July 20, 2009 -- Everybody has a dream, even if it's as odd as wishing more people in the modern world had parasitic worms.
Jasper Lawrence so desperately wanted to be infected with a hookworm that he traveled to Africa and walked barefoot alongside open latrines in Cameroon to get one.
He got the idea from a documentary about a British researcher, David Pritchard, who has infected himself and spent decades researching why populations of people in the world where hookworm is common have virtually no hay fever, no allergies or asthma.
After years of suffering from adult onset asthma and allergies, years of driving himself "with stars in my eyes because [I] couldn't get enough air" to the hospital for treatment, and after years of taking the powerful drug prednisone, Lawrence thought he was ready to try a worm.
"It was only when I realized that there was no way I was going to obtain hookworm through buying it that I [decided I] would go to Africa," said Lawrence.
"I took my shoes off and I walked barefoot in open-air latrines. It was pretty much walking around barefoot in the areas. You didn't have to actually walk in the excrement," he said. "I got laughed at a lot, but some people were really hostile about it. ... While I was there my feet were very itchy, so I felt very confident that I was infected."
Within a few months, Lawrence said his asthma and allergy symptoms dissipated. He stopped prednisone. He started to exercise without worrying about an attack and, as a result, he said he lost 40 pounds.
Seeing an untapped treatment, Lawrence decided to go into business selling parasitic worms to people hoping to temper autoimmune conditions such as asthma, allergies, Crohn's disease, colitis and inflammatory bowel disease. He even has competition. At least one other online business offers patients worm therapy -- all without monitoring by the Food and Drug Administration.
Doctors and researchers say the worm therapy idea not only holds water, it is a promising wide-reaching treatment with FDA-monitored clinical trials for patients in several major U.S. cities.
But some doctors are not pleased by the new parasite treatment companies.
"It is a legitimate field, but it's been bootlegged," said Dr. Joel Weinstock, a professor of medicine at Tufts University, who has used his background in parasitology and specialist training in inflammatory bowel disease to study parasitic treatment for years.
"It could be within two or three years we have some really good things to treat disease," he said. But Weinstock pointed out that "99 times out of 100, most good ideas don't work out."
Weinstock said he and other scientists in Germany and the U.S. are currently working to test the parasitic therapy. He said it takes millions of dollars to clear a therapy under FDA oversight, and it costs money for a reason: The results are funneled into scientific research, and patients will be guaranteed a pure product from laboratories with oversight.
"The question is, what are you actually buying [from such companies]?" asked Weinstock, who added selling parasites over the Internet "hurts the science, and when people do this it makes people skeptical."
For $2,900, clients of Lawrence's company, Autoimmune Therapies, can swallow a dose of whipworm, or apply a Band-Aid of hookworms to penetrate the skin. The clients must submit a patient questionnaire, blood test and undergo a phone interview with a doctor before purchasing.
Todd Troutman, of Alabama, said he was so desperate for relief from his allergies that he was willing to take the risk.
"When I saw it I said 'OK' I forked out $ 3,000 and I was pretty sick, so that will make you do some things," he said.
"My eyes would swell almost entirely shut. Most of my life consisted of blowing my nose or finding something to blow my nose on. I was sleeping 14-15 hours a day having absolutely no energy at all ever, it's just like having the flu and it just never goes away," Troutman said. "You get up to the level of having a bad cold, and then the weather changes again it goes back to having a bad flu."
Troutman said the parasites brought such a relief he was able to get off medication and move out of the desert environment he retreated to for relief.
A Growing Business Selling Parasites
Aglietti treated himself with worms to reduce his psoriasis. He uses beef tapeworm, where Lawrence does not, and he will not sell worms to treat autism.
"The clinic has been open for a little bit more than a year," said Aglietti. "They've only treated more than a dozen people."
While Lawrence claims the therapy is akin to intensive probiotics and is legal in the United States, Aglietti reasoned it would be easier to do business in Mexico rather than attempt to get approval for food, drug or medical devices under the U.S. Food and Drug Administration.
Both Lawrence and Aglietti got the idea for their treatments from a hypothesis circulating among parasitologists and gastroenterologists at top universities in the United States and Britain.
"Many years ago, and the theory is still out there, [it was thought] that a lot of us old people who grew up in the South got infected with all sorts of parasites and that that response prevented us from getting asthma and allergies," said Raymond Kuhn, professor of biology and an expert on parasites at Wake Forest University in Winston-Salem, N.C.
Serious researchers at Tufts University in Boston, Cambridge University and others have explored the idea that humans evolved by building an immune system that was in an arms race of sorts with parasites.
The hypothesis goes that until recently, humans were fighting off some sort of parasite or another for millions of years, ever since humans evolved into humans. That co-existence eventually led humans to evolving an immune system that worked with parasites.
"When you're born you have an immune system, but your immune system is a blank slate," said Weinstock.
Weinstock explained that just as humans create a functioning digestive system by populating their digestive system with bacteria, humans historically developed an immune designed to account for parasites in the body.
But in the last 150 years, the industrialized world's clean food supply and plumbing suddenly removed parasites from people's bodies. In response, researchers now widely think that people's immune systems stopped developing properly.
Weinstock said most people still have a powerful "attack" function of their immune system, but that many believe the immune system does not develop to regulate properly in the absence of helminthes (parasitic worms).
"People who are not exposed to helminthes have sloppy regulation," said Weinstock. As a result some people's immune systems go off kilter and misfire against their own bodies creating autoimmune disorders such as allergies, asthma, or inflammatory bowel disease.
Doctors See Promise, But Warn of Worm Treatments Sold Online
The parasite argument ties in to the so-called "hygiene hypothesis" from the 1980s, and has been in development in renowned scientific journals, such as The Lancet and Nature, ever since.
In the case of adults, Kuhn pointed out, the immune system is already developed and cannot prevent reactions like asthma and allergies. But researchers have noticed that parasites still may have an effect on those suffering from some disorders.
"About 10 years ago, many of us studying parasites realized that parasites could induce the immune system to do odd things," said Kuhn.
For example, Weinstock and colleagues thought that patients suffering from inflammatorybowel disease were missing a chemical in their intestines that helped control inflammatory responses. When a parasite was introduced, the body made the chemical to fight it, and the inflammatory bowel problems began to clear in most patients.
But similar discoveries haven't convinced doctors of the merits of treatments sold and distributed without monitoring under the FDA.
"What is their clinical proof that it's useful?" asked Kuhn. "If they're selling this stuff, they've got to have serious science backing it up."
Medicine widely available in the United States can easily kill the beef tapeworm (Taenia saginata) sold by Worm Therapies and the whipworm (Trichuris trichiura) and hookworm (Necator americanus) sold by both Autoimmune Therapies and Worm Therapy.
But Kuhn pointed out that a parasite is a parasite, and can cause sickness.
"There's a huge movement going on to try and find a vaccine for hookworm throughout the world," said Kuhn. "Infected children and pregnant women can become particularly anemic."
Dr. Henry Milgrom, professor of pediatrics at National Jewish Health University of Colorado in Denver, agreed with Kuhn.
"I have heard of such things. So this is not completely off the wall, and it is possible that parasite infestation can protect against allergic disease. Having said that, I don't think that to infect oneself with parasites without some studies showing that this is safe and effective is reckless," said Milgrom.
"What [parasites] do is they suck blood and cause pain and diarrhea and congestive failure. My guess is they probably pick some more benign forms," said Milgrom. "But you cannot view this in any way than any other treatment that you are giving people."