Helminth Therapy: A Promising Biotherapeutic Approach for Autoimmune Colitis

Of late, the incidence of autoimmune colitis both in adults and children has been progressively increasing globally. The efficacy of conventional therapeutic measures is questionably limited due to shortterm immunosuppressive effect along with possible serious side effects. Evidence from epidemiological studies has demonstrated an inverse relationship between the occurrence of parasitic diseases and various autoimmune pathologies. Co-evolution of parasitic nematodes with humans possibly led to a positive selection pressure favoring a more tolerogenic immune response as an effective strategy of immune-evasion favoring long-term patency of parasitism. These immunomodulatory strategies have provided a significant cue for an alternative therapeutic approach. As proof of this premise, recent evidence has established a platform for the emergence of helminth-therapy as a promising alternative bio-therapeutics for colitis and other immune-mediated disorders. Studies in experimental models of colitis have shown that live/attenuated worms or their eggs or the soluble and/or excretorysecretory products of helminths have definitive therapeutic potential. Several clinical trials have also been conducted in colitis patients aiming to replicate the success of such experimental studies. However, utilization of live/attenuated worms or the crude products derived from them can cause serious complications with obvious ethical concerns, hence rendering these attempts controversial. Therefore, it seems more rational to explore and exploit specific immunomodulatory proteins from parasites having a more selective effect against colitis. Outcomes from the experimental studies that identified and demonstrated the efficacy of the use of certain recombinant parasitic proteins against ulcerative colitis have opened a new vista for developing helminth derived biotherapeutics against colitis. There is a definitive need to focus on this aspect for a better insight to utilize this novel therapeutic venture effectively and safely to resolve a very socially relevant health problem of recent times.