Media release

From: Australian Institute of Tropical Health and Medicine (AITHM)

Researchers at the Australian Institute of Tropical Health and Medicine at James Cook University (JCU) have found gut parasites with immune-modulating powers could hold answers to painful gut health issues like coeliac disease.

In a recent clinical trial, a team led by scientists from the AITHM, and partner clinicians Dr Tony Rahman and Dr John Croese at Brisbane’s Prince Charles Hospital, investigated the potential of parasites to restore gluten tolerance in patients with coeliac disease.

The promising new findings have raised the interest of Coeliac Australia, which has awarded the project new funding to continue the research.

Australian Institute of Tropical Health and Medicine immunologist Dr Paul Giacomin, who led the study at JCU, will continue researching the potential benefits of gut-dwelling hookworms – with a focus on how these worms may change the gut environment to prevent coeliac disease reactivation after exposure to low levels of gluten.

Dr Giacomin said helminth parasites such as hookworms had co-evolved and adapted to their human host, such that infections in well-nourished people are safe and well tolerated.

He said hookworms could induce changes in the immune system that activate or suppress its function, which helps the parasite survive and may have an unexpected collateral effect on other, unrelated inflammatory conditions of the host.

“We know coeliac disease is an autoimmune disorder where an immune response arises in the intestine after gluten consumption, and we are furthering some studies which have suggested hookworm infection in the small intestine may restore gluten tolerance,” he said. “We undertook a randomised, placebo-controlled trial of hookworm infection in 54 people with coeliac disease, and there was some compelling evidence that emerged.

“While hookworms were not able to “cure” coeliac disease and let people return to a normal diet containing moderate levels of gluten, we did observe that people treated with hookworms tended to display improved tolerance to lower gluten challenges, and had reduced gastrointestinal symptoms.”

Senior gastroenterologist at The Prince Charles Hospital Dr Tony Rahman said “This research may have profound implications for the health and lifestyle flexibility or people with coeliac disease, who normally have to adhere to a strict gluten-free diet to avoid accidental gluten exposure.”

The team has been granted funding from Coeliac Australia to continue the research, to undertaking a series of advanced laboratory analyses focusing on the gut reactions.

The advanced analyses is expected to reveal the biological reasons of why some people living with hookworms in their gut were able to develop remarkable tolerance to the gluten challenge, while others did not.

Their hypothesis is that hookworms are likely to create an anti-inflammatory environment in the gut, as well as beneficial changes in the balance of healthy and unhealthy microbes in the gut, which together favours the development of improved gluten tolerance in coeliac disease.

The team hopes that greater understanding of the biological mechanisms that lead to improved gluten tolerance, will advance the development of new treatments such as immunomodulatory therapies, or probiotics for people with coeliac disease.

Read more about this research here in the journal of Clinical and Translational Gastroenterology

What is coeliac disease and who can get it? Find out more here at the Coeliac Australia website