studies are needed to confirm the beneficial side of this treatment, this study indicates that immune-modulating helminths may be a helpful therapy strategy for ASD patients in the future [ 301 ].…”

Trichuris muris as a tool for holistic discovery research: from translational research to environmental bio-tagging

“…Interestingly, since the study of Fahmy ( 1954 ), our understanding of egg embryonation has been primarily furthered via studies using the pig whipworm T. suis rather than T. muris , including detailed morphological observations of the stages of embryonation (Beer, 1973 ). In recent years, the embryonation of T. suis has been investigated in more detail due to the therapeutic potential of T. suis ova (or TSO) (Huang et al ., 2018 ; Fleming et al ., 2019 ; Hollander et al ., 2020 ). Data from these experiments have demonstrated that an increase in temperature will drive an accelerated embryonation process; however, at temperatures above 40°C they become degenerate (Vejzagić et al ., 2016 ).…”