152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...
152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...
152 153 Intestinal Disease Meeting Berlin 2006 - Dr. Falk Pharma ...
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Promising results with helminths<br />
The observation that IBD occurs almost exclusively<br />
in industrial nations and much less frequently<br />
in the developing world may also contribute to<br />
the development of new therapy concepts. “The<br />
pathogenesis of these diseases also appears to<br />
have something to do with the standard of hygiene,”<br />
said J.V. Weinstock (Boston). Observations<br />
in mice that animals exposed to certain worms<br />
of the helminth group appeared to be protected<br />
against inflammation in the colon led to the<br />
effort to establish this principle in humans. According<br />
to J.V. Weinstock, the helminths may<br />
Fig. 30<br />
J.V. Weinstock R.W. Summers<br />
2. Larvae<br />
released<br />
1. Ingestion<br />
Infective ova<br />
Ingested<br />
3. Mucosal attachment<br />
Penetrate<br />
and develop<br />
in mucosa<br />
Internal<br />
Embryonated egg<br />
(infective stage)<br />
External<br />
I Trichuris suis life cycle (R.W. Summers, Iowa City)<br />
Congress Short Report <strong>Falk</strong> Symposium<br />
trigger immune reactions, such as the release of<br />
IL-12 and IFN-γ.<br />
Meanwhile the first clinical studies on humans<br />
treated with helminth (Trichuris suis) ova (figure<br />
30) report a reduction in disease symptoms. Very<br />
promising were the results of a pilot study of<br />
54 patients with ulcerative colitis presented in<br />
<strong>Berlin</strong> by R.W. Summers (Iowa City). Patients were<br />
treated with Trichuris suis ova, with 45% of patients<br />
responding to therapy. The difference with<br />
respect to placebo was not initially significant<br />
but became so after six weeks. Over the twelveweek<br />
treatment a total of 60% of patients responded<br />
positively to treatment with helminth<br />
ova compared to 12% showing improvement<br />
on placebo.<br />
There are also first reports of therapeutic efficacy<br />
in patients with Crohn’s disease. In one study,<br />
29 patients were treated, of whom 65% achieved<br />
remission within twelve weeks, with a total of<br />
76% of patients showing a clear clinical response.<br />
Side effects and serious complications were not<br />
observed.<br />
Cell<br />
Eggs in feces<br />
(diagnostic stage<br />
4. Maturation<br />
5. Egg excretion(noninfective)<br />
6. Embryonation<br />
in soil<br />
<strong>153</strong><br />
43
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